Surgery Commons^™

Automatic Generation And Novel Validation Of Patient-Specific, Anatomically Inclusive Scoliosis Models For Biomechanics-Informed Surgical Planning, Austin Tapp, Michel Audette, James Bennett

College of Engineering & Technology (Batten) Posters

Scoliosis is an abnormal spinal curvature of greater than 10 degrees. Severe scoliotic deformities are addressed with highly invasive procedures: anterior or posterior spinal fusion approaches. This invasiveness is due, in part, to the constraints of current surgical planning, which utilizes computed tomography (CT) scans unable to discern spinal ligaments that are dissected to make the spine sufficiently compliant for correction. If localization of ligaments and soft tissues were achieved pre-operatively, corrective procedures could become safer and more efficient by using finite element (FE) biomechanical simulations to determine decreased incidences of ligament releases. This research aims to achieve ligament localization …

Biomanufacturing Organized Collagen-Based Microfibers As A Tissue Engineered Device (Tend) For Tendon Regeneration, Yas Maghdouri-White, Nardos Sori, Stella Petrova, Hilary Wriggers, Nathan Kemper, Amrita Dasgupta, Kelly Coughenour, Seth Polk, Nick Thayer, Mario Rodriguez, Bill Simon, Anna Bulysheva, Kevin Bonner,, Steven Arnoczky, Samuel Adams, Michael Francis

Bioelectrics Publications

Approximately 800,000 surgical repairs are performed annually in the U.S. for debilitating injuries to ligaments and tendons of the foot, ankle, knee, wrist, elbow and shoulder, presenting a significant healthcare burden. To overcome current treatment shortcomings and advance the treatment of tendon and ligament injuries, we have developed a novel electrospun Tissue ENgineered Device (TEND), comprised of type I collagen and poly(D,L-lactide) (PDLLA) solubilized in a benign solvent, dimethyl sulfoxide (DMSO). TEND fiber alignment, diameter and porosity were engineered to enhance cell infiltration leading to promote tissue integration and functional remodeling while providing biomechanical stability. TEND rapidly adsorbs …

The Impact Of Anterior Cruciate Ligament Reconstructive Surgery On Neuromotor Function, Cortney Noel Armitano

Rehabilitation Sciences Theses & Dissertations

The purpose of this dissertation was to examine the systemic neuromechanical implications in individuals who have had an ACL reconstruction (ACLR) compared to healthy controls. The specific aims addressed were to: 1) examine differences in inter-limb coordination during walking at different speeds, 2) examine differences in trunk, neck and head acceleration during gait, and 3) investigate whether the reaction time responses assessed during stepping are negatively affected by ACLR.

The findings of study 1 revealed that maximal coordination stability was achieved when walking at the person’s preferred gait speed. However, individuals with a previous ACLR exhibited reduced coordination stability between …

Comparing The Effects Of Mental Workload Between Visual And Auditory Secondary Tasks During Laparoscopy, James P. Corcoran

Psychology Theses & Dissertations

The purpose of this study was to test Wickens’ Multiple Resource Theory (MRT) by comparing performance and subjective workload on a visual-spatial secondary task with an auditory-spatial analog when paired with visual-spatial laparoscopic primary tasks. Two primary tasks were performed with a laparoscopic box trainer: a high workload task that consisted of transferring rings from one peg to another and a low workload task that consisted of grasping and placing large pencil erasers in a bowl. It was predicted that the visual-spatial secondary task would be more sensitive when paired with the laparoscopic primary task than the auditory analog. Findings …

Development And Validation Of A Hybrid Virtual/Physical Nuss Procedure Surgical Trainer, Mohammad F. Obeid

Computational Modeling & Simulation Engineering Theses & Dissertations

With continuous advancements and adoption of minimally invasive surgery, proficiency with nontrivial surgical skills involved is becoming a greater concern. Consequently, the use of surgical simulation has been increasingly embraced by many for training and skill transfer purposes. Some systems utilize haptic feedback within a high-fidelity anatomically-correct virtual environment whereas others use manikins, synthetic components, or box trainers to mimic primary components of a corresponding procedure.

