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Gholinejad M, Pelanis E, Aghayan D, Fretland ÅA, Edwin B, Terkivatan T, Elle OJ, Loeve AJ, Dankelman J. Generic surgical process model for minimally invasive liver treatment methods. Sci Rep 2022; 12:16684. [PMID: 36202857 PMCID: PMC9537522 DOI: 10.1038/s41598-022-19891-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 09/06/2022] [Indexed: 11/09/2022] Open
Abstract
Surgical process modelling is an innovative approach that aims to simplify the challenges involved in improving surgeries through quantitative analysis of a well-established model of surgical activities. In this paper, surgical process model strategies are applied for the analysis of different Minimally Invasive Liver Treatments (MILTs), including ablation and surgical resection of the liver lesions. Moreover, a generic surgical process model for these differences in MILTs is introduced. The generic surgical process model was established at three different granularity levels. The generic process model, encompassing thirteen phases, was verified against videos of MILT procedures and interviews with surgeons. The established model covers all the surgical and interventional activities and the connections between them and provides a foundation for extensive quantitative analysis and simulations of MILT procedures for improving computer-assisted surgery systems, surgeon training and evaluation, surgeon guidance and planning systems and evaluation of new technologies.
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Affiliation(s)
- Maryam Gholinejad
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands.
| | - Egidius Pelanis
- The Intervention Centre, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway
| | - Davit Aghayan
- The Intervention Centre, Oslo University Hospital, Oslo, Norway.,Department of Surgery N1, Yerevan State Medical University After M. Heratsi, Yerevan, Armenia
| | - Åsmund Avdem Fretland
- The Intervention Centre, Oslo University Hospital, Oslo, Norway.,Department of HPB Surgery, Oslo University Hospital, Oslo, Norway
| | - Bjørn Edwin
- The Intervention Centre, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway.,Department of HPB Surgery, Oslo University Hospital, Oslo, Norway
| | - Turkan Terkivatan
- Department of Surgery, Division of HPB and Transplant Surgery, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - Ole Jakob Elle
- The Intervention Centre, Oslo University Hospital, Oslo, Norway
| | - Arjo J Loeve
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands
| | - Jenny Dankelman
- Department of Biomechanical Engineering, Faculty of Mechanical, Maritime and Materials Engineering, Delft University of Technology, Delft, The Netherlands
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Wang D, Wu Q, Guo R, Lu C, Niu M, Rao W. Magnetic liquid metal loaded nano-in-micro spheres as fully flexible theranostic agents for SMART embolization. NANOSCALE 2021; 13:8817-8836. [PMID: 33960346 DOI: 10.1039/d1nr01268a] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Transcatheter arterial chemoembolization (TACE) has become one of the preferred choices for advanced liver cancer patients. Current clinically used microsphere embolic agents, such as PVA, gelatin, and alginate microspheres, have limited therapeutic efficacy and lack the function of real-time imaging. In this work, we fabricated magnetic liquid metal nanoparticle (Fe@EGaIn NP) loaded calcium alginate (CA) microspheres (denoted as Fe@EGaIn/CA microspheres), which integrate CT/MR dual-modality imaging and photothermal/photodynamic functions of the Fe@EGaIn NP core, as well as embolization and drug-loading functions of CA microspheres. Namely, such nano-in-micro spheres can be used as fully flexible theranostic agents to achieve smart-chemoembolization. It has been confirmed by in vitro and in vivo experiments that Fe@EGaIn/CA microspheres have advantageous morphology, favorable biocompatibility, splendid versatility, and advanced embolic efficacy. Benefiting from these properties, excellent therapeutic efficiency was achieved with a tumor growth-inhibiting value of 100% in tumor-bearing rabbits. As a novel microsphere embolic agent with promising therapeutic efficacy and diagnostic capability, Fe@EGaIn/CA microspheres have shown potential applications in clinical transcatheter arterial chemoembolization. And the preparation strategy presented here provides a generalized paradigm for achieving multifunctional and fully flexible theranostics.
