Abstract：
OBJECTIVE:Surgeons' vigilance regarding patient condition was assessed using eye-tracking techniques during a simulated laparoscopic procedure. METHODS:Surgeons were required to perform a partial cholecystectomy in a virtual reality trainer (SurgicalSim; METI Inc, Sarasota, FL) while wearing a lightweight head-mounted eye-tracker (Locarna systems Inc, Victoria, British Columbia, Canada). Half of the patients were preprogrammed to present a mildly unstable cardiac condition during the procedure. Surgical performance (evaluated by task time, instrument trajectory, and errors), mental workload (by the National Aeronautics and Space Administration Task Load Index), and eye movement were recorded and compared between 13 experienced and 10 novice surgeons. RESULTS:Experienced surgeons took longer to complete the task and also made more errors. The overall workload reported by surgeons was similar, but expert surgeons reported a higher level of frustration and a lower level of physical demands. Surgeon workload was greater when operating on the unstable patient than on the stable patient. Novices performed faster but focused more of their attention on the surgical task. In contrast, experts glanced more frequently at the anesthetic monitor. CONCLUSIONS:This study shows the usefulness of using eye-tracking technology to measure a surgeon's vigilance during an operation. Eye-tracking observations can lead to inferences about a surgeon's behavior for patient safety. The unsatisfactory performance of expert surgeons on the VR simulator suggests that the fidelity of the virtual simulator needs to improve to enable surgeons to transfer their clinical skills. This, in turn, suggests using caution when having clinical experts as instructors to teach skills with virtual simulators.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Zheng B,Tien G,Atkins SM,Swindells C,Tanin H,Meneghetti A,Qayumi KA,Neely O,Panton Mdoi
10.1016/j.amjsurg.2011.01.016subject
Has Abstractpub_date
2011-05-01 00:00:00pages
673-7issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(11)00114-0journal_volume
201pub_type
杂志文章abstract：:The insertion of pancreaticobiliary drains at the time of endoscopic retrograde cholangiopancreatography can provide access to the bile or pancreatic duct, decompress an obstructed biliary tree, and allow infusion of solubilizing agents to effect gallstone dissolution. Twenty-six patients underwent 32 attempts at drai...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90384-7
更新日期：1983-08-01 00:00:00
abstract：BACKGROUND:Data concerning the long-term efficacy of laparoscopic sleeve gastrectomy in the treatment of morbid obesity remain scarce. In this retrospective, the authors present 5-year follow-up of 30 patients having undergone laparoscopic sleeve gastrectomy. METHODS:Since 2004, 30 patients underwent laparoscopic slee...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2014.04.006
更新日期：2015-02-01 00:00:00
abstract：BACKGROUND:New prognosticators are necessary for optimizing the extent of thyroidectomy and adjuvant radiotherapy in differentiated thyroid carcinoma. METHODS:Tumor microvessel density (MVD), expression of thymidine phosphorylase (dThdPase) and CD68 stained macrophages were evaluated in 71 differentiated thyroid carci...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(98)00238-4
更新日期：1998-11-01 00:00:00
abstract：BACKGROUND:This prospective study was performed to ascertain the added benefit of lymphoscintigraphy to a standard method of intraoperative lymphatic mapping and sentinel node biopsy for breast cancer. METHODS:Patients with invasive breast cancer were injected with 99mTc sulfur colloid prior to sentinel node biopsy; p...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(99)00088-4
更新日期：1999-06-01 00:00:00
abstract：BACKGROUND:Vacuum Assisted Closure (VAC; Kinetic Concepts, Inc., San Antonio, TX) has been used to successfully treat a variety of complex wounds. This technique was investigated for use in managing Fournier's gangrene following initial debridement. METHODS:Ten patients with Fournier's gangrene were treated in this st...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.04.018
更新日期：2009-05-01 00:00:00
abstract：:Although common in Japan, early gastric cancer is rarely seen in Western countries and generally accounts for only 7 to 10 percent of all gastric malignancies. Eleven patients with early gastric cancer seen over a 10 year period have been reviewed for clinical and pathologic features, method of diagnosis, treatment, a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90268-6
更新日期：1987-11-01 00:00:00
abstract：BACKGROUND:This study examined trends in breast conservation surgery (BCS) at our hospital and factors associated with BCS. METHODS:We retrospectively reviewed breast cancer surgeries in patients eligible for BCS (size <4 cm, N0, N1) from 1990 through 1996 (n = 634). We calculated the yearly prevalence of BCS and used...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：
