scholarly journals Percutaneous transhepatic biliary puncture simulator: a cord network prototype

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Rubén Lopez Benítez ◽  
Tomás Reyes del Castillo ◽  
David Benz ◽  
Carsten Fechner ◽  
Lorant Szabo ◽  
...  

Abstract Background The aim of this study was to present a percutaneous transhepatic biliary puncture simulator that can be used without radiation exposure and that reflects the conventional anatomy of the biliary ducts and its vicinity structures. Methods An anatomically based model of the biliary tree was developed using a cord network fixed to a wooden frame. The skin, ribs, intercostal muscles, and right lower lobe pleura were simulated using foam sponge, plastic tubes, a polystyrene foam panel, and an air pad, respectively. For the puncture, we used a 20-G Chiba needle and a wire with distal double arches; these were used to troll a cord, simulating the successful puncture of a bile duct. A camera was also placed above the model to allow the trainees to train eye-hand coordination while viewing the image on a monitor in real time. The simulator was tested with 60 radiology residents to evaluate the confidence and skills transferability of the training model. Results After receiving an introduction of the system and 5 min of training under tutor surveillance, all participants were able to troll a cord of the biliary simulator by themselves in less than 4 min. Only one participant punctured the simulated pleura. The participants’ evaluations showed positive results, with increased user confidence and skills transferability after the training session. Conclusions This proposed simulator can be an effective tool to improve a trainee’s confidence and competence while achieving procedural and non-procedural interventional radiology skills related to the liver. Trial registration Retrospectively registered

2018 ◽  
Vol 85 (4) ◽  
pp. 9-11
Author(s):  
О. V. Ogurtsov ◽  
О. V. Lukavetskyy

Objective. To determine efficacy of intraoperative visualization of biliary tree, using fluorescent cholangiography (FCH) and a high–energy visible laparoscopy vison (HEV LapVison) while laparoscopic cholecystectomy performance (LCHE). Маterials and methods. In 25 patients LCHE was performed. Preoperatively fluorescein was injected intravenously for guaranteeing of the FCH performance. HEV LapVison was applied for intraoperative visualization of fluorescence. Results. Visualization of the cystic duct and its inflow into common biliary duct was guaranteed in 90% patientsх. In 13 (52%) patients the anatomic picture was typical while in 7 (28%) some variants were observed: a parallel course of cystic duct and common biliary duct, and low level of the cystic duct inflow into hepaticocholedochus. Conclusion. FCH is a simple procedure for intraoperative navigation doing and guaranteeing of «critical view on security» while performance of LCHE. FCH together with HEV LapVison constitutes a new surgical procedure, making possible revealing of extrahepatic biliary ducts. This method may be applied as additional one while doing LCHE, preventing damage of biliary ducts.


2017 ◽  
Vol 35 (3) ◽  
pp. 408-420 ◽  
Author(s):  
LuMarie Guth ◽  
Patricia Vander Meer

Purpose Librarians are working with telepresence robotics for various uses, particularly as a communication method inhabiting a space between video chat and face-to-face interactions. The library at (Blinded University) partnered with the (Blinded Laboratory) to showcase this emerging technology in a high-traffic setting utilized by students of every level and major. The purpose of this paper is to discuss patron reactions to this technology exhibition in the library, beta testing of a telepresence robot in various public services tasks, and library employee attitudes toward this unfamiliar technology before and after one-on-one training. Design/methodology/approach The project gathered data through three studies. In study 1, feedback forms were filled out by patrons who interacted with or piloted the robot. In study 2, observations by the librarians piloting the robot for various public services activities were recorded in a log. In study 3, employees were invited to complete a pretest designed to solicit perceptions and attitudes regarding the use of the robot, become trained in navigating the robot, and complete a posttest for comparison purposes. Results were analyzed to find trends and highlight perceived uses for the technology. Findings Patrons and library employees gave positive feedback regarding the novelty of the technology and appreciated its remote communication capability. Trialed uses of the technology for public services yielded positive results when the TR was used for public relations, such as at special events or in greeting tours, and yielded less positive results when used for reference purposes. Library employees comfort with and perceived utility of the robot grew consistently across departments, levels of experience and employment types after a personal training session. Originality/value Although libraries in recent years have surveyed users regarding TR technology, this paper captures quantitative and qualitative data from a library employee training study regarding perception of the technology. Exploration of the public services uses and library employee acceptance of TR technology is valuable to those contemplating expending time and resources in similar endeavors.


