The Experts below are selected from a list of 264 Experts worldwide ranked by ideXlab platform

Jack B Anon - One of the best experts on this subject based on the ideXlab platform.

  • computer aided endoscopic sinus surgery
    Laryngoscope, 1998
    Co-Authors: Jack B Anon
    Abstract:

    OBJECTIVES: To examine four different types of computer-aided endoscopic sinus surgical devices--the ISG Viewing Wand, the ISG infrared OptoTrak, the IGT FlashPoint 5000, and the VTI InstaTrak--with emphasis on their accuracy and ease of use. STUDY DESIGN: Prospective study utilizing laboratory experiments and intraoperative data collection. METHODS: A review of the literature is presented. Patients undergoing endoscopic sinus surgery during the study period were enlisted under FDA protocols with IRB consent. Groups of patients had surgery performed with each of the above devices--except the FlashPoint 5000. Accuracy measurements were recorded, and user and Operating Staff comments about ease of use were collected. The FlashPoint 5000 was used exclusively in the laboratory setting, where accuracy measurements were obtained on a cadaver skull. RESULTS: The systems all demonstrated accuracy to within 2.00 mm. Ease of use was somewhat variable, but following a learning curve by the surgeon and Operating department personnel, all of the units were considered to be relatively user friendly. CONCLUSIONS: Computer-aided endoscopic sinus surgery appears to be the wave of the future. Nevertheless, the modern endoscopic sinus surgeon must have thorough training in the basic anatomy of the paranasal sinuses as well as the various surgical techniques.

Christoph J. Griessenauer - One of the best experts on this subject based on the ideXlab platform.

Bernd Kuhlenkotter - One of the best experts on this subject based on the ideXlab platform.

  • Technical Documentation as a Service – An Approach for Integrating Editorial and Engineering Processes of Machinery and Plant Engineers
    Procedia CIRP, 2016
    Co-Authors: André Barthelmey, Kay Lenkenhof, Julian Schallow, Kai Lemmerz, Jochen Deuse, Bernd Kuhlenkotter
    Abstract:

    Abstract Delivery of technical documentation of manufacturing facilities is still mandatory for machinery and plant engineers as part of the compliance with legal regulations. In addition, current research and development indicate that digital technical documentation can be used as informative support for Operating Staff if contents are provided context-sensitive. Despite the importance and potentials of technical documentation for the engineering process, an integration of editorial Staff into this process is not state of the art. In this paper the authors propose a reference implementation for technical documentation developed within the collaborative research project Cyber System Connector in order to fill this gap both technically and organizationally. The aim is to redesign technical documentation into a service for all participants in product and production development. This new approach is based on a CPS-supported process of creating technical documentation and a virtual representation which serves as a platform for knowledge management in machinery and plant engineering. The benefits of implementing the proposed documentation strategy along the supply chain of manufacturing facilities are depicted by chosen application scenarios.

  • technical documentation as a service an approach for integrating editorial and engineering processes of machinery and plant engineers
    Procedia CIRP, 2016
    Co-Authors: André Barthelmey, Kay Lenkenhof, Julian Schallow, Kai Lemmerz, Jochen Deuse, Bernd Kuhlenkotter
    Abstract:

    Abstract Delivery of technical documentation of manufacturing facilities is still mandatory for machinery and plant engineers as part of the compliance with legal regulations. In addition, current research and development indicate that digital technical documentation can be used as informative support for Operating Staff if contents are provided context-sensitive. Despite the importance and potentials of technical documentation for the engineering process, an integration of editorial Staff into this process is not state of the art. In this paper the authors propose a reference implementation for technical documentation developed within the collaborative research project Cyber System Connector in order to fill this gap both technically and organizationally. The aim is to redesign technical documentation into a service for all participants in product and production development. This new approach is based on a CPS-supported process of creating technical documentation and a virtual representation which serves as a platform for knowledge management in machinery and plant engineering. The benefits of implementing the proposed documentation strategy along the supply chain of manufacturing facilities are depicted by chosen application scenarios.

Melissa L. Kirkwood - One of the best experts on this subject based on the ideXlab platform.

