Review

Authors: Manpreet Singh, Manjula Sharma, Akshay G Nair...

The purpose of this article is to form a basic guide for beginning the cadaver dissection training programs focused on oculoplastic surgical procedures. Ours was a collaborative study between the departments of Ophthalmology and Anatomy in a tertiary care teaching institute. We formed a step-wise approach to begin the cadaver dissection focused on the oculoplastic surgical procedures. The basics of cadaver procurement, processing, and preparation for dissections were described. The operative requirements of trainees, surgical handling of cadavers, and basic oculoplastic surgical steps were discussed. The types of embalming (cadaver preservation process) and steps have been described in detail. We have emphasized the preoperative discussion about the proposed dissections using standard teachings and skull models for easier understanding. Additional helping tools like soft embalming and injectable substances for better intra-dissection understanding (intra-arterial, intravenous and orbital injections) have been described. Post-dissection cadaver handing and soft-tissue disposal protocols have also been described. Overall, the cadaver dissections provide holistic surgical learning for the residents, specialty trainees, and practitioners. This article may act as a basic step-wise guide for starting the cadaver-based oculoplastics lab dissection in various institutes and workshops.

Topics: Cadaver; Dissection; Embalming; Humans; Learning

PubMed: 36018092
DOI: 10.4103/ijo.IJO_3037_21

Review

Authors: Daniel M Costello, Isabel Huntington, Grace Burke...

We conducted a comprehensive review of surgical simulation models used in robotic surgery education. We present an assessment of the validity and cost-effectiveness of virtual and augmented reality simulation, animal, cadaver and synthetic organ models. Face, content, construct, concurrent and predictive validity criteria were applied to each simulation model. There are six major commercial simulation machines available for robot-assisted surgery. The validity of virtual reality (VR) simulation curricula for psychomotor assessment and skill acquisition for the early phase of robotic surgery training has been demonstrated. The widespread adoption of VR simulation has been limited by the high cost of these machines. Live animal and cadavers have been the accepted standard for robotic surgical simulation since it began in the early 2000s. Our review found that there is a lack of evidence in the literature to support the use of animal and cadaver for robotic surgery training. The effectiveness of these models as a training tool is limited by logistical, ethical, financial and infection control issues. The latest evolution in synthetic organ model training for robotic surgery has been driven by new 3D-printing technology. Validated and cost-effective high-fidelity procedural models exist for robotic surgery training in urology. The development of synthetic models for the other specialties is not as mature. Expansion into multiple surgical disciplines and the widespread adoption of synthetic organ models for robotic simulation training will require the ability to engineer scalability for mass production. This would enable a transition in robotic surgical education where digital and synthetic organ models could be used in place of live animals and cadaver training to achieve robotic surgery competency.

Topics: Animals; Cadaver; Clinical Competence; Computer Simulation; Computers; Humans; Robotic Surgical Procedures; Simulation Training

PubMed: 34480323
DOI: 10.1007/s11701-021-01302-8

Authors: Erengül Boduç, Tülay Diken Allahverdi

BACKGROUND

COVID-19 is an important pandemic that affects the whole world. Another branch of the wreckage its devastating effects on the health care system is organ and cadaver donations. This article aimed to raise awareness about cadaver and organ donation during the COVID-19 period, with the support of student opinions.

METHODS

Twelve opinions about cadaver and organ donation during the COVID-19 pandemic were presented to the fourth-, fifth-, and sixth-year students at the Kafkas University Faculty of Medicine. The answers were compared between male and female students using the χ test.

RESULTS

It is seen that the data obtained about cadaver and organ donation are important. In addition, the storage conditions of cadavers and organs, the risk of disease transmission, and the risk of contamination are discussed with striking data.

CONCLUSIONS

It is understood from the obtained data that awareness about cadaver and organ donation is always on the agenda. In particular, conferences and meetings should be held frequently to keep medicine faculty students informed. The handling of COVID-19 has also given a significant impetus to the research throughout.

Topics: Humans; Male; Female; Pandemics; Surveys and Questionnaires; COVID-19; Tissue and Organ Procurement; Students, Medical; Faculty; Cadaver; Health Knowledge, Attitudes, Practice

PubMed: 37032285
DOI: 10.1016/j.transproceed.2023.02.049

Authors: Murat Kocaoglu, Feridun Acar

AIM

To present the configuration of the tentorial venous sinuses, and to determine the optimal incision zone on the tentorium cerebelli.

MATERIAL AND METHODS

This study has been completed with 24 autopsied cadavers. For every cadaver, firstly, supratentorial tissues were removed and tentorial measurements were noted, superior part of the tentorial sinuses was captured, and then infratentorial tissues were removed, and all the sinuses were checked and captured.