Author(s):  
Katarzyna Kordecka ◽  
Andrzej T. Foik ◽  
Agnieszka Wierzbicka ◽  
Wioletta J. Waleszczyk

AbstractRepetitive visual stimulation is successfully used in a study on the visual evoked potential (VEP) plasticity in the visual system in mammals. Practicing visual tasks or repeated exposure to sensory stimuli can induce neuronal network changes in the cortical circuits and improve the perception of these stimuli. However little is known about the effect of visual training at the subcortical level. In the present study, we extend the knowledge showing positive results of this training in the rat’s superior colliculus (SC). In electrophysiological experiments, we showed that a single training session lasting several hours induces a response enhancement both in the primary visual cortex (V1) and in the SC. Further, we tested if collicular responses will be enhanced without V1 input. For this reason, we inactivated the V1 by applying xylocaine solution onto the cortical surface during visual training. Our results revealed that SC’s response enhancement was present even without V1 inputs and showed no difference in amplitude comparing to VEPs enhancement while the V1 was active. These data suggest that the visual system plasticity and facilitation can develop independently but simultaneously in different parts of the visual system.


Author(s):  
Jim Hughes

Surgical treatment of pathologies of the gall bladder or biliary tree may involve the removal of stones and occlusions from biliary ducts, opening up of the ducts where they have become narrowed, or removal of the gall bladder itself if required. These procedures are often performed under a minimally invasive approach to reduce the risks of infection and scarring, and as such can require imaging guidance. This chapter covers a selection of hepatobiliary procedures that require the demonstration of the biliary vessels and gall bladder, including laparoscopic cholangiogram and endoscopic retrograde cholangiopancreatogram. Each procedure includes images that demonstrate the position of the C-arm, patient, and surgical equipment, with accompanying radiographs demonstrating the resulting images.


Author(s):  
Elpidio Maria Garzillo ◽  
Maria Grazia Lourdes Monaco ◽  
Anna Rita Corvino ◽  
Francesco D’Ancicco ◽  
Daniela Feola ◽  
...  

Manual patient handling (MPH) is a major occupational risk in healthcare settings. The aim of this study was to propose an MPH training model involving interdisciplinary aspects. A scheduled training program was performed with 60 healthcare workers (HCWs) from a hospital in Naples, Italy, providing training divided into three sections (occupational health—section one; physical therapy—section two; psychosocial section—section three) and lasting six hours. Fifty-two HCWs performed the training session. In section one, a questionnaire about risk perception related to specific working tasks was administered. Section two provided specific exercises for the postural discharge of the anatomical areas most involved in MPH. The last section provided teamwork consolidation through a role-playing exercise. The training program could also be useful for risk assessment itself, as they can examine the perceptions of the specific risk of the various workers and incorrect attitudes and therefore correct any incorrect procedures, reducing exposure to specific risks in the field. This pilot study proposes a training model that explores all aspects related to MPH risk exposure and also underlines the need for standardization of this formative model, which could represent a useful tool for studying the real effectiveness of training in workplaces.


2021 ◽  
Vol 14 ◽  
pp. 117954762110430
Author(s):  
Ievgen Tsema ◽  
Viktor Slobodianyk ◽  
Dmytro Rahushyn ◽  
Denys Myrhorodskiy ◽  
Oleh Yurkiv ◽  
...  

