• Journal of Trauma and Injury
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• v.37 no.2
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• pp.132-139
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• 2024

Purpose: Curricula for surgical residents should include training in trauma care; however, such training is absent in many low income countries. At the largest surgical training institution in Ethiopia, a trauma training program was developed, integrated into the existing surgical curriculum, and implemented. This study was conducted to evaluate the trainees' response to the new program. Methods: Over a 5-month period, 35 first-year surgical residents participated in weekly trauma care training sessions. The program included journal clubs, practical sessions, didactic sessions, and case-based discussions. Six months after the conclusion of the training, changes in knowledge, attitude, and practices were evaluated through a self-report survey. Results: For knowledge-based items, the survey data revealed reported improvements in 83.8% to 96.8% of students. Furthermore, 90.3% to 93.5% of participants indicated improvements in practice, while 96.7% exhibited a change in attitude. Respondents reported that attending didactic courses improved their presentation skills and facilitated the acquisition of knowledge. They suggested the inclusion of additional practical sessions. Conclusions: Training structures that are simple to implement are crucial for residency programs with limited resources. Such programs can be developed using existing academic staff and can aid residents in delivering improved care to trauma patients.

• Quality Improvement in Health Care
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• v.27 no.2
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• pp.83-93
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• 2021

Purpose: This study tested the effectiveness of brochure- and video-based education on managing surgical site infections by operating room health personnel. Methods: From April 20 to May 4, 2021, 34 operating room health personnel were subjected to training on surgical site infection management using brochures and educational videos. A survey was then conducted on knowledge, perception, and adherence regarding surgical site infection management. Results: After receiving training on surgical site infection management, the knowledge score increased significantly (15.15±2.09 vs.19.70±1.96, p<.001). However, the perception and adherence scores were already near perfect before the intervention and did not further increase after the intervention. Conclusion: It is necessary to develop and utilize continuous and substantive educational programs to improve perception and adherence of surgical site infection management.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.10
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• pp.4989-4992
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• 2012

Purpose: Guide-wire localization (GWL) has been a standard technique for many years. Excision of nonpalpable malignant breast lesions with clear surgical margins reduces the risk of undergoing re-excision. The objective of the present study was to evaluate the efficacy of GWL biopsy for assessing surgical margins. Methods: This retrospective study concerned 53 patients who underwent GWL biopsy for non-palpable breast lesions and breast carcinoma diagnosed by histological examination. Age of the patients, tumour size, radiographic findings, breast density specifications, specimen volumes, menopausal status and family history of the patients and surgical margin status were recorded. Results: Median age was 53.3 years, median tumour size was 1.5 cm and median specimen volume was $71.5cm^3$. In fifteen patients (28%) DCIS and in 38 patients (72%) invasive ductal carcinoma was diagnosed. There was positive surgical margins in twenty eight (52.8%) patients. The median distance to the nearest surgical margin was 7.2 mm in clear surgical margins. Younger age and denser breast specifications were found as statistically significant factors for surgical margin status. Median age of the patients who had positive margins was 49.4 years where it was 56.9 years in the patients with negative margins (p=0.04). 79% of the patients with positive margins had type 3-4 pattern breast density according to BIRADS classification as compared to 48% in the patients who had negative margins (p=0.03). Some 38 patients who had positive or close surgical margins received re-excision (72%). Conclusion: Positive margin rates may be higher because of inherent biological differences and diffuse growth patterns in younger patients. There are also technical difficulties that are relevant to denser fibroglandular tissue in placing hooked wire. High re-excision rates must be taken into consideration while performing GWL biopsy in non-palpable breast lesions.

• Journal of Biomedical Engineering Research
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• v.41 no.4
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• pp.154-164
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• 2020

Various simulator systems for surgery training have been developed and recently become more widely utilized with technology advancement and change in medical education adopting actively simulation-based training. The authors have developed tissue-instrument interaction modeling and graphical simulation algorithms for an arthroscopic surgery training simulator system. In this paper, we propose algorithms for basic surgical techniques, such as cutting, shaving, drilling, grasping, suturing and knot tying for rotator cuff surgery. The proposed method constructs a virtual 3-dimensional model from actual patient data and implements a real-time deformation of the surgical object model through interaction between ten types of arthroscopic surgical tools and a surgical object model. The implementation is based on the Simulation Open Framework Architecture (SOFA, Inria Foundation, France) and custom algorithms were implemented as pulg-in codes. Qualitative review of the developed results by physicians showed both feasibility and limitations of the system for actual use in surgery training.

• Archives of Plastic Surgery
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• v.45 no.5
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• pp.395-402
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• 2018

Increased emphasis on competency-based learning modules and widespread departure from traditional models of Halstedian apprenticeship have made surgical simulation an increasingly appealing component of medical education. Surgical simulators are available in numerous modalities, including virtual, synthetic, animal, and non-living models. The ideal surgical simulator would facilitate the acquisition and refinement of surgical skills prior to clinical application, by mimicking the size, color, texture, recoil, and environment of the operating room. Simulation training has proven helpful for advancing specific surgical skills and techniques, aiding in early and late resident learning curves. In this review, the current applications and potential benefits of incorporating simulation-based surgical training into residency curriculum are explored in depth, specifically in the context of plastic surgery. Despite the prevalence of simulation-based training models, there is a paucity of research on integration into resident programs. Current curriculums emphasize the ability to identify anatomical landmarks and procedural steps through virtual simulation. Although transfer of these skills to the operating room is promising, careful attention must be paid to mastery versus memorization. In the authors' opinions, curriculums should involve step-wise employment of diverse models in different stages of training to assess milestones. To date, the simulation of tactile experience that is reminiscent of real-time clinical scenarios remains challenging, and a sophisticated model has yet to be established.

