Surgical Environment Research Articles

Discovering an unknown risk. The unnoticed, potientially life-threatening risk to people with an inherited cardaic arrhythmia during the non-cardiac perioperative period.

Abstract Background Patient safety is a global goal. Known risks to patient safety are a challenge however, that challenge is significantly increased when a risk is unknown but exists. It is estimated that 18 million major surgeries in Europe are non-cardiac surgical procedures. Preventable adverse events remain a challenge within healthcare systems worldwide. Potentially life-threatening conditions such as inherited cardiac arrhythmias (ICA) can be triggered by a number of factors during the perioperative phase. Healthcare professionals’ lack of knowledge, awareness or confidence about risks associated with ICAs during non-cardiac surgical procedures may have an impact on patient safety and quality of care for people with an ICA. Purpose To determine the knowledge and experience of ICA by healthcare professionals, their views towards and confidence in caring for a person with an ICA in a surgical environment. Method A multiple method study using a twenty-four-item questionnaire was distributed to registered nurses and midwives, surgeons and anaesthetists within surgical areas of seventeen hospitals in the Republic of Ireland and Northern Ireland of which 154 were returned and nine qualitative face to face interviews with registered nurses, midwives, and anaesthetists within surgical areas of one hospital in the Republic of Ireland and one hospital in Northern Ireland. Results Triangulation and convergence of data found a lack of knowledge in relation to inherited cardiac arrhythmias the study focused on, Long QT syndrome, Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) and Brugada syndrome. Within this, it was reported that 88.4% of participants were not aware of the drugs to avoid lists. Of those who were aware, 11.6%, no surgeon reported being aware of the drugs to avoid lists. It was also reported that participants had no confidence to care for people with an ICA in surgical settings. Years since graduation did not equate to an increase in confidence to care for these conditions. Participants reported reliance on the anaesthetist to be knowledgeable, manage care or take the lead should an adverse event occur. However, only seven of the nineteen anaesthetists who took part were aware of the drugs to avoid lists for ICA. Conclusions This study has found a lack of knowledge and confidence relating to inherited cardiac arrhythmias in surgical settings. It also highlighted that anaesthetists are seen as the professional to go to, however they may be unaware of this. Many surgeries take place globally which have the potential to induce an adverse event in people with an ICA that may result in death. This study has found an unknown blind spot which is a serious patient safety issue and a hazardous medical risk factor.

Adaptive infrared patterns for microscopic surface reconstructions.

Multi-zoom microscopic surface reconstructions of operating sites, especially in ENT surgeries, would allow multimodal image fusion for determining the amount of resected tissue, for recognizing critical structures, and novel tools for intraoperative quality assurance. State-of-the-art three-dimensional model creation of the surgical scene is challenged by the surgical environment, illumination, and the homogeneous structures of skin, muscle, bones, etc., that lack invariant features for stereo reconstruction. An adaptive near-infrared pattern projector illuminates the surgical scene with optimized patterns to yield accurate dense multi-zoom stereoscopic surface reconstructions. The approach does not impact the clinical workflow. The new method is compared to state-of-the-art approaches and is validated by determining its reconstruction errors relative to a high-resolution 3D-reconstruction of CT data. 200 surface reconstructions were generated for 5 zoom levels with 10 reconstructions for each object illumination method (standard operating room light, microscope light, random pattern and adaptive NIR pattern). For the adaptive pattern, the surface reconstruction errors ranged from 0.5 to 0.7 mm, as compared to 1-1.9 mm for the other approaches. The local reconstruction differences are visualized in heat maps. Adaptive near-infrared (NIR) pattern projection in microscopic surgery allows dense and accurate microscopic surface reconstructions for variable zoom levels of small and homogeneous surfaces. This could potentially aid in microscopic interventions at the lateral skull base and potentially open up new possibilities for combining quantitative intraoperative surface reconstructions with preoperative radiologic imagery.

