The Experts below are selected from a list of 195 Experts worldwide ranked by ideXlab platform
Michael L Tuggy - One of the best experts on this subject based on the ideXlab platform.
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virtual reality flexible sigmoidoscopy simulator training impact on resident performance
Journal of The American Board of Family Practice, 1998Co-Authors: Michael L TuggyAbstract:BACKGROUND Flexible sigmoidoscopy, a core skill for the primary care physician, requires learned hand-eye skills that can be difficult to master during residency training. With recent advances in virtual reality simulation technology, simulated flexible Sigmoidoscopes are available to family medicine residents for training before their initial and subsequent live patient examinations. The purpose of the study was to determine whether a virtual reality flexible Sigmoidoscope simulator would improve the hand-eye skills and various performance parameters in a live patient. METHODS Residents were assigned to a control (n = 5) or experimental group (n = 5) in which the experimental group trained on a virtual reality sigmoidoscopy simulator before their first sigmoidoscopies on live patient volunteers. After the initial live patient sigmoidoscopies, both control and experimental groups trained on the simulator so that it was possible to evaluate presimulator and postsimulator training effects on live patient performance and to compare speed and skill between the groups at different levels of training. RESULTS Training on the virtual reality simulator produced substantial improvements in examination times and hand-eye skill measures. After 6 to 10 hours of training on the simulator, the experimental group achieved significantly faster insertion times to 30 cm (119 versus 357 sec, P = 0.03), 40 cm (211 versus 518 sec, P = 0.03), and a shorter mean length of examination (323 versus 654 sec, P = 0.01). There was also significant improvement of hand-eye skill measures of the experimental group in directional errors (1.6 versus. 8.6, P < 0.01), percentage of colon visualized (79 versus 45 percent, P = 0.02), and viewing quality of examination when compared with the control group's initial performance on live patients. Resident survey findings after the study confirmed the trainee's perception of the benefit of the simulator training. CONCLUSIONS This study shows the value of virtual reality simulator training for accelerating the development of the hand-eye skills to perform adequate sigmoidoscopy.
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Virtual reality flexible sigmoidoscopy simulator training: Impact on resident performance
1998Co-Authors: Michael L TuggyAbstract:Background: Flexible sigmoidoscopy, a core skill for the primary care physician, requires learned hand-eye skills that can be difficult to master during residency training. With recent advances in virtual reality simulation technology, simulated flexible Sigmoidoscopes are available to family medicine residents for training before their initial and subsequent live patient examinations. The purpose of the study was to determine whether a virtual reality flexible Sigmoidoscope simulator would improve the hand-eye skills and various performance parameters in a live patient. llethods: Residents were assigned to a control (n = 5) or experimental group (n = 5) in which the experimental group trained on a virtual reality sigmoidoscopy simulator before their first sigmoidoscopies on live patient volunteers. After the initial live patient sigmoidoscopies, both control and experimental groups trained on the simulator so that it was possible to evaluate presimulator and postsimulator training effects on live patient performance and to compare speed and skill between the groups at different levels of training. Results: Training on the virtual reality simulator produced substantial improvements in examination times and hand-eye skill measures. After 6 to 10 hours of training on the simulator, the experimental group achieved significantly faster insertion times to 30 em (119 versus 357 sec, P = 0.03), 40 em (211 versus 518 sec, P = 0.03), and a shorter mean length of examination (323 versus 654 sec, P = 0.01). There was also sig
J. G. Guillem - One of the best experts on this subject based on the ideXlab platform.
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Anastomotic occlusive web following double-stapled anterior resection and fecal diversion
Surgical Endoscopy, 1998Co-Authors: A. I. Picon, J. G. GuillemAbstract:The incidence of occlusive web following stapled anastomosis for curative resection of rectal cancer is unknown and the management of this entity not well defined. A 73-year-old patient underwent a double-stapled anterior resection with a temporary loop ileostomy for a T3,N1 rectal cancer. He received postoperative chemoradiation adjuvant therapy. Prior to ileostomy closure, sigmoidoscopy revealed an anastomotic occlusive web at 10–12 cm from the anal verge. Under monitored sedation, a flexible Sigmoidoscope was inserted per anus and advanced to the level of the occlusive web. Utilizing hydrostatic balloon dilatation, the occlusive web was broken and the bowel lumen was restored. The procedure was performed expeditiously and without complications. Subsequently the patient underwent ileostomy closure and experienced normal bowel movements. Although occlusive webs are uncommon after colorectal anastomosis, this case report describes a safe, effective, and uncomplicated endoscopic procedure that can be performed in patients with anastomotic occlusive web developing after prolonged fecal diversion.
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Anastomotic occlusive web following double-stapled anterior resection and fecal diversion. Presentation and endoscopic management.
