Publications
563 results found
Manasnayakorn S, Khan F, Levison RA, et al., 2009, Influence of compression pressure from the hand access device on hand microcirculation during hand-assisted laparoscopic surgery, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 23, Pages: 1070-1074, ISSN: 0930-2794
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- Citations: 1
Manasnayakorn S, Cuschieri A, Hanna GB, 2009, Ergonomic assessment of optimum operating table height for hand-assisted laparoscopic surgery, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 23, Pages: 783-789, ISSN: 0930-2794
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- Citations: 36
Fakhry M, Bello F, Hanna GB, 2009, A Real-Time Compliance Mapping System Using Standard Endoscopic Surgical Forceps, IEEE TRANSACTIONS ON BIOMEDICAL ENGINEERING, Vol: 56, Pages: 1245-1253, ISSN: 0018-9294
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- Citations: 8
Talebpour M, Alijani A, Hanna GB, et al., 2009, Proficiency-gain curve for an advanced laparoscopic procedure defined by observation clinical human reliability assessment (OCHRA), SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 23, Pages: 869-875, ISSN: 0930-2794
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- Citations: 28
Lee ACH, Elson DS, Neil MA, et al., 2009, Solid-state semiconductors are better alternatives to arc-lamps for efficient and uniform illumination in minimal access surgery., Surg Endosc, Vol: 23, Pages: 518-526
INTRODUCTION: Current arc-lamp illumination systems have a number of technical and ergonomic limitations. White light-emitting diodes (LEDs) are energy-efficient solid-state lighting devices which are small, durable and inexpensive. Their use as an alternative to arc-lamp light sources in minimal access surgery has not been explored. This study aims to develop an LED-based endo-illuminator and to determine its lighting characteristics for use in minimal access surgery. METHODS: We developed an LED endo-illuminator using a white LED mounted at the tip of a steel rod. Offline image analysis was carried out to compare the illuminated field using the LED endo-illuminator or an arc-lamp based endoscope in terms of uniformity, shadow sharpness and overall image intensity. Direct radiometric power measurements in light intensity and stability were obtained. Visual perception of fine details at the peripheral endoscopic field was assessed by 13 subjects using the different illumination systems. RESULTS: Illumination from the LED endo-illuminator was more uniform compared to illumination from an arc-lamp source, especially at the closer distance of 4 cm (0.0006 versus 0.0028 arbitrary units--lower value indicates more uniform illumination). The shadows were also sharper (edge widths of 16 versus 44 pixels for the first edge and 15 versus 61 pixels for the second edge). The overall mean image intensity was higher (127 versus 100 arbitrary units) when using the autoshutter mode despite the lower direct radiometric power, about one tenth of the arc-lamp endoscopic system. The illumination was also more stable with less flickering (0.02% versus 5% of total power in non-DC components). Higher median scores on visual perception was also obtained (237 versus 157, p < 0.001). CONCLUSION: The LED endo-illuminator provides more uniform illumination with sharper shadows, less flickering and better illumination for visual perception than the arc-lamp-based system currently used.