Introduction: One of the methods for the biliary tree decompression in the case of Klatskin tumor is transpapillary stenting, which could be completed by stent migration in 4% to 10% of cases. Approximately half of the stent migrations are in the proximal direction. In this study, we reported a rare case of proximal trans-diaphragmatic stent migration to the lower lobe of the right lung with the formation of a biliary-bronchial fistula (BBF). Case presentation: A 60-year-old woman was diagnosed with hilar cholangiocarcinoma (type 3B by Bismuth-Corlette) complicated by posthepatic jaundice. To relieve jaundice there were performed endoscopic retrograde cholangiopancreatography, endoscopic sphincterotomy, endobiliary stent placement (10 Fr, 150 mm). A restenting (11.5 Fr, 130 mm) was performed in 2.5 months due to endobiliary tube occlusion. In the next 2 months, coughing attacks and biliptysis have appeared in the patient. A CT scan showed penetration of the liver, diaphragm, and lower lobe of the right lung with the proximal part of the stent and caused BBF formation. Anti-inflammatory and antibacterial therapy was administrated for 14 days and BBF was closed. Stent retrieval from the right hemithorax and endobiliary restenting was performed in 9 months after primary stenting. During follow-up, appropriate positioning and functioning of the stent were observed. Conclusion: BBF formation is a rare complication of endobiliary stenting, which can be successfully treated by anti-inflammatory and antibiotic therapy, followed by transpapillary stent retrieval.


Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Philip Toner ◽  
Michael Connolly ◽  
Patrice McGrath ◽  
Leanne Laverty ◽  
David Connolly ◽  
...  

Aims: Northern Ireland has one of the highest incidences of ischaemic heart disease in the world. Teaching BLS to school children has previously been recommended. Our aim was to assess if eleven year old children can aquire and retain knowledge of basic life support (BLS) skills six months after a course of instruction (Study 1) and to assess the effectiveness of a three tier ‘peer training’ model using medical students, teachers and pupils (Study 2). This would be a cost effective way of significantly decreasing mortality from out-of-hospital cardiac arrests. Methods: The ‘ABC for Life’ programme is a regional course in BLS training in Northern Ireland specifically designed for 10 –12 year old school children. Medical students are trained as instructors in BLS by cardiac resuscitation officers at a major teaching hospital. Children were given a 22 point questionnaire before training and immediately after training to assess acquisition of BLS, and again six months after training to assess retention of knowledge (Study 1). In study 2, medical students instructed teachers how to teach BLS to their pupils. Pupils were given the same questionnaire to assess knowledge of BLS immediately before and after a teacher led training session at their school. Results: Study 1: Children showed a highly significant increase in knowledge following the training session (46.8% vs 82.7%, p<0.001). Six months later their knowledge remained significantly higher than that of a control group who had never been trained (61.1% vs 46.8%, p<0.01). Study 2: Thirty eight teachers were trained from one education board. The first five children trained at each school were randomly selected. Questionnaires were returned for 44.7% pupils at baseline and 42.1% pupils after training. Mean baseline scores improved significantly after training (57.2% vs 77.7%, p<0.001). Conclusion These studies demonstrate that by using medical students and teachers, a large number of children can be trained in a short time period and at relatively low cost. Children can acquire and retain knowledge of BLS for at least six months. The initiative provides manikins and training resources to all schools. To date, the programme has trained 350 schools. We have commenced research of physical skills using a recordable mainikin.


HPB Surgery ◽  
1992 ◽  
Vol 5 (4) ◽  
pp. 267-270 ◽  
Author(s):  
A. Halevy ◽  
A. Adam ◽  
G. Stamp ◽  
I. S. Benjamin ◽  
L. H. Blumgart

Two patients with stricture of the extrahepatic biliary tree are described. Both patients presented with a clinical picture of obstructive jaundice one to two years following radiotherapy for a malignant condition. As no recurrent tumour was detected in either of the patients the strictures were considered to be the result of radiation therapy. Bilio-enteric decompression was performed in both patients who are well at follow up one and ten years after the procedure.