更新日期：1998-12-01 00:00:00
abstract：:The relative roles of bacterial infection, fluid loss and myocardial failure were investigated in 24 patients in whom circulatory shock appeared as a complication of purulent peritonitis. The 13 acute survivors, including 6 hospital survivors, had strikingly lower initial plasma volumes and total blood volumes than th...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(81)90290-7
更新日期：1981-08-01 00:00:00
abstract：:Herein, we have described the surgical management of 23 patients with chronic intestinal ischemia. The patients presented most commonly with postprandial pain and weight loss. Diagnosis was confirmed by angiography, including lateral aortography. Surgery included bypass with Dacron being the most common graft material...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90301-5
更新日期：1984-07-01 00:00:00
abstract：BACKGROUND:To assess the impact of adding a surgical oncologist to our faculty we examined the operative experience in our program before and after the addition. METHODS:Operative case numbers reported to the American Board of Surgery over a 10-year period were analyzed. This time period encompassed 5 years before and...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.01.001
更新日期：2004-01-01 00:00:00
abstract：BACKGROUND:The insertion and subsequent removal of chest tubes are frequently performed procedures. We hypothesize that routine chest radiographs obtained after chest tube removal to confirm the absence of any post-procedure complications have little impact on clinical management. MATERIALS AND METHODS:A 5-year retros...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)00260-3
更新日期：2000-01-01 00:00:00
abstract：:Previous "blind" surgical intervention for recurrent, sustained ventricular tachycardia has been disappointing. Successful surgical intervention requires that a local arrhythmia circuit be interrupted, ablated, or disengaged from the adjacent healthy myocardium while incurring minimal injury to the remaining functiona...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(83)90128-9
更新日期：1983-06-01 00:00:00
abstract：BACKGROUND:The pathophysiology of adrenal insufficiency, common in surgical intensive care units, has not been fully elucidated. METHODS:Patients at risk (age > 55 years, in the surgical intensive care unit >1 week, baseline cortisol < 20 μg/dL) were enrolled. After measuring cortisol and adrenocorticotropic hormone (...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.11.015
更新日期：2012-02-01 00:00:00
abstract：:Twenty-eight consecutive patients with tibial or peroneal artery injury are reported. Of these, eight underwent direct arterial repair, eight received vein graft reconstruction, and the involved artery was ligated in the remainder, with amputation required for various reasons in four. Tibial or peroneal artery injury ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90021-6
更新日期：1982-09-01 00:00:00
abstract：:Recurrence of hyperparathyroidism after initially successful primary operation is usually caused by inadequate resection of diseased tissue or recurrent carcinoma. Since it is known that normal parathyroid tissue may be autotransplanted into a muscle bed, it is plausible that inadvertent implantation of parathyroid ti...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(85)80178-1
更新日期：1985-06-01 00:00:00
abstract：BACKGROUND:This study was designed to establish whether the spatial structure of a prosthesis conditions its behavior at the peritoneal level. METHODS:Abdominal defects comprising all the wall (except skin) were created in rabbits and repaired with a laminar (DM) or reticular (CV-4) ePTFE-prosthesis. Fourteen days pos...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)00907-8
更新日期：2002-08-01 00:00:00
abstract：:Fine-needle aspiration (FNA) biopsy of a thyroid nodule was performed in 797 patients. Ninety-six patients had resection of the thyroid nodule performed subsequent to a one-time FNA biopsy. The surgical pathology of these 96 cases demonstrated a 5.8% false-negative rate and a 9.9% false-positive rate. As a consequence...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80330-7
更新日期：1993-10-01 00:00:00
abstract：:This study evaluates the impact of the autopsy on a general surgical training program from 1984 through 1988. We have retrospectively examined the charts of all patients who died during this period. Included in this analysis are the records of patients from the general, cardiac, pediatric, and transplant surgery depar...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(91)90114-s
更新日期：1991-12-01 00:00:00
abstract：BACKGROUND:The effectiveness of the nonsteroidal anti-inflammatory drug ketorolac in reducing pulmonary morbidity after rib fractures remains largely unknown. METHODS:A retrospective cohort study was conducted spanning January 2003 to June 2011 assessing pneumonia within 30 days and potential adverse effects of ketoro...
