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Annals of Anatomy = Anatomischer... Dec 2014A survey was conducted to test three hypotheses: anatomists believe that dissection by students conveys not just anatomical knowledge but also essential skills and...
A survey was conducted to test three hypotheses: anatomists believe that dissection by students conveys not just anatomical knowledge but also essential skills and attitudes, including professionalism; anatomists approve of the donation of their own bodies or body parts/organs for medical/health-care training and research; attitudes towards body dissection and donation are not dependent upon gender or upon the extent of teaching experience, but are related to transcendental convictions relating to beliefs in the afterlife. Eighty-one anatomists, from 29 countries responded to the survey; 80% indicated that they required medical/health-care students to dissect human cadavers (60% females-86% males, p=0.02). Most teachers recorded that dissection was an instrument for training undergraduate students, an instrument for the development of professional skills, and an instrument to help to control emotions in the future doctor rather than being only a means of teaching/learning anatomy facts. Males were more receptive to the concept that dissection helps to control emotions in the future doctor (p=0.02). Most teachers (75%) said they were willing to donate their bodies, 41% saying they would donate body organs only, 9% would donate their entire bodies only, 25% would separately donate organs and also the entire body. The willingness to donate increased significantly with the years of teaching experience (p=0.04). Teachers who were not believers in the afterlife were more likely to donate their organs/bodies than were believers (p=0.03). Our findings showed that anatomists' attitudes towards body dissection and donation are dependent upon gender, upon the extent of teaching experience, and upon transcendental convictions.
Topics: Anatomy; Attitude of Health Personnel; Attitude to Death; Cadaver; Data Collection; Directed Tissue Donation; Dissection; Employment; Faculty, Medical; Internationality; Sex Distribution
PubMed: 25048843
DOI: 10.1016/j.aanat.2014.06.004 -
Journal of Laparoendoscopic & Advanced... Mar 2010The aim of this study was to examine mechanical, microbiologic, and morphologic changes of the appendicle rim to assess if it is appropriate to dissect the appendix with...
BACKGROUND
The aim of this study was to examine mechanical, microbiologic, and morphologic changes of the appendicle rim to assess if it is appropriate to dissect the appendix with the ultrasound-activated scalpel (UAS) during laparoscopic appendectomy.
MATERIALS AND METHODS
After laparoscopic resection of the appendix, using conventional Roeder slings, we investigated 50 appendicle rims with an in vitro procedure. The overall time of dissection of the mesoappendix with UAS was noted. Following removal, the appendix was dissected in vitro with the UAS one cme from the resection rim. Seal-burst pressures were recorded. Bacterial cultures of the UAS-resected rim were compared with those of the scissors resected rim. Tissue changes were quantified histologically with hematoxylin and eosin (HE) stains.
RESULTS
The average time to dissect the mesoappendix was 228 seconds (25-900). Bacterial culture growths were less in the UAS-resected probes (7 versus 36 positive probes; (p > 0.01). HE-stained tissues revealed mean histologic changes in the lamina propria muscularis externa of 2 mm depth. The seal-burst pressure levels of the appendicle lumen had a mean of 420 mbar. Seal-burst pressures and depths of histologic changes were not dependent on the different stages of appendicitis investigated, gender, or age groups. Seal-burst pressure levels were not related to different depths of tissue changes (P = 0.64).
CONCLUSIONS
The UAS is a rapid instrument for laparoscopic appendectomy and appears to be safe with respect to stability, sterility and tissue changes. It avoids complex time consuming instrument change manoeuvres and current transmission, which may induce intra- and postoperative complications. Our results suggest that keeping a safety margin of at least 5 mm from the bowel would be sufficient to avoid thermal damage.
Topics: Adolescent; Analysis of Variance; Appendectomy; Appendicitis; Child; Child, Preschool; Dissection; Female; Humans; Laparoscopy; Male; Prospective Studies; Surgical Instruments; Ultrasonics
PubMed: 19943784
DOI: 10.1089/lap.2009.0028 -
Clinical Anatomy (New York, N.Y.) Mar 2012Human dissection continues to be strongly argued for teaching human anatomy to medical students and is technically and emotionally demanding. An orientation to...