Operating Room Orientation Using Visual Media Virtual Reality Box (Vr.Box) On Decreasing The Level of Fear of Pre Operation Patients

Background: Effective new patient orientation is crucial in reducing preoperative anxiety, which can significantly impact patient outcomes. Anxiety in patients often stems from unmet needs for security and fear of imminent threats. The Virtual Reality Box (VR Box) has emerged as a potential tool to alleviate this anxiety by providing a distracting and calming experience. Purposes: This study evaluates the impact of operating room orientation on preoperative anxiety levels, with a focus on its effectiveness when combined with VR Box technology. Methods: This study utilized the Amsterdam Preoperative Anxiety and Information Scale (APAIS) to measure anxiety levels in patients before and after receiving operating room orientation. The intervention involved providing comprehensive orientation about the nursing process and surgical environment. A total of [number] preoperative patients participated in the study, and their anxiety levels were assessed pre- and post-orientation. Findings: The analysis revealed a reduction in average anxiety levels from 20.1% before the orientation to 16.2% after the orientation, indicating a 3.9% decrease in anxiety. This suggests that the orientation process effectively mitigated some of the anxiety associated with preoperative procedures. Conclusion: The findings demonstrate that operating room orientation can significantly reduce preoperative anxiety. The integration of orientation strategies with tools such as the VR Box could enhance patient comfort and preparedness, potentially improving overall surgical outcomes. Future research should explore the long-term benefits and potential enhancements of combining orientation with advanced anxiety-reducing technology.

The Effect of Operating Room Tour Video on Pre-Anesthetic Anxiety in Sectio Caesarea Patients

Background: Preoperative anxiety in patients undergoing cesarean sections (CS) can significantly impact both psychological well-being and physiological responses, potentially affecting the success of anesthesia. An educational intervention, such as an Operating Room (OR) Tour video, may alleviate anxiety by familiarizing patients with the surgical environment and process. Purpose: To determine the effect of an Operating Room Tour video on pre-anesthetic anxiety levels in CS patients. Methods: This study employed a pre-experimental design with a pretest-posttest approach to assess the impact of the video on pre-anesthetic anxiety in 30 CS patients at Cilacap General Hospital. Anxiety levels were measured using the Visual Analog Scale for Anxiety (VAS-A) before and after the intervention. Statistical analysis was conducted using the Wilcoxon signed-rank test to evaluate the significance of the change in anxiety levels. Results: The findings revealed a significant reduction in anxiety following the video intervention. Prior to the intervention, 43.3% of participants experienced moderate anxiety, while post-intervention, 66.7% reported only mild anxiety. The Wilcoxon test confirmed the significant impact of the OR Tour video on reducing pre-anesthetic anxiety (p = 0.011, p < 0.05). Conclusion: The use of an Operating Room Tour video is an effective strategy to reduce preoperative anxiety in CS patients. This educational intervention could be a valuable addition to pre-anesthesia care, improving patient comfort and potentially contributing to better surgical outcomes.

How teaching surgeons communicate: An analysis of intraoperative discourse among male and female surgeons

BackgroundOur objective was to compare the use of agentic (“I”) and communal (“we”) spoken intraoperative discourse between male and female attending and resident surgeons. MethodsWe analyzed transcripts involving attending and resident surgeons from 5 specialties at a single Midwestern academic teaching hospital. We adapted and expanded Grebelsky-Lichtman's codes, assessed rater agreement, and systematically coded transcripts for agentic and communal terms. Differences between genders and roles were evaluated using Mann-Whitney U tests. ResultsIn the operating room, attendings used significantly more Action Demands, Rationality, Collective Speech, Passive Speech, Nurturing Speech, and Degree Modifiers. Conversely, residents used significantly more Assertive Speech, and Display Solution. Attendings were also more likely to use Action Demands combined with Passive Speech. No significant gender differences were found in any categories. ConclusionsLanguage use in the OR is more closely associated with professional role rather than gender and may reflect underlying power dynamics and the nature of the surgical teaching environment.

First reported human use of wireless laparoscopic system: is it ready for prime time?

During the advent of laparoscopy, surgeons directly explored the abdominal cavity with a telescope-like device through a small incision. Since then, numerous technological advances have transformed minimally invasive surgery (MIS). Yet, in our wireless world, various devices crowd the surgical field, with long wires and light sources posing fall and fire risks. The primary objective of this study was to analyze the first reported human use of a novel wireless laparoscopy system or WLS (ArthroFree™, Lazurite®, Cleveland, Ohio). The utility and convenience of the WLS was assessed via two avenues: (1) by analyzing surgical outcomes from first human use and (2) by surveying healthcare professionals regarding its quality and utility. Eighteen patients (mean age 44.2, 83.3% female, mean BMI 33.4) underwent operations with the WLS. Operations included gynecologic and general surgical procedures. There were no intraoperative or postoperative complications, and no conversions to traditional laparoscopy or laparotomy. Mean operating time was 71.94 ± 20.41min, and estimated blood loss was minimal. Survey results revealed varied individual experiences. Strengths included adequate illumination, improved ergonomics, and simplicity of setup and ease of operation. One respondent criticized the image resolution. Feedback indicated an overall positive impact, and 67% of respondents supported inclusion of the device at their facility. Moreover, its deployment in resource-limited settings abroad has demonstrated its efficacy in global surgery, indicating its potential in various healthcare environments. This is the first reported human use of a novel WLS. Clinical results supported efficiency and safety of the technology. The successful deployment of the WLS in diverse surgical environments, including resource-limited settings, highlights its potential as a universally adaptable tool in global surgery. This report represents a strong first step toward a wireless operating room with the promise of redefining surgical standards as well as bridging gaps in surgical care worldwide.

