Robin Sawaya1, Abdulgadir Bugdadi1,2, Hamed Azarnoush1,3, Alexander Winkler-Schwartz1, Fahad E Alotaibi1,4, Khalid Bajunaid1,5, Gmaan A AlZhrani1,4, Ghusn Alsideiri1,6, Abdulrahman J Sabbagh1,4,7, Rolando F Del Maestro1. 1. Neurosurgical Simulation Research and Training Centre, Department of Neurosurgery, Montréal Neurological Institute and Hospital, McGill University, Montréal, Québec, Canada. 2. Department of Surgery, Faculty of Medicine, Umm Al-Qura University, Makkah Almukarramah, Saudi Arabia. 3. Department of Biomedical Engineering, Amirkabir University of Technology (Tehran Polytechnic), Tehran, Iran. 4. Department of Neurosurgery, National Neuroscience Institute, King Fahad Medical City, Riyadh, Saudi Arabia. 5. Division of Neurosurgery, Faculty of Medicine, University of Jeddah, Saudi Arabia. 6. Department of Surgery, College of Medicine, Sultan Qaboos University, Muscat, Oman. 7. Division of Neurosurgery, Department of Surgery, Faculty of Medicine and Clinical Skill and Simulation Center, King Abdulaziz University, Jeddah, Saudi Arabia.
Abstract
BACKGROUND: The force pyramid is a novel visual representation allowing spatial delineation of instrument force application during surgical procedures. In this study, the force pyramid concept is employed to create and quantify dominant hand, nondominant hand, and bimanual force pyramids during resection of virtual reality brain tumors. OBJECTIVE: To address 4 questions: Do ergonomics and handedness influence force pyramid structure? What are the differences between dominant and nondominant force pyramids? What is the spatial distribution of forces applied in specific tumor quadrants? What differentiates "expert" and "novice" groups regarding their force pyramids? METHODS: Using a simulated aspirator in the dominant hand and a simulated sucker in the nondominant hand, 6 neurosurgeons and 14 residents resected 8 different tumors using the CAE NeuroVR virtual reality neurosurgical simulation platform (CAE Healthcare, Montréal, Québec and the National Research Council Canada, Boucherville, Québec). Position and force data were used to create force pyramids and quantify tumor quadrant force distribution. RESULTS: Force distribution quantification demonstrates the critical role that handedness and ergonomics play on psychomotor performance during simulated brain tumor resections. Neurosurgeons concentrate their dominant hand forces in a defined crescent in the lower right tumor quadrant. Nondominant force pyramids showed a central peak force application in all groups. Bimanual force pyramids outlined the combined impact of each hand. Distinct force pyramid patterns were seen when tumor stiffness, border complexity, and color were altered. CONCLUSION: Force pyramids allow delineation of specific tumor regions requiring greater psychomotor ability to resect. This information can focus and improve resident technical skills training.
BACKGROUND: The force pyramid is a novel visual representation allowing spatial delineation of instrument force application during surgical procedures. In this study, the force pyramid concept is employed to create and quantify dominant hand, nondominant hand, and bimanual force pyramids during resection of virtual reality brain tumors. OBJECTIVE: To address 4 questions: Do ergonomics and handedness influence force pyramid structure? What are the differences between dominant and nondominant force pyramids? What is the spatial distribution of forces applied in specific tumor quadrants? What differentiates "expert" and "novice" groups regarding their force pyramids? METHODS: Using a simulated aspirator in the dominant hand and a simulated sucker in the nondominant hand, 6 neurosurgeons and 14 residents resected 8 different tumors using the CAE NeuroVR virtual reality neurosurgical simulation platform (CAE Healthcare, Montréal, Québec and the National Research Council Canada, Boucherville, Québec). Position and force data were used to create force pyramids and quantify tumor quadrant force distribution. RESULTS: Force distribution quantification demonstrates the critical role that handedness and ergonomics play on psychomotor performance during simulated brain tumor resections. Neurosurgeons concentrate their dominant hand forces in a defined crescent in the lower right tumor quadrant. Nondominant force pyramids showed a central peak force application in all groups. Bimanual force pyramids outlined the combined impact of each hand. Distinct force pyramid patterns were seen when tumor stiffness, border complexity, and color were altered. CONCLUSION: Force pyramids allow delineation of specific tumor regions requiring greater psychomotor ability to resect. This information can focus and improve resident technical skills training.
Authors: Recai Yilmaz; Alexander Winkler-Schwartz; Nykan Mirchi; Aiden Reich; Sommer Christie; Dan Huy Tran; Nicole Ledwos; Ali M Fazlollahi; Carlo Santaguida; Abdulrahman J Sabbagh; Khalid Bajunaid; Rolando Del Maestro Journal: NPJ Digit Med Date: 2022-04-26
Authors: Alessandro Iop; Victor Gabriel El-Hajj; Maria Gharios; Andrea de Giorgio; Fabio Marco Monetti; Erik Edström; Adrian Elmi-Terander; Mario Romero Journal: Sensors (Basel) Date: 2022-08-14 Impact factor: 3.847