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Affiliation(s)
- Dawei Wang
- Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing 100190, China. and School of Future Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Qirun Wu
- Department of Interventional Medical, Zhuhai People's Hospital (Zhuhai hospital affiliated with Jinan University), Zhuhai 519000, China
| | - Rui Guo
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing 100084, China
| | - Chennan Lu
- Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing 100190, China. and School of Future Technology, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Meng Niu
- Department of Radiology, First Hospital of China Medical University, Shenyang 110001, China
| | - Wei Rao
- Technical Institute of Physics and Chemistry, Chinese Academy of Sciences, Beijing 100190, China. and School of Future Technology, University of Chinese Academy of Sciences, Beijing 100049, China
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Neumann J, Angrick C, Höhn C, Zajonz D, Ghanem M, Roth A, Neumuth T. Surgical workflow simulation for the design and assessment of operating room setups in orthopedic surgery. BMC Med Inform Decis Mak 2020; 20:145. [PMID: 32616031 PMCID: PMC7333415 DOI: 10.1186/s12911-020-1086-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 03/31/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The design and internal layout of modern operating rooms (OR) are influencing the surgical team's collaboration and communication, ergonomics, as well as intraoperative hygiene substantially. Yet, there is no objective method for the assessment and design of operating room setups for different surgical disciplines and intervention types available. The aim of this work is to establish an improved OR setup for common procedures in arthroplasty. METHODS With the help of computer simulation, a method for the design and assessment of enhanced OR setups was developed. New OR setups were designed, analyzed in a computer simulation environment and evaluated in the actual intraoperative setting. Thereby, a 3D graphical simulation representation enabled the strong involvement of clinical stakeholders in all phases of the design and decision-making process of the new setup alternatives. RESULTS The implementation of improved OR setups reduces the instrument handover time between the surgeon and the scrub nurse, the travel paths of the OR team as well as shortens the procedure duration. Additionally, the ergonomics of the OR staff were improved. CONCLUSION The developed simulation method was evaluated in the actual intraoperative setting and proved its benefit for the design and optimization of OR setups for different surgical intervention types. As a clinical result, enhanced setups for total knee arthroplasty and total hip arthroplasty surgeries were established in daily clinical routine and the OR efficiency was improved.
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Affiliation(s)
- Juliane Neumann
- Innovation Center Computer Assisted Surgery (ICCAS), Leipzig University, Semmelweisstr. 14, 04103, Leipzig, Germany.
| | - Christine Angrick
- Innovation Center Computer Assisted Surgery (ICCAS), Leipzig University, Semmelweisstr. 14, 04103, Leipzig, Germany
| | - Celina Höhn
- Innovation Center Computer Assisted Surgery (ICCAS), Leipzig University, Semmelweisstr. 14, 04103, Leipzig, Germany
- Department of Orthopaedic, Trauma and Plastic Surgery, Division of Endoprothetic Joint Surgery and General Orthopaedics, University of Leipzig Medical Center, Leipzig, Germany
| | - Dirk Zajonz
- Department of Orthopaedic, Trauma and Plastic Surgery, Division of Endoprothetic Joint Surgery and General Orthopaedics, University of Leipzig Medical Center, Leipzig, Germany
| | - Mohamed Ghanem
- Department of Orthopaedic, Trauma and Plastic Surgery, Division of Endoprothetic Joint Surgery and General Orthopaedics, University of Leipzig Medical Center, Leipzig, Germany
| | - Andreas Roth
- Department of Orthopaedic, Trauma and Plastic Surgery, Division of Endoprothetic Joint Surgery and General Orthopaedics, University of Leipzig Medical Center, Leipzig, Germany
| | - Thomas Neumuth
- Innovation Center Computer Assisted Surgery (ICCAS), Leipzig University, Semmelweisstr. 14, 04103, Leipzig, Germany
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