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Surgical Education and Surgical Simulation 总被引:6,自引:0,他引:6
The science of virtual reality provides
an entirely new opportunity in the area of simulation of surgical
skills using computers for training, evaluation, and eventually
certification. A taxonomy of the types of simulators is proposed based
upon the level of complexity of the task which is being simulated.
These tasks are precision placement, simple manipulation, complex
manipulation, and integrated procedure. Representative simulators in
each category are illustrated and discussed in the context of their
contribution to the education and training of a surgeon. The importance
of a curriculum is to give content to the role of simulators as another
advanced tool for education. Simulators must be integrated into a
comprehensive curriculum and not considered as a stand-alone system.
The current accomplishments as well as challenges are discussed. 相似文献
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Rachel Rosenthal Walter P. Weber Marcel Zwahlen Heidi Misteli Stefan Reck Daniel Oertli Andreas F. Widmer Walter R. Marti 《World journal of surgery》2009,33(6):1165-1173
Background Despite availability of other training forms, tutorial assistance cannot be entirely replaced in surgical education. Concerns
exist that tutorial assistance may lead to an increased rate of surgical site infection (SSI). The purpose of the present
study was to investigate whether the risk of SSI is higher after surgery with tutorial assistance than after surgery performed
autonomously by a fully trained surgeon.
Methods All consecutive visceral, vascular, and traumatological inpatient procedures at a Swiss University Hospital were prospectively
recorded during a 24-month period, and the patients were followed for 12 months to ascertain the occurrence of SSI. Using
univariable and multivariable logistic regressions, we assessed the association of tutorial assistance surgery with SSI in
6,103 interventions.
Results Autonomously performed surgery was associated with SSI in univariable analysis (5.36% SSI vs. 3.81% for tutorial assistance,
p = 0.006). In multivariable analysis, the odds of SSI for tutorial assistance was no longer significantly lower (Odds Ratio
[OR] = 0.82; 95% Confidence Interval [CI]: 0.62–1.09; p = 0.163).
Conclusions Surgical training does not lead to higher SSI rate if trainees are adequately supervised and interventions are carefully selected.
Although other forms of training are useful, tutorial assistance in the operating room continues to be the mainstay of surgical
education. 相似文献
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K.-W. Jauch 《Der Chirurg》1997,68(6):551-558
Summary. Trauma, operative interventions, infection and other disturbances of homeostasis lead to a uniform reaction of the body,
namely release and activation of hormones and cytokines. Profound alterations of substrate flow result, with mobilization
of energy stores and degradation of structural and functional proteins of vital organs like the gut mucosa. Due to these reactions
the energy demands of the organs are met and energy-consuming synthesis of substrates is indicated. Clinically, hypermetabolism,
hyperglycemia, lipolysis and increased urea production with negative nitrogen balance can be observed. The metabolic reactivity
is reached by an increased substrate cycling. To avoid negative consequences such as organ dysfunction, a rational situation-adapted
substrate supply is warranted as well as reduction of catabolic stimuli and stimulation of anabolic factors. The metabolic
care of the surgical patient is still a basic and important task.
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Reith HB Rauchschwalbe S Endter F Thiede A 《Zentralblatt für Chirurgie》2003,128(9):W88-96, quiz W97-100
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