Articles: surgery.
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Registration is a critical and important process in maintaining the accuracy of CT-based image-guided surgery. The aim of this study was to evaluate the effects of the area of intraoperative data sampling and number of sampling points on the accuracy of surface-based registration in a CT-based spinal-navigation system, using an optical three-dimensional localizer. A cadaveric dry-bone phantom of the lumbar spine was used. ⋯ The use of 20 surface points on the lamina usually allows surgeons to carry out sufficiently accurate registration to conduct computer-aided spine surgery. In the case of severe spondylosis, however, it might be difficult to digitize the surface points from the lamina, due to a hypertrophic facet joint or the deformity of the lamina and noisy sampling data. In such cases, registration accuracy can be improved by combining use of the 20 surface points on the lamina with surface points on other zones, such as on the both sides of the spinous process.
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Comparative Study Clinical Trial
Intraoperative three-dimensional fluoroscopy-based computerized tomography guidance for percutaneous kyphoplasty.
Percutaneous kyphoplasty is an established method for the treatment of pathological vertebral compression fractures (VCFs). This procedure is usually performed with the aid of biplanar fluoroscopic image guidance. There are currently no published clinical studies in which the use of three-dimensional (3D) image guidance to facilitate this technique has been evaluated. The purpose of this study was to evaluate the efficacy of isocentric fluoroscopy-based navigation for the kyphoplasty procedure, with special reference to operating time and the amount of radiation exposure. ⋯ The main advantage of isocentric fluoroscopy is the significant reduction in radiation exposure for the patient and surgical staff without an increase in the mean operating time. This technique is a significant advancement over biplanar fluoroscopy in this setting.
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Comparative Study
Computational simulations of the total cavo-pulmonary connection: insights in optimizing numerical solutions.
The Fontan procedure is a palliative surgical technique that is used to treat patients with congenital heart defects that include complex lesions such as those with a hypoplastic ventricle. In vitro, in vivo, and computational models of a set of modifications to the Fontan procedure, called the total cavopulmonary connection (TCPC), have been developed. Using these modeling methods, attempts have been made at finding the most energy efficient TCPC circuit. ⋯ Furthermore, our computational modeling results suggest fluctuating flow patterns as well as the magnitudes of these secondary flow structures diminish if the TCPC offset between vena cavae is increased or if flanged connections are added. An association was found between these modifications and improvements in TCPC circuit flow efficiencies. In summary, development of accurate computational simulations in the validation process is critical to efforts in finding the most efficient TCPC circuits, efforts aimed at potentially improving the long term outcome for Fontan patients.
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Aesthetic surgery journal · Mar 2005
Ambulatory abdominoplasty tailored to patients with an appropriate body mass index.
The office-based surgery setting potentially offers advantages to both the patient and the plastic surgeon, but some patients may not be considered good candidates for abdominoplasty or combined abdominoplasty/lipoplasty performed in the ambulatory setting. ⋯ BMI evaluation, and in some cases additional risk assessment by a qualified anesthesia provider, can be helpful in determining proper candidates for ambulatory abdominoplasty and combined abdominoplasty/lipoplasty procedures.