A Prospective Randomized Assessment of a Spatial Orientation Device in Natural Orifice Translumenal Endoscopic Surgery (NOTES)
Notice bibliographique
Résumé
Purpose: One of the challenges in natural orifice translumenal endoscopic surgery (NOTES) is spatial orientation. Compared to laparoscopic surgery, NOTES is complicated by the flexibility of the endoscope, making understanding the orientation of the distal tip difficult. Knowledge of the endoscopic tip orientation is important for safe and efficient navigation in the peritoneum. A method to improve spatial orientation must be technically feasible, reliable, easy to implement, and safe, with no added risk to the patient. The Queen's NOTES research group has devised a novel method of orientation using a magnetic orientation device which passes within an endoscope channel and allows for 3-dimensional imaging of the shape and orientation of the endoscope. This experiment was designed to assess the feasibility of this device in a pig model. Methods: The device was tested by six experienced endoscopists and six experienced laparoscopic surgeons. Starting from the gastrotomy site, the time to identify four targets was recorded. For the first iteration the targets were the spleen, gallbladder, bladder, and fallopian tube. For the second iteration participants were required to identify, and touch with a closed forceps, the gallbladder, fallopian tube, a clip on the abdominal wall, and liver edge. Use of the orientation device was randomized for each session in which all four targets were identified. Results: The first iteration experiments appeared too simple to adequately assess the effects of the device (longest average time to target 13.69 seconds). Participants thought the device was helpful, but may be of more use for complex tasks. A second iteration was therefore designed. During the second iteration the mean time to identify all four targets using the device was 75.08 ± 42.68 seconds compared to 100.20 ± 60.70 seconds without the device. Regardless of randomization order, both groups were faster when using the device. In order to account for potential learning from the first to second attempt, the mean change in time was analyzed. Participants who used the device first were 14.21 ± 74.53% slower the second time (when not using the device). Participants who used the device second were 33.60 ± 32.07% faster than the first session (p=0.179). Conclusion: The results of our study demonstrate a trend towards faster times for identification of targets within the peritoneum when using the Queen's orientation device. The small sample size and simplicity of the study tasks limits our ability to assess the full utility of the device. The usefulness of the device may not be measured in speed, but in the improvement in ease and accuracy of surgery. Consequently, these encouraging results warrant further study using more complex scenarios.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,008 | 0,012 |
| Méta-épidémiologie (sens strict) | 0,002 | 0,001 |
| Méta-épidémiologie (sens large) | 0,002 | 0,001 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,002 |
| Communication savante | 0,001 | 0,002 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 0,002 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».