FP5.7 - Why I don’t want a career in surgery? - Uncovering obstacles and investigating barriers among year 3 UK medical students: A thematic analysis

Abstract Aims Surgical training and placements can be stereotyped negatively by medical students. Our study aimed to identify barriers to pursuing a surgical career amongst UK year 3 medical students, to improve surgical educational policies. Methods An optional, anonymous, single-question, open-text survey was administered to 190, year 3 UK medical student, after they had completed an 11 week surgical clinical placement, comprising Breast, Emergency Department, Interventional Radiology, Orthopaedics, Peri-op anaesthetics, Plastics, Vascular, Upper/Lower GI and Urology. The specific question asked was, 'Would you contemplate pursuing a career in surgery?' Responses from students NOT considering a surgical career were analysed qualitatively using a thematic approach to identify perceived barriers to a surgical career. Results 102 responses were received of which 35 were not suitable for analysis. Of the remaining 67 students, 30 (44.8%) demonstrated a negative view towards a surgical career. Following thematic analysis four main themes were identified:Pre-existing interest in another specialty.Nature of surgical training (long duration, competitive, poor work-life balance).Stressful clinical workload, high emotional pressure and burnout.Negative, masculine culture within surgical teams. Positively, despite not planning to pursue surgery - some students reported surgery was not as intimidating as they had expected it to be and surgeons did not meet stereotypes they were expecting. Conclusions Medical students continue to comment on negative surgical working environment experiences. Our study highlights areas that high pressure surgical training placements, need to actively improve in order to ensure a positive working and teaching surgical environment for our future medical workforce.

SP1.14 - Advancing Surgical Education: A Pilot Study Evaluating the Impact of Augmented Reality in Post-Graduate Surgical Skill Training

Abstract Aim The landscape of post-graduate surgical education, influenced by the clinical pressures of the COVID-19 pandemic, has prompted a shift towards prioritizing patient safety and embracing simulated technology for skill development and assessment. This study aims to evaluate the influence of (LapAR™) simulation on the acquisition of surgical skills and the overall training experience for junior surgical trainees. Methods 15 trainees and 2 consultants were recruited across five training sites. Participants used (LapAR™) at home to perform ten appendicectomies, interspersed with LapPass tasks. Objective metrics, including completion time and distance, were quantified, followed by comprehensive interviews. Results Junior surgical trainees demonstrated improvements in completion time, distance travelled, smoothness, acceleration, and ambidexterity during repeated laparoscopic appendicectomies. It is of interest that trainees were meeting consultant benchmarks across all modalities. Qualitative analysis emphasized the relevance of Augmented Reality in early surgical training, advocating for its mandatory integration. Participants sought prolonged access to (LapAR™), acknowledging its value for list preparation, skill acquisition, and knowledge enhancement. Home-based training offered flexibility, contrast to the pressures of traditional surgical environments. Despite technical challenges, (LapAR™) delivered realistic educational benefits. Conclusion (LapAR™) presents a scalable and transformative approach to enhancing surgical skills while addressing common challenges faced by trainees. This study validates its efficacy through improved skills aligned with objective metrics, positive evaluations of educational content, and unanimous agreement on the realism of the simulation. Augmented Reality bridges the gap between surgical training and practice, offering a scalable solution to elevate the standards of surgical education.