Surgical endoscopy, 1998Co-Authors: A. I. Picon, J. G. GuillemAbstract:The incidence of occlusive web following stapled anastomosis for curative resection of rectal cancer is unknown and the management of this entity not well defined. A 73-year-old patient underwent a double-stapled anterior resection with a temporary loop ileostomy for a T3,N1 rectal cancer. He received postoperative chemoradiation adjuvant therapy. Prior to ileostomy closure, sigmoidoscopy revealed an anastomotic occlusive web at 10–12 cm from the anal verge. Under monitored sedation, a flexible Sigmoidoscope was inserted per anus and advanced to the level of the occlusive web. Utilizing hydrostatic balloon dilatation, the occlusive web was broken and the bowel lumen was restored. The procedure was performed expeditiously and without complications. Subsequently the patient underwent ileostomy closure and experienced normal bowel movements. Although occlusive webs are uncommon after colorectal anastomosis, this case report describes a safe, effective, and uncomplicated endoscopic procedure that can be performed in patients with anastomotic occlusive web developing after prolonged fecal diversion.
Debbie Glass - One of the best experts on this subject based on the ideXlab platform.
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Efficiency and productivity of a sheathed fiberoptic Sigmoidoscope compared with a conventional Sigmoidoscope
Diseases of the Colon & Rectum, 1997Co-Authors: T. Cristina Sardinha, Steven D. Wexner, Janice Gilliland, Norma Daniel, Michelle Kroll, Eleanor Lee, Joanne Wexler, Denise Hudzinski, Debbie GlassAbstract:PURPOSE: The aim of this study was to measure and compare time and productivity between a new sheathed flexible Sigmoidoscope and a traditional fiberoptic flexible Sigmoidoscope relative to labor and cost analysis. METHODS: Two flexible Sigmoidoscopes, the Vision Sciences Sigmoidoscope using a protective sheath covering requiring removal and replacement between procedures and a conventional flexible Sigmoidoscope requiring meticulous cleaning using a washer and high-level disinfection, were compared. Sigmoidoscope preparation was defined as the average time between the procedures (reprocessing, start to finish) and was measured by an independent nonmedical timekeeper (JG). The parameter recorded was scope reprocessing time. RESULTS: Ten procedures were performed using the sheathed flexible Sigmoidoscope system compared with nine using a conventional Sigmoidoscope. Scope performance and endoscopic visualization for both systems were comparable. The average reprocessing time was 46.8 minutes for the conventional Sigmoidoscope vs . 4.9 minutes for the sheathed Sigmoidoscope ( P
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efficiency and productivity of a sheathed fiberoptic Sigmoidoscope compared with a conventional Sigmoidoscope
Diseases of The Colon & Rectum, 1997Co-Authors: Cristina T Sardinha, Steven D. Wexner, Janice Gilliland, Norma Daniel, Michelle Kroll, Eleanor Lee, Joanne Wexler, Denise Hudzinski, Debbie GlassAbstract:PURPOSE: The aim of this study was to measure and compare time and productivity between a new sheathed flexible Sigmoidoscope and a traditional fiberoptic flexible Sigmoidoscope relative to labor and cost analysis. METHODS: Two flexible Sigmoidoscopes, the Vision Sciences Sigmoidoscope using a protective sheath covering requiring removal and replacement between procedures and a conventional flexible Sigmoidoscope requiring meticulous cleaning using a washer and high-level disinfection, were compared. Sigmoidoscope preparation was defined as the average time between the procedures (reprocessing, start to finish) and was measured by an independent nonmedical timekeeper (JG). The parameter recorded was scope reprocessing time. RESULTS: Ten procedures were performed using the sheathed flexible Sigmoidoscope system compared with nine using a conventional Sigmoidoscope. Scope performance and endoscopic visualization for both systems were comparable. The average reprocessing time was 46.8 minutes for the conventional Sigmoidoscope vs.4.9 minutes for the sheathed Sigmoidoscope ( P <0.0001). The average time saved was 9.5 times greater with the sheathed flexible Sigmoidoscope system than with the conventional Sigmoidoscope. CONCLUSION: The almost tenfold difference in the time saved using the sheathed flexible Sigmoidoscope system represents increased productivity and potentially decreased overall labor cost. By reducing endoscope turnover time, this new sheathed system can reduce or even eliminate the need for backup endoscopes and endoscope washers and potentially allow better use of nursing staff.
A. I. Picon - One of the best experts on this subject based on the ideXlab platform.
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Anastomotic occlusive web following double-stapled anterior resection and fecal diversion
Surgical Endoscopy, 1998Co-Authors: A. I. Picon, J. G. GuillemAbstract:The incidence of occlusive web following stapled anastomosis for curative resection of rectal cancer is unknown and the management of this entity not well defined. A 73-year-old patient underwent a double-stapled anterior resection with a temporary loop ileostomy for a T3,N1 rectal cancer. He received postoperative chemoradiation adjuvant therapy. Prior to ileostomy closure, sigmoidoscopy revealed an anastomotic occlusive web at 10–12 cm from the anal verge. Under monitored sedation, a flexible Sigmoidoscope was inserted per anus and advanced to the level of the occlusive web. Utilizing hydrostatic balloon dilatation, the occlusive web was broken and the bowel lumen was restored. The procedure was performed expeditiously and without complications. Subsequently the patient underwent ileostomy closure and experienced normal bowel movements. Although occlusive webs are uncommon after colorectal anastomosis, this case report describes a safe, effective, and uncomplicated endoscopic procedure that can be performed in patients with anastomotic occlusive web developing after prolonged fecal diversion.