RESULTS

Average age of the studied 24 fresh cadavers was 50 years, wherein 4 were females and 20 were males. Tentorial sinus was presented in 87% of the cases, with 45% medial, 33% lateral, and 22% in the middle third of each tentorium half.

CONCLUSION

This study showed the pattern, incidence, location, and distribution of tentorial venous sinuses and tried to find the optimum incision zone by identifying sparse areas for the venous sinuses during transtentorial surgical approaches.

Topics: Male; Female; Humans; Middle Aged; Cranial Sinuses; Dura Mater; Cadaver; Surgical Wound; Head

PubMed: 36482851
DOI: 10.5137/1019-5149.JTN.37725-22.5

Authors: Guglielmo Mantica, Rosario Leonardi, Raquel Diaz...

INTRODUCTION

Recent systematic reviews highlighted increasing use of cadaveric models in the surgical training, but reports on the characteristics of the models and their impact on training are lacking, as well as standardized recommendations on how to ensure the quality of surgical studies. The aim of our survey was to provide an easy guideline that would improve the quality of the studies involving cadavers for surgical training and research.

METHODS

After accurate literature review regarding surgical training on cadaveric models, a draft of the CACTUS guidelines involving 10 different items was drawn. Afterwards, the items were improved by questionnaire uploaded and spread to the experts in the field via Google form. The guideline was then reviewed following participants feedback, ergo, items that scored between 7 and 9 on nine-score Likert scale by 70% of respondents, and between 1 and 3 by fewer than 15% of respondents, were included in the proposed guideline, while items that scored between 1 and 3 by 70% of respondents, and between 7 and 9 by 15% or more of respondents were not. The process proceeded with Delphi rounds until the agreement for all items was unanimous.

RESULTS

In total, 42 participants agreed to participate and 30 (71.4%) of them completed the Delphi survey. Unanimous agreement was almost always immediate concerning approval and ethical use of cadaver and providing brief outcome statement in terms of satisfaction in the use of the cadaver model through a short questionnaire. Other items were subjected to the minor adjustments.

CONCLUSION

'CACTUS' is a consensus-based guideline in the area of surgical training, simulation and anatomical studies and we believe that it will provide a useful guide to those writing manuscripts involving human cadavers.

Topics: Cadaver; Consensus; Delphi Technique; Humans

PubMed: 35429658
DOI: 10.1016/j.ijsu.2022.106619

Review

Authors: John Elfar, Ron Martin Garcia Menorca, Jeffrey Douglas Reed...

Composite bone models are increasingly used in orthopaedic biomechanics research and surgical education-applications that traditionally relied on cadavers. Cadaver bones are suboptimal for many reasons, including issues of cost, availability, preservation, and inconsistency between specimens. Further, cadaver samples disproportionately represent the elderly, whose bone quality may not be representative of the greater orthopaedic population. The current fourth-generation composite bone models provide an accurate reproduction of the biomechanical properties of human bone when placed under bending, axial, and torsional loads. The combination of glass fiber and epoxy resin components into a single phase has enabled manufacturing by injection molding. The high level of anatomic fidelity of the cadaver-based molds and negligible shrinkage properties of the epoxy resin results in a process that allows for excellent definition of anatomic detail in the cortical wall and optimized consistency of features between models. Recent biomechanical studies of composites have validated their use as a suitable substitute for cadaver specimens.

Topics: Biomechanical Phenomena; Bone Substitutes; Cadaver; Epoxy Resins; Equipment Design; Glass; Humans; Lower Extremity; Materials Testing; Orthopedic Procedures; Orthopedics; Research; Upper Extremity

PubMed: 24486757
DOI: 10.5435/JAAOS-22-02-111

Authors: Sandro Beros, Ivo Dobrev, Tahmine S Farahmandi...

OBJECTIVE

To investigate transcranial transmission (TT) and the dampening effect of the skin in patients and cadaver heads.

DESIGN

In patients a pure tone bone conduction audiogram for ipsilateral and contralateral stimulation was performed. The TT was defined as the difference between ipsilateral and contralateral hearing thresholds. In cadaver heads ipsilateral and contralateral promontory motion was measured using a three-dimensional Laser Doppler Vibrometer system.

STUDY SAMPLE

Seven single-sided deaf patients fitted with a Baha Connect, fifteen single-sided deaf patients without a bone conduction hearing aid and five Thiel-embalmed cadaver heads were included.

RESULTS

The TT decreased with increasing frequency in patients and cadaver heads. No significant difference was seen between patients and cadaver heads. Measurements on patients and cadaver heads showed increasing skin attenuation with increasing frequency. However, the dampening effect was 3-12 dB higher in patients than in cadavers at all frequencies.