Lee ACH, Elson DS, Neil MA, et al., 2009, Solid-state semiconductors are better alternatives to arc-lamps for efficient and uniform illumination in minimal access surgery, Scientific Congress of the Royal-College-of-Surgeons-of-Edinburgh/College-of-Surgeons-of-Hong-Kong (RCSED/CSHK), Publisher: SPRINGER, Pages: 518-526, ISSN: 0930-2794
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- Citations: 19
Fakhry M, Gallagher B, Bello F, et al., 2009, Visual exposure using single-handed magnet-driven intra-abdominal wireless camera in minimal access surgery, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 23, Pages: 539-543, ISSN: 0930-2794
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- Citations: 14
Ahmed K, Nagpal K, Aggarwal R, et al., 2009, Observational tools for assessment of technical skills – a systematic review, Society of Academic and Research Surgery
Rao C, Haycock A, Zacharakis E, et al., 2009, Economic analysis of esophageal stenting for management of malignant dysphagia, DIS ESOPHAGUS, Vol: 22, Pages: 337-347, ISSN: 1120-8694
Boshier P, Priest O, Hanna G, et al., 2009, Influence of Respiratory Manoeuvres on the On-Line Detection of Volatile Organic Compounds (VOCs) in Exhaled Breath by PTR-MS and SIFT-MS., AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 179, ISSN: 1073-449X
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- Citations: 2
Boshier PR, Hanna GB, Marczin N, 2009, Influence of CO2-Triggered "Alveolar" Breath Sampling on the Concentrations of Exhaled Volatile Organic Compounds (VOCs)., AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, Vol: 179, ISSN: 1073-449X
Floume T, Syms RRA, Darzi AW, et al., 2009, Broadband transmission spectroscopy in tissue, application to radiofrequency tissue fusion, Conference on Optical Sensors, Publisher: SPIE-INT SOC OPTICAL ENGINEERING, ISSN: 0277-786X
Hanna GB, Cuschieri A, 2008, Ergonomics of task performance in endoscopic surgery, Endoscopic Surgery in Infants and Children, Pages: 39-50, ISBN: 9783540001157
Ergonomics is the scientific study of people at work in terms of workplace layout, equipment design, the work environment, safety, productivity and training. Ergonomics is based on multiple disciplines such as anatomy, physiology, psychology and engineering combined in a systems approach. The ergonomic approach has been used in industry and the military to improve the safety and productivity of the work environment. By contrast in surgical practice, morbidity and mortality are used as an index of safety but this approach does not address adequately the causation of surgical complications or the measures that increase efficient delivery of surgical care. Since 1995 there has been widespread use of endoscopic surgical techniques in almost all surgical specialities, and the laparoscopic approach has become the gold standard management of many surgical disorders. Both industry and surgeons have responded positively to the new endoscopic era. The medical technology industry has developed and marketed a whole range of new endoscopic instrumentation and video equipment, while surgeons have developed or modified existing techniques and, more recently, instituted measures to audit the benefit, safety and impact of the new endoscopic surgical management. This rapid advancement of endoscopic surgery has encountered and still faces some problems. Most of the endoscopic equipment and instruments in current usage are adaptations from other areas of technology and from open surgery without adequate considerations to the demands of endoscopic techniques. The ergonomic layout of the current operating theatres, designed for conventional open practice, is also not ideal for the needs of endoscopic surgery where a variety of high technology ancillary devices are necessary for the conduct of endoscopic interventions. Despite the increasing complexity of these technologies used in the operating theatre, ergonomic progress and design has laggednnn behind these developments. Only a few sur
Floume T, Syms RRA, Darzi AW, et al., 2008, Real-time optical monitoring of radio-frequency tissue fusion by continuous wave transmission spectroscopy, JOURNAL OF BIOMEDICAL OPTICS, Vol: 13, ISSN: 1083-3668
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- Citations: 13
Lee ACH, Fahmy RRR, Hanna GB, 2008, Objective Evidence for Optimum Knot Configuration, International Surgical Week Conference, Publisher: SPRINGER, Pages: 2736-2741, ISSN: 0364-2313
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- Citations: 11
Lee ACH, Fahmy RRR, Hanna GB, 2008, Objective evidence for optimum knot configuration., World J Surg, Vol: 32, Pages: 2736-2741, ISSN: 0364-2313
BACKGROUND: The knot configurations used in clinical practice often are based on tradition and previous training. This study was designed to test the hypothesis that knot quality improves with the addition of a single throw in two-throw and three-throw knots. We tested this hypothesis by using commonly used knot configurations and suture materials. METHODS: Three suture materials, SURGIPRO, BIOSYN and POLYSORB, of 3-0 caliber were used. The break force and integrated force of each material, a single-hitch throw on each material, and 2160 knots of six configurations were measured by using tensiometry. The knot quality scores (KQS) of the different knot configurations were compared by using nonparametric tests. RESULTS: A single-hitch throw on the suture material reduced the break force by up to 40%. The addition of an extra throw improved KQS in 2 x 1 x 1, 2 x 2, and 2 x 2 x 1 knots. The four-throw knot configurations resulted in high KQS and low slippage rates. The 2 x 2 knots were most likely to slip and had the lowest KQS. CONCLUSIONS: If a double-hitch throw is used in the first throw, two to three further throws are recommended. The four-throw knot configurations have the best knot qualities and should generally be used.