Human dissection continues to be strongly argued for teaching human anatomy to medical students and is technically and emotionally demanding. An orientation to dissection and the laboratory are provided for students before beginning their work because students' and families' reactions to dissection are often complex. This study explored medical students' experiences of attending an orientation to human dissection and the anatomy laboratory. Students' reactions, feelings, and thoughts were enquired about 1 year after beginning dissection at the University of Auckland, New Zealand. Qualitative research methods, specifically one-on-one semistructured interview were utilized. Third-year medical students self-selected into the study and were interviewed 1 year after entering the laboratory. Transcribed audiotapes of the interviews were analyzed for themes across the interviews. One year after dissection students have vivid memories with differing ways of viewing the body that may help or hinder with dissection. The themes presented include orientation, student anticipation, psychological approach to the body, normalizing-continuing disquiet, and social reference. The orientation eases student entry into the laboratory. There can be ongoing feelings of ambivalence regards the body for some students. Novel findings include that students not only have their own feelings to deal with but also those of friends and family who question them and may feel uncomfortable with the idea of them dissecting. Even one year after beginning dissection, students may emotionally struggle with their work and may require further support, including how they talk about sensitive topics with other people.
Topics: Anatomy; Attitude; Dissection; Education, Medical, Undergraduate; Female; Humans; Male; Orientation
PubMed: 21815220
DOI: 10.1002/ca.21244 -
Acta Medico-historica Adriatica : AMHA 2014Judging from his writings, Andreas Vesalius must have had dozens of bodies at his disposal, thirteen of which were definitely from before 1543. They came from...
Judging from his writings, Andreas Vesalius must have had dozens of bodies at his disposal, thirteen of which were definitely from before 1543. They came from cemeteries, places of execution or hospitals. Not only did his students help him obtain the bodies, but also public and judicial authorities. At first, he used the corpses for his own learning purposes, and later to teach his students and to write De humani corporis fabrica, his principal work. Clearly he had an eye for comparative anatomy. He observed anatomical variants and studied foetal anatomy. Occasionally, he would dissect a body to study physiological processes, while the post-mortems on the bodies brought in by the families of the deceased gave him an insight into human pathology. Some of his dissection reports have been preserved.
Topics: Autopsy; Cadaver; Dissection; History, 16th Century; Medical Illustration; Netherlands; Physicians
PubMed: 25310608
DOI: No ID Found -
The Surgical Clinics of North America Jun 1996There is little doubt that laparoscopic herniorrhaphy has assumed a place in the pantheon of hernia repair. There is also little doubt that further work needs to be done... (Review)
Review
There is little doubt that laparoscopic herniorrhaphy has assumed a place in the pantheon of hernia repair. There is also little doubt that further work needs to be done to determine the exact role that laparoscopic hernia repair should play in the surgical armamentarium. Hernias have been surgically treated since the early Greeks. In contrast, laparoscopic hernia repair has a history of only 6 years. Even within that short time, laparoscopic hernia repair techniques have not remained unchanged. This is obviously a technique in evolution, as indicated by the abandonment of early repairs ("plug and mesh" and IPOM) and the gradual gain in pre-eminence of the TEP repair. During the same time frame, surgery itself has evolved into a discipline more concerned with cost-effectiveness, outcomes, and "consumer acceptance." Confluence of these two developments has led to a situation in which traditional concerns regarding surgical procedures (i.e., recurrence rates or complication rates) assume less of a role than cost-effectiveness, learnability, marketability, and medical-legal considerations. No surgeon, whether practicing in a academic setting or a private practice, is exempt from these pressures. Laparoscopic hernia repair therefore seems to fit into a very specialized niche. In our community, the majority of general surgeons are only too happy to not do laparoscopic hernia repairs. On the other hand, in our experience, certain indications do seem to cry out for a laparoscopic approach. At our own center we have found that laparoscopic repairs can indeed be effective, and even cost-effective, under specific circumstances. These include completing a minimal learning curve, utilizing the properitoneal approach, minimizing the use of reusable instruments, using dissecting balloons as a time-saving device, and very specific patient selection criteria. At present these include patients with bilateral inguinal hernias on clinical examination, patients with recurrent unilateral or bilateral hernias, and patients who, because of economic pressures, must return to work within 10 days of surgery. Within these limitations we feel that the laparoscopic approach definitely has a place in repair of inguinal hernias. In the future new techniques, decreased equipment costs, and the ability to use local anesthesia may increase the applicability of laparoscopic herniorrhaphy.