Author(s):  
A. Hakman ◽  
M. Osadets ◽  
N. Lymarenko

Training in motor actions is necessary in any activity. In sports, training has its own specifics, the essence of which is that the bulk of the new is learned in the acquisition of various motor actions that take the form of exercise. The goal of this research was to develop a method of teaching motor actions in volleyball using the didactic principles of educational activities and developmental learning and to test its effectiveness in experimental work. Research findings. The results of the influence of the developed method on the ability to differentiate their motor actions and on the physical preparation of young volleyball players are shown. In this research, an attempt was made to find ways to solve the most important tasks facing the coach. These include children's training of the necessary techniques faster and more efficiently than the traditional method based on the main points of the theory of educational activities and developmental learning. Thus besides direct training of techniques in volleyball in experiment we developed the personality and mental abilities of children. To do this, students have mastered the basics of educational activities related to the ability to analyze the subject under study, identify primary and secondary elements and their relationship, monitor their actions, evaluate the results and ways to achieve them. The first classes in the experimental group showed that the motor density of the training session decreased slightly. This happened due to spending more time on theoretical conversations, discussing the arising issues, working with a training model and testing on it of the main parts of the studied motor actions. Subsequently, this was offset by a faster mastery of the technique of motor actions due to greater independence, greater activity on the classes and fewer mistakes.


2015 ◽  
Vol 3 (1) ◽  
pp. 66-78
Author(s):  
Nurhidayah Nurhidayah ◽  
Pamuji Sukoco

Penelitian ini bertujuan untuk mengetahui (1) perbedaan pengaruh model latihan guided discovery style dan model latihan command style terhadap keterampilan bola basket siswi, (2) perbeda-an pengaruh siswi yang memiliki koordinasi tinggi dan koordinasi rendah terhadap keterampilan bola basket, dan (3) interaksi antara model latihan dengan koordinasi terhadap keterampilan bola basket siswi. Penelitian ini merupakan penelitian eksperimen. Populasi penelitian adalah seluruh siswi ekstrakurikuler bola basket yang berjumlah 43 orang. Sampel berjumlah 24 siswi ditentukan dengan teknik purposive sampling. Intrumen tes yang digunakan adalah tes Wall Bounce Pass untuk mengukur koordinasi mata-tangan dan tes Sekolah Tinggi Olahraga (STO) untuk mengukur keterampilan bola basket siswi. Teknik analisis data yang menggunakan ANAVA. Hasil penelitian adalah sebagai berikut: (1) Tidak terdapat perbedaan pengaruh antara model latihan guided discovery style dan model latihan command style terhadap keterampilan bola basket siswi. (2) Terdapat perbedaan pengaruh siswi yang memiliki koordinasi tinggi dan rendah terhadap keterampilan bola basket. (3) Tidak terdapat interaksi yang signifikan antara model latihan dan koordinasi terhadap keterampilan bola basket siswi.   THE EFFECT OF TRAINING MODEL AND COORDINATION ON THE BASKETBALL SKILLS OF EXTRACURRICULAR STUDENTS OF JUNIOR HIGH SCHOOL 1 BANTUL   Abstract This study aims to investigate: (1) the different effects of the guided discovery style model training and command style model training on basketball skills of students, (2) the different effects on basketball skills of students who have high and low coordination, and (3) the interaction effects between training models of guided discovery style and command style with coordination (high and low) on the basketball skills of students.This research was an experiment. The population comprised 43 basketball extracurricular students. A sample of 24 students was established using the purposive sampling technique. The instruments of this research were wall bounce pass test to measure eye-hand coordination and Sekolah Tinggi Olahraga (STO) test to measure the basketball skills. The data were analyzed using the two-way ANAVA  analysis.The results of the study are as follows. (1) There is no different effect between guided discovery style model training and command style model training on the basketball skills of the students. (3) There is an effect difference on the basketball skills of the students who have high and low coordination. (4) There is no a significant interaction between model training and coordination on the basketball skills of students. Key words: guided discovery style, command style, coordination, basketball skills


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