Investigation the Frequency of Fungal Contamination in Surgical Instruments

Background: Fungal contamination of surgical instruments poses a significant risk to patient safety, potentially leading to surgical site infections and other severe complications. By examining contamination levels both immediately after opening sterile sets and after two hours of environmental exposure, it becomes possible to assess contamination reduction strategies. Objectives: The aim of this study was to identify which instruments and operating rooms were most affected by fungal contamination. Understanding the extent of this contamination is critical to developing more effective sterilization protocols, improving infection control practices, and ultimately enhancing patient safety in surgical settings. Methods: This study was conducted on surgical instruments at Ali ebn Abi Talib Zahedan Hospital in 2023, across seven operating rooms (emergency, general surgery, gynecology, and urology). Samples were randomly collected under sterile conditions to prevent external contamination. The collected samples were cultured in Sabouraud Dextrose Agar (SDA), and data were analyzed using SPSS version 26. Results: The findings revealed that different surgical instruments, such as Pinzette (without teeth), Allis forceps, Babcock forceps, curved clamps, Gully pots, receivers, retractors, ring forceps, and towel clamps, were contaminated with fungal pathogens within two hours of opening the sterile sets. The highest contamination rates were observed in general surgery (39%), followed by emergency (29%), urology (21%), and gynecology (11%) rooms. The most common fungal contaminants were Aspergillus spp., yeast, and Penicillium spp. Conclusions: This study highlights the challenge of maintaining sterility in surgical environments post-sterilization, as fungal contamination reappeared on surgical instruments within two hours despite the initial sterilization. These findings emphasize the need for enhanced infection control measures, advanced environmental controls, and regular monitoring to reduce the risks associated with fungal contamination in surgical settings.

The Analysis Study of Risk of Complication Post Tonsillectomy in Children : A Comprehensive Systematic Review

Background: This study aims to provide a comprehensive regarding possible postoperative complications following tonsillectomy in children, highlighting how various interventions and preoperative measures can influence outcomes and postoperative recovery. Methods: Following PRISMA 2020 guidelines, this systematic review focused exclusively on full-text articles published in English between 2014 and 2024. Result: The study conducted a comprehensive review of over 100 publications sourced from reputable databases, including ScienceDirect, SagePub, and PubMed. Following an initial screening, eight publications were identified as warranting more in-depth analysis. Consequently, a thorough review of these selected studies was performed to ensure a detailed and rigorous evaluation. Conclusion: The tonsillar lodge is crucial for children's health, but postoperative complications can arise in various forms. Despite advancements in anesthesia, challenges remain due to the surgical environment. Infectious and traumatic complications are prevalent, requiring timely detection and intervention. Timely detection and intervention are essential to optimizing patient outcomes and addressing these potential issues effectively.

Active constraint control for the surgical robotic platform with concentric connector joints

Robotic minimally invasive surgery (MIS) has changed numerous surgical techniques in the past few years and enhanced their results. Haptic feedback is integrated into robotic surgical systems to restore the surgeon's perception of forces in response to interaction with objects in the surgical environment. The ideal exact emulation of the robot's interaction with its physical environment in free space is a very challenging problem to solve completely. Previously, we introduced the surgical robotic platform (SRP) with a novel concentric connector joint (CCJ). This study aims to develop a haptic control system that integrates an active constraint controller into a surgical robot platform. We have successfully established haptic feedback control for the surgical robot using constraint control and inverse kinematic relationships integrated into the overall positioning structure. A preliminary feasibility study, modelling, and simulation were presented.

Vibrational Feedback for a Teleoperated Continuum Robot with Non-contact Endoscope Localization

Abstract Limited or absent haptic feedback is reported as a factor hindering the continued adoption of surgical robots. This article presents a proof of concept for vibrotactile feedback integrated into a continuum robot to explore whether such feedback improves spatial perception in surgical settings. The robot is equipped with a capacitive sensor for noncontact endoscope localization, enabling spatial awareness of the robot’s tool center point (TCP) within the surgical environment. The data from the sensor is processed and transmitted to a bracelet worn by the user, which generates vibrotactile feedback. The bracelet contains four vibration motors providing tactile cues for navigation and positioning of the robot’s TCP. All subsystems are integrated into a unified system to deliver vibrotactile feedback to the user. When the user maneuvers the TCP of the robot near an object, they receive vibrotactile feedback via the bracelet. Thereby, the intensity of vibration increases as the TCP approaches the object, and the direction of the obstacle is mapped on the bracelet. Initial functional tests were performed and prove the functionality of the proposed system.

