Articles: surgery.
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Although patients benefit considerably from minimally invasive surgery, the use of new instruments such as robotic systems is challenging for surgeons, and extensive training is required. ⋯ Virtual reality is a useful technique for medical training. The simulator is currently in its early stages, but this preliminary work is promising.
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J Vasc Interv Radiol · Sep 2007
Clinical TrialElectromagnetic tracking for thermal ablation and biopsy guidance: clinical evaluation of spatial accuracy.
To evaluate the spatial accuracy of electromagnetic needle tracking and demonstrate the feasibility of ultrasonography (US)-computed tomography (CT) fusion during CT- and US-guided biopsy and radiofrequency ablation procedures. ⋯ The demonstrated spatial tracking accuracy is sufficient to display clinically relevant preprocedural imaging information during needle-based procedures. Virtual needles displayed within preprocedural images may be helpful for clandestine targets such as arterial phase enhancing liver lesions or during thermal ablations when obscuring gas is released. Electromagnetic tracking may help improve imaging guidance for interventional procedures and warrants further investigation, especially for procedures in which the outcomes are dependent on accuracy.
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Rev Chir Orthop Reparatrice Appar Mot · Sep 2007
Comparative Study[Low accuracy of the anterior pelvic plane to guide the position of the cup with imageless computer assistance: variation of position in 106 patients].
The anterior pelvic plane, also called the Lewinnek plane, is commonly used as the reference plane to guide imageless computer assisted surgery for total hip arthroplasty (THA) because this plane is considered to be globally vertical in the standing position. To our knowledge, no study has evaluated this hypothesis or the potential variations in orientation as a function of gender, position of the subject, or THA insertion. The purpose of this work was to examine these different hypotheses in a radio-clinical study. ⋯ Variations in the orientation of the anterior pelvic plane in relation to the vertical would suggest that this plane is not a reliable reference. To our knowledge, there is no reliable reference which can be easily identified during the operation which would take into account variations in the position of the pelvis. We thus believe it would be preferable to attempt to operate without a reference plane, relying on a more kinematic approach to guide computer-assisted implantation of the THA cup.
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Percutaneous nephrostomy (PCN) has been established as an effective technique for urinary decompression or diversion. This procedure may be performed with the guidance of fluoroscopy, ultrasonography, a combination of fluoroscopy and ultrasonography, computed tomography (CT), or magnetic resonance imaging. ⋯ CT-guided PCN is an efficient and safe procedure with major and minor complication rates below the accepted thresholds. It can be used for the management of patients requiring nephrostomy insertion in inpatient settings, and might be a preferable procedure in patients with minimal or no dilatation of the renal pelvis.
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Comput. Aided Surg. · Sep 2007
Early results of CyberKnife image-guided robotic stereotactic radiosurgery for treatment of lung tumors.
To determine if image-guided robotic stereotactic radiosurgery (IGR-SRS) by CyberKnife achieves acceptable local control in resectable but medically inoperable patients with non-small cell lung cancer (NSCLC) or pulmonary metastasis, and to evaluate control rates and toxicity. ⋯ The delivery of precisely targeted high radiation doses with surgical precision to lung tumors in a hypo-fractionated fashion is feasible and safe. Image-guided robotic stereotactic radiosurgery (IGR-SRS) of lung tumors with the CyberKnife achieves excellent rates of local disease control with limited toxicity to surrounding tissues, and in many cases may be curative for patients for whom surgery is not an option.