Surgical simulation development for some minimally invasive procedures is still, however, suboptimal or otherwise embryonic. This is true for the Nuss procedure, which is a minimally invasive surgery for correcting pectus excavatum (PE) – …

Body Image And Quality Of Life Among Postsurgical Bariatric Patients, Amy Leigh White

Psychology Theses & Dissertations

In recent decades, bariatric surgery has become an increasingly popular intervention for the treatment of morbid obesity. Bariatric surgery leads to substantial improvements in physical health (e.g., weight loss, increased life expectancy) and psychological health (e.g., body image, quality of life). After bariatric surgery, many patients undergo subsequent surgical procedures to remove excess skin (“body contouring”), which are also associated with positive medical and psychological outcomes.

The present study sought to expand upon existing research into the psychosocial outcomes of bariatric surgery, investigate correlates of patients’ desire for body contouring, and determine whether presurgical motivations were associated with postsurgical outcomes. …

A Microfluidic-Based Tactile Sensor For Palpating Mice Tumor Tissues, Yichao Yang, Garett Johnson, Dean Krusienski, Siqi Guo, Cheng Lin, Zhili Hao

Mechanical & Aerospace Engineering Faculty Publications

In light of the need of tissue palpation for Robotics-assisted Minimally Invasive Surgery (RMIS), this paper presents a microfluidic-based tactile sensor for palpating mice tissues for tumor localization. The core of the sensor is a 3x3 sensing-plate/transducer array built into a single polydimethylsiloxane (PDMS) microstructure, with a transducer spacing of 3.75mmx1.5mm. Mounted on a robot, the sensor is pressed against a tissue region with a pre-defined indentation depth pattern, and consequently the stiffness distribution across the tissue region translates to the deflection distribution of the sensing-plate array and is captured by the transducer array underneath as resistance changes. Thus, the …

Mobile Cloud Computing Based Non Rigid Registration For Image Guided Surgery, Arun Brahmavar Vishwanatha

Computer Science Theses & Dissertations

In this thesis we present the design and implementation of a Mobile Cloud computing platform for non-rigid registration required in Image Guided Surgery (MCIGS). MCIGS contributes in flexible, portable and accurate alignment of pre-operative brain data with intra-operative MRI, for image guided diagnosis and therapy and endoscopic skull base surgery. Improved precision of image guided therapy and specifically neurosurgery procedures is known to result in the improved prognosis for brain tumor patients. MCI GS system is tested with Physics Based Non-Rigid Registration method form ITK. Our preliminary results for brain images indicate that the proposed system over Wi-Fi can be …

Assessing The Effectiveness Of An Interval Estimation And A Visual-Spatial Secondary Task As Measures Of Mental Workload During Laparoscopy, Levi Parker Warvel

Psychology Theses & Dissertations

The goal of the present study was to compare two secondary workload tasks, specifically a time interval estimation and visual-spatial task, to determine which of these is most appropriate for the assessment of laparoscopic mental workload. Participants performed a peg transfer task in two conditions: a normal camera angle and a 90° camera angle intended to increase mental workload. Based on multiple resource theory, it was predicted the visual-spatial task would be more sensitive to the workload manipulation than the time estimation task because it draws upon the specific, as opposed to more general, attentional resources required by laparoscopy. Primary …

Multi-Surface Simplex Spine Segmentation For Spine Surgery Simulation And Planning, Rabia Haq

Computational Modeling & Simulation Engineering Theses & Dissertations

This research proposes to develop a knowledge-based multi-surface simplex deformable model for segmentation of healthy as well as pathological lumbar spine data. It aims to provide a more accurate and robust segmentation scheme for identification of intervertebral disc pathologies to assist with spine surgery planning. A robust technique that combines multi-surface and shape statistics-aware variants of the deformable simplex model is presented. Statistical shape variation within the dataset has been captured by application of principal component analysis and incorporated during the segmentation process to refine results. In the case where shape statistics hinder detection of the pathological region, user-assistance is …

Meshless Mechanics And Point-Based Visualization Methods For Surgical Simulations, Rifat Aras

Computational Modeling & Simulation Engineering Theses & Dissertations

Computer-based modeling and simulation practices have become an integral part of the medical education field. For surgical simulation applications, realistic constitutive modeling of soft tissue is considered to be one of the most challenging aspects of the problem, because biomechanical soft-tissue models need to reflect the correct elastic response, have to be efficient in order to run at interactive simulation rates, and be able to support operations such as cuts and sutures.