Gender Disparities in Surgical Subspecialties: A CMS Data Analysis

IntroductionThe persistent under-representation of women in surgery remains a critical concern within the medical profession, prompting a need for a nuanced analysis of gender distribution. Despite advancements in medical education, historical gender disparities in surgery persist, necessitating an exploration of the specific realms where gaps are most pronounced. Leveraging the 2023 Center for Medicare & Medicaid Services National Downloadable Database, this study aims to contribute insights into the multifaceted dynamics of gender representation within surgical disciplines. MethodsData from 1,168,064 physicians in the 2023 Center for Medicare & Medicaid Services National Downloadable Database were analyzed to distinguish between surgeons and physicians in medicine subspecialties. Univariable and multivariable logistic regression explored demographic variables, practice settings, and temporal trends to comprehensively understand factors contributing to the observed gender gap. ResultsThe analysis revealed a statistically significant gender difference, with only 16.7% of surgeons identified as female. Temporal trends indicated a slow increase in female surgeon representation, and specialty-specific analysis unveiled variations, such as lower likelihoods of females in cardiac surgery and higher likelihoods in colorectal surgery. Multivariable logistic regression emphasized factors influencing the odds of physicians practicing surgery, with female physicians exhibiting a lower likelihood. Regional and graduation year variations also played roles in surgical practice. ConclusionsThis study provides evidence-based insights into the persistent gender gap within surgical specialties, emphasizing the need for targeted interventions to enhance inclusivity and equity in the surgical workforce. The findings highlight intricate interplays of demographic, temporal, and specialty-specific factors, laying a foundation for future initiatives promoting a more diverse and inclusive surgical environment.

Perioperative Patient Safety Management: The Perspective of Operating Room Nurses

Perioperative patient safety management is a critical aspect of healthcare, requiring a comprehensive understanding of the roles and responsibilities of operating room nurses in ensuring patient safety. This paper emphasizes the significance of nurses' perspectives in enhancing safety protocols during the perioperative phase. It explores the multifaceted responsibilities of operating room nurses, highlighting their pivotal role in patient safety, from preoperative assessment to postoperative care. The challenges faced by nurses in maintaining safety standards are discussed, along with innovative solutions to mitigate these issues. Drawing on insights from contemporary practices, the paper advocates for a proactive approach to safety management, emphasizing continuous education, effective communication, and the implementation of evidence-based guidelines. The conclusions offer a roadmap for future directions in perioperative safety, underscoring the need for collaborative efforts among healthcare professionals to achieve optimal patient outcomes. By integrating the experiences and insights of operating room nurses, this work contributes to a more nuanced understanding of perioperative safety management, aiming to foster a culture of safety in surgical environments.

Recent advances on application of continuum robots in minimally invasive surgery

Continuum robots have emerged as pivotal tools in advancing minimally invasive surgery (MIS), offering enhanced flexibility and precision compared to traditional rigid instruments. This review categorizes continuum robots based on structural designs and actuation strategies, highlighting their ability to navigate complex surgical environments with minimal invasiveness. The integration of advanced sensing technologies for shape and environmental perception is examined, underscoring their role in improving surgical accuracy and patient safety. Specific applications in bronchoscopy, gastrointestinal endoscopy, and orthopedic procedures demonstrate the diverse capabilities of continuum robots in clinical settings. Despite challenges in material stiffness and sensor miniaturization, continuum robots show promising potential to reshape the landscape of MIS through continued innovation and research advancements.

Artificial intelligence facilitates the potential of simulator training: An innovative laparoscopic surgical skill validation system using artificial intelligence technology.

The development of innovative solutions, such as simulator training and artificial intelligence (AI)-powered tutoring systems, has significantly changed surgical trainees' environments to receive the intraoperative instruction necessary for skill acquisition. In this study, we developed a new objective assessment system using AI for forceps manipulation in a surgical training simulator. Laparoscopic exercises were recorded using an iPad®, which provided top and side views. Top-view movies were used for AI learning of forceps trajectory. Side-view movies were used as supplementary information to assess the situation. We used an AI-based posture estimation method, DeepLabCut (DLC), to recognize and positionally measure the forceps in the operating field. Tracking accuracy was quantitatively evaluated by calculating the pixel differences between the annotation points and the points predicted by the AI model. Tracking stability at specified key points was verified to assess the AI model. We selected a random sample to evaluate tracking accuracy quantitatively. This sample comprised 5% of the frames not used for AI training from the complete set of video frames. We compared the AI detection positions and correct positions and found an average pixel discrepancy of 9.2. The qualitative evaluation of the tracking stability was good at the forceps hinge; however, forceps tip tracking was unstable during rotation. The AI-based forceps tracking system can visualize and evaluate laparoscopic surgical skills. Improvements in the proposed system and AI self-learning are expected to enable it to distinguish the techniques of expert and novice surgeons accurately. This system is a useful tool for surgeon training and assessment.