Topics: Anesthesia, Local; Consumer Behavior; Cost-Benefit Analysis; Dissection; Hernia, Inguinal; Humans; Laparoscopy; Length of Stay; Patient Selection; Recurrence; Treatment Outcome
PubMed: 8669008
DOI: 10.1016/s0039-6109(05)70455-2 -
Acta Neurochirurgica Jul 2004Waterjet dissection is under close investigation as a new neurosurgical tool. Experimentally, a precise tissue dissection with vessel preservation has been demonstrated... (Comparative Study)
Comparative Study
Waterjet dissection is under close investigation as a new neurosurgical tool. Experimentally, a precise tissue dissection with vessel preservation has been demonstrated in the porcine cadaver brain. The safety of the device has been shown in first clinical applications. However, a detailed in-vivo analysis of the waterjet device is still awaited. In the present study, two often applied nozzle types (100 microm diameter emitting a coherent straight jet; 120 microm diameter emitting a helically rotating jet) were experimentally studied in vivo. Forty-one rabbits received a frontal waterjet corticotomy on either side with one nozzle type after microsurgical removal of the arachnoid membranes. Animals were sacrificed at 1, 3, 7 days and 6 weeks after surgery. Dissection morphology and vessel preservation were evaluated. Tissue trauma was analyzed by the extent of intra-operative haemorrhage, postsurgical oedema formation and astrocytic as well as microglial reactions. In all animals, reliable brain dissection was observed. Macroscopically, only minor bleeding occurred. Microscopically, also very precise brain dissection with both nozzle types was found. Vessels were preserved with both pressures applied (5 and 10 bar). Dissections with the 100 microm straight nozzle were more precise with respect to dissection margins. However, no significant difference in vessel preservation and extent of haemorrhage, oedema formation, astrocytic and microglial reactivity was shown. Malfunction defined as clotting of the instrument occurred only with the 100 microm nozzle. In four 100 microm straight nozzle hemispheres, even no brain dissection was seen. The results indicate that the waterjet enables very precise and reliable brain parenchyma dissection with minimal trauma and vessel preservation in vivo. If this can be proven to be of clinical relevance, the instrument will become a valuable neurosurgical tool. Based on these results, the authors selected the 120 microm Helix nozzle for further research with this device in the CNS.
Topics: Animals; Astrocytes; Blood Loss, Surgical; Brain; Brain Edema; Dissection; Equipment Design; Male; Microglia; Rabbits; Reproducibility of Results; Subarachnoid Hemorrhage; Water
PubMed: 15197615
DOI: 10.1007/s00701-004-0265-9 -
Scientific Reports Jan 2018The aim of this study was to evaluate the feasibility of a novel bracing basket for Endoscopic submucosal tunnel dissection (ESTD), which was developed for improved...
The aim of this study was to evaluate the feasibility of a novel bracing basket for Endoscopic submucosal tunnel dissection (ESTD), which was developed for improved effectiveness and ease of use. This was a prospective randomized, comparative, experimental animal study carried out at a single center. The primary aim was to evaluate the efficacy of ESTD with a novel bracing basket, compared with conventional ESTD. The secondary aims were to assess the quality control of the procedures and adverse events. Twenty procedures (6 esophageal and 14 gastric) were performed in four pigs. All resections were completed as en bloc resections. The technical success rate was 100% for both techniques (bracing basket-assisted ESTD vs. conventional ESTD). The procedure times were similar, but the cutting speed was quicker with bracing basket-assisted ESTD in gastric (antrum:23.3 ± 2.2 mm/min vs. 15.2 ± 3.2 mm/min, body: 26.1 ± 1.3 mm/min vs. 18.4 ± 2.0 mm/min, p < 0.05). There was one bleeding in the bracing basket-assisted ESTD group and one perforation in the conventional ESTD group. Compared with conventional ESTD, the use of this basket has potential advantages. Comparison studies with larger gastric or colorectal lesions treated with conventional ESTD are needed.