Mesh-based solutions, where the connections between the individual degrees of freedom (DoF) are defined explicitly, have been the traditional choice to approach these problems. However, when the problem …

Development And Validation Methodology Of The Nuss Procedure Surgical Planner, Krzysztof J. Rechowicz

Computational Modeling & Simulation Engineering Theses & Dissertations

Pectus excavatum (PE) is a congenital chest wall deformity which is characterized, in most cases, by a deep depression of the sternum. A minimally invasive technique for the repair of PE (MIRPE), often referred to as the Nuss procedure, has been proven to be more advantageous than many other PE treatment techniques. The Nuss procedure consists of placement of a metal bar(s) underneath the sternum, thereby forcibly changing the geometry of the ribcage. Because of the prevalence of PE and the popularity of the Nuss procedure, the demand to perform this surgery is greater than ever. Therefore, a Nuss procedure …

Analysis Of Bar Deformation Under Sternum Forces During Surgical Correction Of Pectus Excavatum In Children, Rohit N. Nikam

Mechanical & Aerospace Engineering Theses & Dissertations

Pectus excavatum (PE) also known as sunken or funnel chest is the most common chest wall deformity and affects 1 in every 1,000 children. In PE patients, the middle lower portion of the sternum is depressed producing concave appearance of the anterior part of the chest wall. This problem can be corrected with minimally invasive surgery developed by Dr. Donald Nuss in 1986. A specially made steel bar is implanted to lift the sternum to its normal position. This technique has been modified several times to improve safety and effectiveness of the bar placement and removal. One of the significant …

Understanding The Nature Of Surgical Excellence Using A Competency Modeling Approach, Hope S. Hanner-Bailey

Psychology Theses & Dissertations

Currently, a thorough description of the knowledge, skills, abilities, and other personal characteristics (KSAOs) that distinguish an exceptional surgeon does not exist. This knowledge is pertinent to the development of selection, training, and performance assessment methods that can be used to develop high performing surgeons. Expert surgeons from around the country were recruited to participate in an interview to discuss the KSAOs (i.e., the competencies) needed to be exceptional in the field. A smaller number of novice surgeons were also interviewed. The expert interview data were distilled into a competency model that consists of ten competencies and patterns within the …

Art Therapy As A Measure Of Children’S Concept Of Surgery: A Preliminary Study, Emily C. Clark

EVMS School of Health Professions Theses & Dissertations

Surgery is a strange, and often frightening experience for children. A number of programs have been studied which attempt to prepare children for the surgery experience. Art therapy may be especially suited to help prepare children for surgery because art making is an effective form of communication for children, and can allow them to express their thoughts and fears about surgery. Unfortunately, studies of art therapy preparation programs are rare, and usually take the form of case studies. This research study is the first step in designing an art therapy preparation program for preparing children for surgery.

The purpose of …

Insulinlike Growth Factor 1- And 2-Augmented Collagen Gel Repair Of Facial Osseous Defects, James S. Toung, Roy C. Ogle, Raymond F. Morgan, William H. Lindsey

School of Medical Diagnostics & Translational Sciences Publications

BACKGROUND: Defects of the facial bone structure are common problems for the facial plastic surgeon. Native type 1 collagen gels (T1CGs) have been shown to mediate repair of facial critical-size defects in rat models.

OBJECTIVE: To evaluate the efficacy of T1CG augmented with insulinlike growth factor (IGF) 1, IGF-2, and a combination of IGF-1 and IGF-2 on the repair of facial critical-size defects in a rodent model.

METHODS: Twenty-four retired male breeder Sprague-Dawley rats were divided into 4 groups of 6 animals. Facial critical-size defects were created by removing the nasalis bones with a bone-cutting drill. Defects were treated with …

Needle Localization For Breast Biopsy: The Patient's Experience, Marian De Walt Morgan

Psychology Theses & Dissertations

The needle localization procedure for breast biopsy (NLP) can be painful and distressing for some women. This study was carried out to learn what factors might increase or decrease NLP pain and distress, and to gain insight into possible interventions to make the procedure more comfortable for all patients. One hundred and thirty-eight women were surveyed following breast needle localization at two central Virginia hospitals. The influence of eight variables (lidocaine, self-regulation, anxiety, worry about breast cancer, breast tenderness, finding mammography painful, difficulty with surgery, and distress of blood drawing) on four outcome variables (pain incidence, pain intensity, pain unpleasantness, …

Endothelial Nitric Oxide Synthase And Growth Factor Regulation Of Flow-Mediated Vascular Remodeling, David Anthony Tulis