• Journal of Chest Surgery
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• v.46 no.2
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• pp.135-137
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• 2013

An atrial septal defect is the most common type of congenital heart disease among adults. Surgical repair or percutaneous closure of the defect is the treatment options. Even though percutaneous closure seems to be less risky than surgical repair, it may result in fatal complications like device embolism, cardiac perforation and tamponade. Herein we report a case of the embolism of a device into the pulmonary artery after one hour of percutaneous closure in which the embolized device was surgically removed and the defect was closed with a pericardial patch.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3317-3320
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• 2016

Purpose: To assess the success rates of two step loop electrosurgical excision procedure (LEEP) compared with conventional cold conization procedures for decreasing positive surgical margins. Materials and Methods: This study was conducted on 70 patients who underwent colposcopic evaluation in Zeynep Kamil Women and Children's Health Training and Research Hospital between 2013-2015 with indications of CIN 2/3 or persistent CIN 1 for more than 2 years. The study included age matched groups of patients with similar histopathololical lesions who underwent cold conization (n=40) or LEEP (N=30). Results: Comparison of tissue characteristics between the two groups revealed significantly higher deepest depth and lower volume of tissue removed by the two step LEEP. Ectocervical positivity rate was similar between groups (1/39 versus 0/29, P>0.05), while endocervical surgical margin positivity rate was significantly higher in the cold conization group (9/39 versus 0/29, P<0.05). Surgical margin positive cases were significantly older than the cases with negative margins (P<0.05). Conclusions: Two step LEEP made it easier to reach the squamocolumnar junction in the endocervical region with lower blood loss and applicability in office settings. Our study suggests to use two step approach in cases with high grade and glandular CIN.

• Advances in pediatric surgery
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• v.3 no.1
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• pp.61-67
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• 1997

To understand the current status of pediatric surgical practice of the members of the Korean Association of Pediatric Surgeons, a survey of the practice of the 31 members in both 1994 and 1995. Twenty five members(80%) representing 20 hospitals responded. An average of four hundred and seventy four cases pediatric surgical operations were performed at individual institution in 1995 with 40 newborn cases. Eighteen members(72%) are currently working at university hospital. Fourteen institutions(70%) are currently classified as tertiary by the health insurance agency. The majority(15 to 60%) of members are working in the metropolitan Seoul area, while five in Taegu area. Sixteen members reported having the title of department head/director. Four members reported occasional non-pediatric surgical practice. Nine members out of 20 reported having independent pediatric surgical out-patient clinic before the establishment of the association(1985). Eight out of 15 members reported being appointed chief of pediatric surgery before 1985. In 20 institutions, 34 full time physicians(27 members, reportedly) are working in pediatric surgery. In regarding to pediatric surgical training, 16 members(64%) received an average of 16 months of training abroad, 5 members trained at home and abroad, and 4 from only at home. There are no differences in length of training periods in these groups. Twenty one members received their basic pediatric surgical training before 1985, the year of inauguration of the association. Twelve members received post-pediatric surgery refresher courses averaging 11 months' duration, after 2-11 years. Thirteen participants of this study belongs to the founding members of the association.

• Archives of Plastic Surgery
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• v.41 no.3
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• pp.209-212
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• 2014

Microsurgery training in Singapore began in 1980 with the opening of the Experimental Surgical Unit. Since then, the unit has continued to grow and have held microsurgical training courses biannually. The road to becoming a full-fledged reconstructive surgeon requires the mastering of both microvascular as well as flap raising techniques and requires time, patience and good training facilities. In Singapore, over the past 2 decades, we have had the opportunity to develop good training facilities and to refine our surgical education programmes in reconstructive microsurgery. In this article, we share our experience with training in reconstructive microsurgery.

• Proceedings of the KIEE Conference
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• 2008.10b
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• pp.68-70
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• 2008

Since the beginning of the 21st century, the emergence of innovative technologies made further advances in minimal access surgery possible. Robotic surgery and telepresence surgery effectively addressed the limitations of laparoscopic procedures, thus revolutionizing minimal access surgery. Surgical robots provide surgeons with to technologically advanced vision and hand skills. As a result, such systems are expected to revolutionize the field of surgery. In that time, much progress has been made in integrating robotic technologies with surgical instrumentation. However, robotic surgery will not only require special training, but it will also change the existing surgical training pattern and reshape the learning curve by offering new solutions, such as robotic surgical simulators and robotic telementoring. This article provides an introduction to medical robotic technologies, develops a possible classification, reviews the evolution of a surgical robot, and discusses future prospects for innovation. In the future, surgical robots should be smaller, less expensive, easier to operate, and should seamlessly integrate emerging technologies from a number of different fields. We believe that, in the near future as robotic technology continues to develop, almost all kinds of endoscopic surgery will be performed by this technology.