Introducing the Nuances of Tool–Tissue Interaction Forces in Hemangioblastoma Surgery
Notice bibliographique
Résumé
Objectives: Surgical resection of intracranial hemangioblastoma poses technical challenges which may be difficult to impart to trainees. The use of excessive force in such lesion may result in bleeding and failure of task completion. Knowledge of the ideal forces required for hemangioblastoma dissection has not been quantified nor analyzed with respect to surgical performance and education. Here, we introduce an early level data on the forces in Newton (N), observed for different surgical tasks in hemangioblastoma surgery comparing the force profiles of trainees to expert surgeons. Methods: “SmartForceps System,” a force-sensing bipolar forceps was developed to quantify tool-tissue forces during surgery. Seven surgeons (2 groups: novice and expert) participated in the study, with expert surgeons ( n = 1, 10+ years of experience), and novice surgeons ( n = 6, PGY 1–6 including clinical fellowship). Five patients who underwent surgical resection of hemangioblastoma using the SmartForceps System between October 2019 and June 2021 were included. Demographics, histopathology, and radiology data were recorded. We recorded the force profile of five predetermined surgical tasks: (1) dissection, (2) coagulation, (3) retracting, (4) pulling, and (5) manipulating. Task-specific force recording started from the time when the surgeon stated the specific task, and stopped when the forceps tip was no longer in contact with the tissue. The force profile was measured for each trial and included force duration, average, maximum, minimum, range, standard deviation, and correlation coefficient. Results: All patients were male with a mean age of 48 years (range 41–69 years). All tumors were located in the cerebellum, and had a cystic component. Force data from 718 trials were collected, of which 452 trials were recorded for expert surgeons. The mean (SD) for tumor coagulation was 0.17 ± 0.10 N. The forces exerted by novice surgeons were significantly lower than those of the expert surgeon (0.13 vs 0.22; p < 0.0001). Force variability decreased from novice (0.63) to expert surgeon (0.56). The duration of task completion was similar in both groups. Of all the tasks, dissection required the least amount of force, and was significantly lower than most other tasks. Surgeons use higher force toward the end of tumor resection (0.17 vs 0.20; p = 0.003) Conclusion: Trainees exert lower forces during hemangioblastoma surgery. This finding may suggest hesitancy by trainees to avoid injury to delicate structures and bleeding. The use of slightly higher force was particularly common at the end of the surgery, which might be related to surgeon fatigue. The quantification of tool–tissue interaction forces during hemangioblastoma surgery with feedback to the surgeon could well enhance surgical training and the avoidance of bleeding associated with high force error. Fig. 1 Publication History Article published online: 15 February 2022 © 2022. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
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 | 0,001 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,002 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
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 ».