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Anastomotic occlusive web following double-stapled anterior resection and fecal diversion. Presentation and endoscopic management.
Surgical endoscopy, 1998Co-Authors: A. I. Picon, J. G. GuillemAbstract:The incidence of occlusive web following stapled anastomosis for curative resection of rectal cancer is unknown and the management of this entity not well defined. A 73-year-old patient underwent a double-stapled anterior resection with a temporary loop ileostomy for a T3,N1 rectal cancer. He received postoperative chemoradiation adjuvant therapy. Prior to ileostomy closure, sigmoidoscopy revealed an anastomotic occlusive web at 10–12 cm from the anal verge. Under monitored sedation, a flexible Sigmoidoscope was inserted per anus and advanced to the level of the occlusive web. Utilizing hydrostatic balloon dilatation, the occlusive web was broken and the bowel lumen was restored. The procedure was performed expeditiously and without complications. Subsequently the patient underwent ileostomy closure and experienced normal bowel movements. Although occlusive webs are uncommon after colorectal anastomosis, this case report describes a safe, effective, and uncomplicated endoscopic procedure that can be performed in patients with anastomotic occlusive web developing after prolonged fecal diversion.
Eleanor Lee - One of the best experts on this subject based on the ideXlab platform.
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Efficiency and productivity of a sheathed fiberoptic Sigmoidoscope compared with a conventional Sigmoidoscope
Diseases of the Colon & Rectum, 1997Co-Authors: T. Cristina Sardinha, Steven D. Wexner, Janice Gilliland, Norma Daniel, Michelle Kroll, Eleanor Lee, Joanne Wexler, Denise Hudzinski, Debbie GlassAbstract:PURPOSE: The aim of this study was to measure and compare time and productivity between a new sheathed flexible Sigmoidoscope and a traditional fiberoptic flexible Sigmoidoscope relative to labor and cost analysis. METHODS: Two flexible Sigmoidoscopes, the Vision Sciences Sigmoidoscope using a protective sheath covering requiring removal and replacement between procedures and a conventional flexible Sigmoidoscope requiring meticulous cleaning using a washer and high-level disinfection, were compared. Sigmoidoscope preparation was defined as the average time between the procedures (reprocessing, start to finish) and was measured by an independent nonmedical timekeeper (JG). The parameter recorded was scope reprocessing time. RESULTS: Ten procedures were performed using the sheathed flexible Sigmoidoscope system compared with nine using a conventional Sigmoidoscope. Scope performance and endoscopic visualization for both systems were comparable. The average reprocessing time was 46.8 minutes for the conventional Sigmoidoscope vs . 4.9 minutes for the sheathed Sigmoidoscope ( P
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efficiency and productivity of a sheathed fiberoptic Sigmoidoscope compared with a conventional Sigmoidoscope
Diseases of The Colon & Rectum, 1997Co-Authors: Cristina T Sardinha, Steven D. Wexner, Janice Gilliland, Norma Daniel, Michelle Kroll, Eleanor Lee, Joanne Wexler, Denise Hudzinski, Debbie GlassAbstract:PURPOSE: The aim of this study was to measure and compare time and productivity between a new sheathed flexible Sigmoidoscope and a traditional fiberoptic flexible Sigmoidoscope relative to labor and cost analysis. METHODS: Two flexible Sigmoidoscopes, the Vision Sciences Sigmoidoscope using a protective sheath covering requiring removal and replacement between procedures and a conventional flexible Sigmoidoscope requiring meticulous cleaning using a washer and high-level disinfection, were compared. Sigmoidoscope preparation was defined as the average time between the procedures (reprocessing, start to finish) and was measured by an independent nonmedical timekeeper (JG). The parameter recorded was scope reprocessing time. RESULTS: Ten procedures were performed using the sheathed flexible Sigmoidoscope system compared with nine using a conventional Sigmoidoscope. Scope performance and endoscopic visualization for both systems were comparable. The average reprocessing time was 46.8 minutes for the conventional Sigmoidoscope vs.4.9 minutes for the sheathed Sigmoidoscope ( P <0.0001). The average time saved was 9.5 times greater with the sheathed flexible Sigmoidoscope system than with the conventional Sigmoidoscope. CONCLUSION: The almost tenfold difference in the time saved using the sheathed flexible Sigmoidoscope system represents increased productivity and potentially decreased overall labor cost. By reducing endoscope turnover time, this new sheathed system can reduce or even eliminate the need for backup endoscopes and endoscope washers and potentially allow better use of nursing staff.