journal_title：American journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2013.05.011
更新日期：2014-04-01 00:00:00
abstract：:The results of the present study emphasize the importance of minimizing the time delay between a significant elevation in CEA and a second-look operation. Equally important are the frequency of serial determinations, a thorough understanding of the limitations of the assay, and careful evaluation of the clinical condi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90137-5
更新日期：1979-02-01 00:00:00
abstract：BACKGROUND:Ductal carcinoma in situ (DCIS) accounts for nearly 20% of new breast cancer diagnoses and ductal carcinoma in situ with microinvasion (DCIS-MI) is found in 5% to 10% of DCIS. Controversy exists regarding the appropriate local treatment as well as whether or not examination of the axilla should be performed ...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(03)00166-1
更新日期：2003-08-01 00:00:00
abstract：:Recurrent, nodular necrotizing granulomatous mastitis in two patients is reported in detail. Pathologic, immunologic, and bacteriologic studies in one patient indicate that this entity is different from plasmas cell mastitis, fat necrosis, mammary ductal ectasia, and the usual infectious and puerperal mastitis. System...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90397-0
更新日期：1979-08-01 00:00:00
abstract：BACKGROUND:The standard paradigm for acutely injured patients involves evaluation in an emergency department (ED). Our center has employed a policy for bypassing the ED and proceeding directly to the operating room (OR) based on prehospital criteria. METHODS:This is a retrospective analysis of all trauma patients admi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.06.001
更新日期：2012-08-01 00:00:00
abstract：BACKGROUND:Whether or not tumor response to chemotherapy-sensitized radiation therapy (CTRT) for head and neck cancer leads to an improved outcome is unknown. METHODS:Forty patients who received preoperative cisplatin plus simultaneous radiotherapy for operable stage III and IV head and neck cancer were reviewed retro...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00151-7
更新日期：1997-11-01 00:00:00
abstract：BACKGROUND:Hepatic resection is main approach to treatment of hepatolithiasis, but the long-term follow-up results of hepatic resection for hepatolithiasis are rarely reported. METHODS:A retrospective study was conducted of 87 patients with hepatolithiasis who underwent hepatic resection. RESULTS:The final stone clea...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.08.020
更新日期：2009-08-01 00:00:00
abstract：:The records of 46 immunocompromised patients who presented with diffuse pulmonary infiltrates were reviewed to determine the role of open lung biopsy in their management. Fifty-two percent of these patients had underlying hematologic malignancies and 54 percent had received chemotherapy within 3 months prior to biopsy...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(87)90246-7
更新日期：1987-12-01 00:00:00
abstract：:Splenic infarction is rare in inflammatory diseases of the pancreas, although the spleen and its vessels have an intimate relation with the pancreas. Most reported cases are of focal infarction, and treatment is mostly conservative. The authors report a case of diffuse splenic infarction in a 17-year-old boy with seve...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.03.020
更新日期：2011-03-01 00:00:00
abstract：:A controlled prospective study was conducted to compare the results of kidney preservation and transplantation in regard to the type of perfusate used for perfusion preservation. Cryoprecipitated plasma, plasma protein fraction and serum albumin solution were used as perfusate. Between February 1979 and July 1980, 176...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/0002-9610(81)90137-9
更新日期：1981-04-01 00:00:00
abstract：:Three distinct forms of postoperative breakdown after Nissen fundoplication have been discussed. Disruption and recurrent reflux is most common, with slipping occurring infrequently. For the first time, three patients developing a proximal gastric pouch deformity causing partial obstruction of the fundus without recur...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90278-1
更新日期：1977-07-01 00:00:00
abstract：:Though morbidity and mortality rates following pancreatic resection have improved in recent years, they are still around 35% and 5%, respectively. Typical complications, such as pancreatic fistula, abscess, and subsequent sepsis, are chiefly associated with exocrine pancreatic secretion. In order to clarify whether th...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1016/0002-9610(92)90264-r
更新日期：1992-01-01 00:00:00