Nadeau VJ, Elson DS, Hanna GB, et al., 2008, Modelling of a laser-pumped light source for endoscopic surgery, ISSN: 0277-786X
A white light source, based on illumination of a yellow phosphor with a fibre-coupled blue-violet diode laser, has been designed and built for use in endoscopic surgery. This narrow light probe can be integrated into a standard laparoscope or inserted into the patient separately via a needle. We present a Monte Carlo model of light scattering and phosphorescence within the phosphor/silicone matrix at the probe tip, and measurements of the colour, intensity, and uniformity of the illumination. Images obtained under illumination with this light source are also presented, demonstrating the improvement in illumination quality over existing endoscopic light sources. This new approach to endoscopic lighting has the advantages of compact design, improved ergonomics, and more uniform illumination in comparison with current technologies. © 2008 SPIE.
Deeba S, Corcoles EP, Hanna GB, et al., 2008, Use of rapid sampling microdialysis for intraoperative monitoring of bowel ischemia (Diseases of the Colon and Rectum DOI: 10.1007/s10350-008-9375-4), Diseases of the Colon and Rectum, Vol: 51, ISSN: 0012-3706
Yakoub D, Fahmy R, Athanasiou T, et al., 2008, Evidence-based choice of esophageal stent for the palliative management of malignant dysphagia, WORLD JOURNAL OF SURGERY, Vol: 32, Pages: 1996-2009, ISSN: 0364-2313
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- Citations: 24
Deeba S, Corcoles EP, Hanna BG, et al., 2008, Use of rapid sampling microdialysis for intraoperative monitoring of bowel ischemia, DISEASES OF THE COLON & RECTUM, Vol: 51, Pages: 1408-1413, ISSN: 0012-3706
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- Citations: 36
Lim CBB, Goldin RD, Darzi A, et al., 2008, Characterization of materials eliciting foreign body reaction in stapled human gastrointestinal anastomoses, BRITISH JOURNAL OF SURGERY, Vol: 95, Pages: 1044-1050, ISSN: 0007-1323
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- Citations: 16
Hanna GG, Edgar D, Clarke JEM, 2008, A case of prolonged type 1 hypersensitivity reaction to pegfilgrastim, CLINICAL ONCOLOGY, Vol: 20, Pages: 315-316, ISSN: 0936-6555
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- Citations: 4
Manasnayakorn S, Cuschieri A, Hanna GB, 2008, Ideal manipulation angle and instrument length in hand-assisted laparoscopic surgery, Pages: 924-929, ISSN: 0930-2794
Background: This study aimed to investigate the impact of manipulation angles and instrument length on task performance and muscle workload in hand-assisted laparoscopic surgery. Methods: The standard task was to close a 5-cm enterotomy of porcine small bowel inside a hand-assisted laparoscopic trainer. Surgeons were instructed to place the sutures 3 to 5 mm apart and from the enterotomy edge. Ten surgeons participated in each experiment. In the first experiment, each surgeon performed one task for each of the following manipulation angles: 45°, 60°, 75°, and 90°. In the second experiment, each surgeon performed two sessions of three tasks using either standard-length (330 mm) or short (250 mm) needle holders in the external hand. Outcome measures were execution time (s), placement error score (mm deviation from exact placement), leaking pressure (mmHg), and muscle workload by upper extremities as measured by integrated electromyography (mV s). Results: In the first experiments, the mean execution time was significantly longer with 90° angles than with 45° and 60° manipulation angles (1,074.9 vs 715.9 s and 657.9 s with p < 0.05 and p < 0.01, respectively). The 90° manipulation angle had the greatest muscle workload by the deltoid and trapezius of the extracorporeal and intracorporeal limbs and the extracorporeal dominant arm extensor and flexor groups. In the second experiment, the short instruments had a shorter mean execution time than the standard-length instrument (572.05 vs 618.75 s; p < 0.01). There was less muscle workload with the short than with the standard-length instrument by the extracorporeal dominant forearm extensor and flexor muscle groups and the deltoid of extracorporeal dominant and intracorporeal limbs. There were no significant differences in leaking pressure or placement error score between the different manipulation angles and instrument lengths. The best ergonomic setup in hand-assisted laparoscopic