Surgical cystectomy training using human cadavers embalmed using Thiel's method: a pilot study.

To develop the use of Thiel soft embalmed human cadavers (TeC) in open radical cystectomy (ORC) training for the first time, to investigate the effect of cadaveric training on surgical trainees' technical skills/performance and to determine how trainees perceive the use of cadaveric workshops. A 3-day hands-on workshop was organised. Ten trainees performed ORC on five TeC, supervised by five experts. Feedback from trainees and mentors was evaluated on a five-point Likert scale. All procedures were completed in a fully equipped surgical environment and complied with the principles outlined in the Declaration of Helsinki. The workshop participants evaluated the anatomical and manipulation characteristics of the TeC as similar to real-life conditions. The colour and consistency of the urethra and ureter differed little from those in live patients. The trainees stated that the TeC were beneficial for learning the stages of ORC and urinary diversion (UD), while their self-confidence increased. In terms of realism, all steps of radical cystectomy (RC) were rated 4 out of 5 or higher on the Likert scale by both trainees and faculty. The use of TeC for RC und UD was perceived as favourable by trainees and faculty. The TeC demonstrated a surprising ability to mimic real-life anatomy and represent a new and effective surgical training tool.

Professional disrespect between doctors and nurses: implications for voicing concerns about threats to patient safety

Purpose Previous research has demonstrated that social-relational factors are instrumental to employee voice. An essential aspect of this relates to notions of respect or disrespect. Although nurses commonly report experiencing professional disrespect in their interaction with doctors, earlier studies have focused on how the professional status hierarchy and power imbalance between doctors and nurses hinder speaking up without considering the role of professional disrespect. Addressing this gap, we explore how professional disrespect in the doctor–nurse relationship in surgical teams influences the willingness of nurses to voice legitimate concerns about threats to patient safety.Design/methodology/approach Fifty-seven semi-structured interviews with nurses drawn from a range of specialities, ranks and surgical teams in three hospitals in a West African Country. In addition, two interviews with senior representatives from the National Registered Nurses and Midwifery Association (NRNMA) of the country were undertaken and analysed thematically with the aid of NVivo.Findings Disrespect is expressed in doctors’ condescending attitude towards nurses and under-valuing their contribution to care. This leads to safety concerns raised by nurses being ignored, downplayed or dismissed, with deleterious consequences for patient safety. Feeling disrespected further motivates nurses to consciously disguise silence amidst speech and engage in punitive silence aimed at making clinical practice difficult for doctors.Originality/value We draw attention to the detrimental effect of professional disrespect on patient safety in surgical environments. We contribute to employee voice and silence by showing how professional disrespect affects voice independently of hierarchy and conceptualise the notion of punitive silence.

Automatic Surgery in Transcatheter Aortic Valve Replacement Using Augmented Reality.

Augmented Reality (AR) is in high demand in medical applications. The aim of the paper is to provide automatic surgery using AR for the Transcatheter Aortic Valve Replacement (TAVR). TAVR is the alternate medical procedure for open-heart surgery. TAVR replaces the injured valve with the new one using a catheter. In the existing model, remote guidance is given, while the surgery is not automated based on AR. In this article, we deployed a spatially aligned camera that is connected to a motor for the automation of image capture in the surgical environment. The camera tracks the 2D high-resolution image of the patient's heart along with the catheter testbed. These captured images are uploaded using the mobile app to a remote surgeon who is a cardiology expert. This image is utilized for the 3D reconstruction from 2D image tracking. This is viewed in a HoloLens like an emulator in a laptop. The surgeon can remotely inspect the 3D reconstructed images with additional transformation features such as rotation and scaling. These transformation features are enabled through hand gestures. The surgeon's guidance is transmitted to the surgical environment to automate the process in real-time scenarios. The catheter testbed in the surgical field is controlled by the hand gesture guidance of the remote surgeon. The developed prototype model demonstrates the effectiveness of remote surgical guidance through AR.

Vitreoretinal surgical performance after acute alcohol consumption and hangover

AimRoutine alcohol testing of practicing physicians remains controversial since there are no uniform guidelines or legal regulations in the medical field. Our aim was to quantitatively study the acute and...