  • Dual fluoroscopy with live-image digital zooming significantly reduces patient and Operating Staff radiation during fenestrated-branched endovascular aortic aneurysm repair.
    Journal of vascular surgery, 2020
    Co-Authors: Laura I. Timaran, Carlos H. Timaran, Carla K. Scott, Marilisa Soto-gonzalez, David E. Timaran-montenegro, Jeffrey B Guild, Melissa L. Kirkwood
    Abstract:

    OBJECTIVE Fenestrated-branched endovascular aneurysm repair (F/B-EVAR) is a complex procedure that generates high radiation doses. Magnification aids in vessel cannulation but increases radiation. The aim of the study was to compare radiation doses to patients and Operating room Staff from two fluoroscopy techniques, standard magnification vs dual fluoroscopy with live-image digital zooming during F/B-EVAR. METHODS An observational, prospective, single-center study of F/B-EVAR procedures using Philips Allura XperFD20 equipment (Philips Healthcare, Amsterdam, The Netherlands) was performed during a 42-month period. Intravascular ultrasound, three-dimensional fusion, and extreme collimation were used in all procedures. Intraoperative live-image processing was performed with two imaging systems: standard magnification in 123 patients (81%) and dual fluoroscopy with live-image digital zooming in 28 patients (18%). In the latter, the live "processed" zoomed images are displayed on examination displays and live images are displayed on reference displays. The reference air kerma was collected for each case and represents patient dose. Operating Staff personal dosimetry was collected using the DoseAware system (Philips Healthcare). Patient and Staff radiation doses were compared using nonparametric tests. RESULTS Mean age was 71.6 ± 11.4 years. The median body mass index was 27 kg/m2 (interquartile range [IQR], 24.4-30.6 kg/m2) and was the same for both groups. Procedures performed with dual fluoroscopy with digital zooming demonstrated significantly lower median patient (1382 mGy [IQR, 999-2045 mGy] vs 2458 mGy [IQR, 1706-3767 mGy]; P < .01) and primary operator radiation doses (101 μSv [IQR, 34-235 μSv] vs 266 μSv [IQR, 104-583 μSv]; P < .01) compared with standard magnification. Similar significantly reduced radiation doses were recorded for first assistant, scrub nurse, and anesthesia Staff in procedures performed with dual fluoroscopy. According to device design, procedures performed with four-fenestration/branch devices generated higher operator radiation doses (262 μSv [IQR, 116.5-572 μSv] vs 171 μSv [IQR, 44-325 μSv]; P < .01) compared with procedures with three or fewer fenestration/branches. Among the most complex design (four-vessel), operator radiation dose was significantly lower with digital zooming compared with standard magnification (128.5 μSv [IQR, 70.5-296 μSv] vs 309 μSv [IQR, 150-611 μSv]; P = .01). CONCLUSIONS Current radiation doses to patients and Operating personnel are within acceptable limits; however, dual fluoroscopy with live-image digital zooming results in dramatically lower radiation doses compared with the standard image processing with dose-dependent magnification. Operator radiation doses were reduced in half during procedures performed with more complex device designs when digital zooming was used.

Stefan Zangos - One of the best experts on this subject based on the ideXlab platform.

  • radiation exposure to Operating Staff during rotational flat panel angiography and c arm cone beam computed tomography ct applications
    European Journal of Radiology, 2012
    Co-Authors: Boris Schulz, Ralf Heidenreich, Monika Heidenreich, K Eichler, A Thalhammer, Naguib Nagy Naguib Naeem, Thomas J Vogl, Stefan Zangos
    Abstract:

    Abstract Purpose To evaluate the radiation exposure for Operating personel associated with rotational flat-panel angiography and C-arm cone beam CT. Materials and methods Using a dedicated angiography-suite, 2D and 3D examinations of the liver were performed on a phantom to generate scattered radiation. Exposure was measured with a dosimeter at predefined heights (eye, thyroid, breast, gonads and knee) at the physician's location. Analysis included 3D procedures with a field of view (FOV) of 24 cm × 18 cm (8 s/rotation, 20 s/rotation and 5 s/2 rotations), and 47 cm × 18 cm (16 s/2 rotations) and standard 2D angiography (10 s, FOV 24 cm × 18 cm). Results Measurements showed the highest radiation dose at the eye and thyroid level. In comparison to 2D-DSA (3.9 μSv eye-exposure), the 3D procedures caused an increased radiation exposure both in standard FOV (8 s/rotation: 28.0 μSv, 20 s/rotation: 79.3 μSv, 5 s/2 rotations: 32.5 μSv) and large FOV (37.6 μSv). Proportional distributions were measured for the residual heights. With the use of lead glass, irradiation of the eye lens was reduced to 0.2 μSv (2D DSA) and 10.6 μSv (3D technique with 20 s/rotation). Conclusion Rotational flat-panel angiography and C-arm cone beam applications significantly increase radiation exposure to the attending operator in comparison to 2D angiography. Our study indicates that the physician should wear protective devices and leave the examination room when performing 3D examinations.