CONCLUSION

The TT was not significantly different for patients compared to cadaver heads. The value of promontory motion to estimate TT in patients need to be further evaluated. The skin attenuates a BC stimulus by 10-20 dB in patients and by a smaller amount in cadaver heads, probably due to changes in the properties of the Thiel-conserved skin.

Topics: Bone Conduction; Cadaver; Hearing; Hearing Aids; Humans; Sound; Vibration

PubMed: 34097554
DOI: 10.1080/14992027.2021.1903586

Authors: Toshiaki Shichinohe, Hiroshi Date, Satoshi Hirano...

The "Guidelines for Cadaver Dissection in Education and Research of Clinical Medicine" drafted by the Japan Surgical Society (JSS) and the Japanese Association of Anatomists in 2012 helped dispel legal concerns over cadaver surgical training (CST) and the usage of donated human bodies for research and development (R&D) in the country. Subsequently, in the fiscal year 2018, the Ministry of Health, Labour and Welfare increased the funding for CST, prompting its wider implementation. This study analyzed data obtained in 2012-2021 through the reporting system of the JSS-CST Promotion Committee to map the usage of cadavers for clinical purposes, specifically education and R&D, in Japan. We found that the number of medical universities using cadavers for CST and R&D programs was just 5 in 2012, and it reached 38 for the decade. Thus, about half of Japan's medical universities implemented such programs over the period. Meanwhile, the total number of programs was 1,173. In the clinical field, the highest number of programs were implemented in orthopedics (27%), followed by surgery (21%), and neurosurgery (12%). Based on the purpose, the most common objective of the programs (approximately 70%) was acquiring advanced surgical techniques. Further, the highest number of programs and participants were recorded in 2019 (295 programs, 6,537 participants). Thus, the guidelines helped expand cadaver usage for clinical purposes in Japan. To further promote the clinical usage of cadavers in medical and dental universities throughout Japan, sharing know-how on operating cadaver laboratories and building understanding among the general public is recommended.

Topics: Anatomists; Cadaver; Dissection; Education, Medical; Humans; Japan

PubMed: 35380362
DOI: 10.1007/s12565-022-00659-6

Authors: Beom Suk Kim, Im Joo Rhyu, Dong Hwee Kim...

Ultrasound (US) is commonly used to evaluate ulnar nerve instability (UNI) and snapping of the medial head of the triceps brachii muscle (ST). We aimed to determine the diagnostic accuracy of US in evaluating UNI, through cadaveric dissection, and to evaluate the US features and relationships of UNI and ST according to elbow flexion. Dynamic US was performed with elbow extension, 90° flexion, and full flexion positions on 18 elbows from 9 fresh cadavers. UNI was classified into N (normal), S (subluxation), and D (dislocation) types. On US exams, the following findings and parameters were evaluated: the presence of UNI and ST; the horizontal distance from the apex of the medial epicondyle (ME) to the margins of the UN and medial head of the triceps brachii muscle (ME_UN and ME_TB, respectively); cross-sectional area and flattening ratio (FR) of UN. After US, all cadavers were dissected to expose the UN and TB, and elbow flexion and extension were simulated to confirm UNI and ST. The gross anatomic findings of UNI and ST were consistent with the US findings. In extension and 90° flexion positions, all cases were type N. In full flexion position, types N and S occurred in 10 (56%) and 8 (44%) elbows, respectively. FR and ME_UN in 90° flexion position, FR, ME_UN, and ME_TB in full flexion position differed significantly between types S and N. Positive correlations were found between ME_UN and ME_TB in 90° flexion and full flexion positions. Dynamic US accurately assessed UNI and ST. UNI was positively correlated to medial TB movement.

Topics: Humans; Elbow; Ulnar Nerve; Elbow Joint; Arm; Joint Dislocations; Cadaver

PubMed: 36749280
DOI: 10.1097/MD.0000000000032835

Review

Authors: Qing-Qing Xiang, Li-Fang Chen, Qin Su...

The postmortem interval (PMI) estimation is a key and difficult point in the practice of forensic medicine, and forensic scientists at home and abroad have been searching for objective, quantifiable and accurate methods of PMI estimation. With the development and combination of high-throughput sequencing technology and artificial intelligence technology, the establishment of PMI model based on the succession of the microbial community on corpses has become a research focus in the field of forensic medicine. This paper reviews the technical methods, research applications and influencing factors of microbial community in PMI estimation explored by using high-throughput sequencing technology, to provide a reference for the related research on the use of microbial community to estimate PMI.

Topics: Humans; Postmortem Changes; Artificial Intelligence; Autopsy; Cadaver; Microbiota

PubMed: 37859480
DOI: 10.12116/j.issn.1004-5619.2022.420606