Theses and Dissertations in Biomedical Sciences

This study was designed to characterize structural remodeling of male Wistar rat mesenteric arteries exposed to elevated blood flow in vivo for 1, 3, or 7 days. A series of arterial ligations induced blood flow increases in ileal and second-order branch arteries compared to same animal control vessels. Neither mean carotid nor local mesenteric arterial pressures changed significantly pre- to post-ligation. The primary flow-mediated force in both vessels was shear stress with possible involvement of acute stretch-induced wall stress in the ileal artery. Significant luminal expansion and medial wall hypertrophy occurred in the ileal and second-order arteries in a time-dependent …

Axotomy And Regeneration Of The Rat Facial Nerve: A Histomorphometric Study Of The Facial Nucleus, Nerve And Orbicularis Oculi Muscle In An Experimental Model Of Facial Paralysis, Peter Konstantinos Thanos

Theses and Dissertations in Biomedical Sciences

One of the most unsettling sequela of facial paralysis (FP) is the loss of eye sphincter function and the blink response, leading to functional, psychological and aesthetic deficits. A medley of restorative microsurgery approaches have been employed in treating these deficits, however full recovery of function remains elusive. The present research utilized the rat model of facial paralysis, and consisted of three stages. Stage I examined the facial motor neuron (FMN) pool of the eye sphincter (orbicularis oculi muscle=OOM) and identified the facial nerve branch which provides the majority of innervation to the OOM. II. Examined the efficacy of the …

A Comparison Of Four Muscle Relaxant Techniques And Their Incidence Of Postoperative Myalgia In Ambulatory Patients, William James Garske Jr.

Community & Environmental Health Theses & Dissertations

Postoperative myalgia was measured 24 and 72 hours following the administration of four different anesthetic regimens to 36 patients undergoing outpatient or 23-hour admission procedures. Each patient, ASA class I or II, was to undergo procedures of limited duration, 30 to 90 minutes, and surgical stimulation, including procedures such as knee arthroscopy, hernia repair, and breast biopsy. Anesthesia was induced with propofol 1.5 mg/kg, fentanyl 50 mcg, and maintained with O₂ , N₂O, and isoflurane. Group I (n=20), the control, received no muscle relaxant and was maintained with mask ventilation. Group II (n=5) received succinylcholine 1.5 mg/kg …

The Effects Of Orthopaedic Surgery And Dorsal Rhizotomy On Selected Gait Characteristics Of Cerebral Palsy Children, Danielle M. Lanoue

Rehabilitation Sciences Theses & Dissertations

Surgical management of cerebral palsy children typically involves multiple orthopaedic surgeries in order to achieve and maintain the maximum functional level of ambulation. Orthopaedic intervention to address lower extremity spasticity often includes: muscle lengthenings, muscle releases and tendon transfers. The most recent advance in management of lower extremity spasticity has been through a neurosurgical approach; selective dorsal rhizotomy. The long term effects of dorsal rhizotomy are still being investigated. Through the use of instrumented gait analysis, the specific objective results of both of these types of surgeries can be investigated. The purpose of this retrospective study was to examine the …

A Comparison Of Myofascial Release And Ultrasound In The Treatment Of Musculoskeletal Pain, Dianna Lynn Bishop

Community & Environmental Health Theses & Dissertations

The purpose of this study was to evaluate the effectiveness of myofascial release (MFR) compared to ultrasound (US) in treating musculoskeletal pain. Data in the form of number of trigger points, active range-of-motion of the affected joint, pain scale measurement, and a Treatment Response Questionnaire score, were collected.

The Mann-Whitney U value supported that the MFR group outranked the US group 47 percent when ranking the percent change in trigger point number from pre to post treatment.

The Mann-Whitney U value supported that the MFR group outranked the US group in pain scale measurement. Kruskal-Wallis H value supported that MFR …

Protein Contributions Of The Male Accessory Organs To The Composition Of Human Seminal Plasma As Determined By High Resolution Two-Dimensional Electrophoresis, Edward E. Gaunt

Theses and Dissertations in Biomedical Sciences

Human Seminal Plasma was evaluated using a High Resolution Two-Dimensional Electrophoresis technique adapted by this laboratory. Seminal plasma from healthy volunteers with recently proven fertility were characterized using this technique to establish "normal" protein distribution patterns in the two-dimensional polyacrylamide gel slab. In addition, time studies were performed on selected specimens to determine the effects of liquefaction on seminal plasma protein composition within the first several hours after collection. Split ejaculates were collected for identification and elaboration of accessory organ components in the whole seminal plasma specimen. A more direct approach to accessory organ component analysis involved electrophoresis of semen …