Topics: Animals; Dissection; Endoscopy; Models, Animal; Surgery, Computer-Assisted; Swine
PubMed: 29348662
DOI: 10.1038/s41598-018-19203-6 -
Anatomical Sciences Education 2015At the University of Texas Houston Medical School, a rotational dissection system was introduced to improve coordination between the Gross Anatomy and the Introduction... (Comparative Study)
Comparative Study
At the University of Texas Houston Medical School, a rotational dissection system was introduced to improve coordination between the Gross Anatomy and the Introduction to Clinical Medicine (ICM) courses. Six students were assigned to each cadaver and divided into two teams. For each laboratory, one team was assigned to dissect and the other to attend ICM or study independently. For the next laboratory, the assignments were reversed. At the start of the session, the team that had dissected previously spent 30 minutes teaching the other team. In 2012, the students were given three traditional practical examinations with 50 questions drawn equally from each laboratory. Students also completed three mid-course evaluations. There were no significant differences in overall performance between the two teams. Nevertheless, we wanted to determine how well individual students identified structures they had dissected compared with those they had not. For dissected structures, the mean percent correct was 80.0 ± 13.0 (mean ± standard deviation), and for undissected structures, it was 78.3 ± 14.1. The difference was small, but statistically significant (P = 0.0007). Although this result validated the concerns expressed by some students, it did not appear that a change in the system was justified. Students were generally enthusiastic about the opportunity to learn clinical skills in the first semester of medical school, and 91-96% of the students agreed that learning anatomy at the same time helped them understand the physical examination exercises in ICM.
Topics: Anatomy; Cadaver; Comprehension; Curriculum; Dissection; Education, Medical, Undergraduate; Educational Measurement; Educational Status; Female; Humans; Learning; Male; Program Evaluation; Schools, Medical; Students, Medical; Surveys and Questionnaires; Teaching; Texas; Young Adult
PubMed: 25358463
DOI: 10.1002/ase.1497 -
BMC Research Notes Jun 2020Dorsal root ganglia (DRG) are heterogeneous assemblies of assorted sensory neuron cell bodies found in bilateral pairs at every level of the spinal column....
OBJECTIVE
Dorsal root ganglia (DRG) are heterogeneous assemblies of assorted sensory neuron cell bodies found in bilateral pairs at every level of the spinal column. Pseudounipolar afferent neurons convert external stimuli from the environment into electrical signals that are retrogradely transmitted to the spinal cord dorsal horn. To do this, they extend single axons from their DRG-resident somas that then bifurcate and project both centrally and distally. DRG can be dissected from mice at embryonic stages and any age post-natally, and have been extensively used to study sensory neuron development and function, response to injury, and pathological processes in acquired and genetic diseases. We have previously published a step-by-step dissection method for the rapid isolation of post-natal mouse DRG. Here, the objective is to extend the protocol by providing training videos that showcase the dissection in fine detail and permit the extraction of ganglia from defined spinal levels.
RESULTS
By following this method, the reader will be able to swiftly and accurately isolate specific lumbar, thoracic, and cervical DRG from mice. Dissected ganglia can then be used for RNA/protein analyses, subjected to immunohistochemical examination, and cultured as explants or dissociated primary neurons, for in-depth investigations of sensory neuron biology.
Topics: Animals; Dissection; Female; Ganglia, Spinal; Guidelines as Topic; Mice; Mice, Inbred C57BL; Video Recording
PubMed: 32580748
DOI: 10.1186/s13104-020-05147-6 -
Clinical Anatomy (New York, N.Y.) 1996The gross anatomy course at St. Louis University School of Medicine consists of 40 regions or units covering the entire body and utilizes peer teaching in which students...
The gross anatomy course at St. Louis University School of Medicine consists of 40 regions or units covering the entire body and utilizes peer teaching in which students do every fourth dissection. One-fourth of the students learn each unit by dissecting; three-fourths learn from predissected material. Four multiple choice tests were studied to determine whether students scored better on questions on units they dissected than those who learned from predissected material. Results were adjusted on the basis of students' scores on whole tests. There were four teams of students and four tests resulting in 16 sets of questions. Dissectors scored better than nondissectors in 13 sets, but the overall differences were small (67.80 vs. 66.70). It is concluded that there is a small advantage gained from dissecting and demonstrating to their peers, but that learning from dissected cadavers is a satisfactory method of study, since our students traditionally score above the national average on the anatomy portion of the National Board Examination.
Topics: Anatomy; Cadaver; Dissection; Education, Medical; Humans; Students, Medical; Teaching
PubMed: 8838283
DOI: 10.1002/(SICI)1098-2353(1996)9:1<57::AID-CA12>3.0.CO;2-9