Manasnayakorn S, Cuschieri A, Hanna GB, 2008, Ideal manipulation angle and instrument length in hand-assisted laparoscopic surgery, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 22, Pages: 924-929, ISSN: 0930-2794
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- Citations: 20
Hanna GB, Drew T, Arnold G, et al., 2008, Development of force measurement system for clinical use in minimal access surgery, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 22, Pages: 467-471, ISSN: 0930-2794
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- Citations: 21
Nadeau VJ, Elson DS, Neil MAA, et al., 2008, Laser-pumped endoscopic illumination source., Annu Int Conf IEEE Eng Med Biol Soc, Vol: 2008, Pages: 2059-2062, ISSN: 2375-7477
Light sources currently employed in endoscopy have a number of disadvantages including inefficiency, high temperature, non-uniform illumination, and the production of shadow-less images. In this paper, we present a novel endoscopic illumination source, based on the use of a blue-violet laser diode in combination with a yellow phosphor for the production of white light. By using this approach, the resulting illumination source is more compact and potentially more ergonomic than those currently used in endoscopy. Spectral measurements of the emitted light indicate that it has a colour similar to that of daylight, and images obtained under illumination with this light source indicate that it provides more uniform illumination and sharper shadows than standard endoscopic light sources.
Nadeau VJ, Elson DS, Neil MAA, et al., 2008, Laser-Pumped Endoscopic Illumination Source, 30th Annual International Conference of the IEEE-Engineering-in-Medicine-and-Biology-Society, Publisher: IEEE, Pages: 2059-+, ISSN: 1557-170X
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- Citations: 7
Fakhry M, Bello F, Hanna GB, 2007, Employing Bending Beam Transducer Design and Statistical Algorithms to Develop a Clinical Real Time Tissue Compliance Mapping System, 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Fakhry M, Bello F, Hanna GB, 2007, Employing bending beam transducer design and statistical algorithms to develop a clinical real time tissue compliance mapping system, Pages: 3064-3068, ISSN: 0589-1019
In keyhole surgery, the use of long surgical instruments inserted through small ports in the body diminishes tactile feedback. Earlier methodologies to overcome this challenge never gained popularity in routine clinical practice due to either major modifications to the design of conventional surgical instruments, or relying on surgeons' subjective interpretation of compliance data that is often inaccurate with crossovers. In this paper we present a real time compliance mapping system which comprises of (i) bending beam transducer design to conventional surgical forceps, (ii) statistical analysis for real time objective interpretation of output signals, and (iii) novel human computer interaction techniques suitable for use in the operative theatre working environment. The system was calibrated and put into clinical practice in four routine human keyhole settings. In a research experiment involving 10 surgeons, the system's tissue discriminatory power was three times more sensitive, and 10% less specific than surgeon's hand. © 2007 IEEE.
Lee ACH, Haddad MJ, Hanna GB, 2007, Influence of instrument size on endoscopic task performance in pediatric intracorporeal knot tying - Smaller instruments are better in infants, SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol: 21, Pages: 2086-2090, ISSN: 0930-2794
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- Citations: 16
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