Framework for detailed workflow analysis and modelling for simulation of multi‐modal image‐guided interventions

Fernández‐Gutiérrez, Fabiola; Barnett, Iain; Taylor, Bruce; Houston, Graeme; Melzer, Andreas

doi:10.1108/17410391311289550

Cited by 14 publications

(13 citation statements)

References 28 publications

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“…The length of time taken to perform the MRI-guided procedures was reduced (minimum procedure time: 6 minutes and 33 seconds) as our experience with the setup increased. Further experience and training with our developed framework of technologies could potentially lead to shorter procedure times in future [22, 32]. …”

Section: Discussionmentioning

confidence: 99%

“…A detailed analysis of the equivalent workflow from the X-Ray angiography suite was conducted according to a protocol that was previously described elsewhere [22]. In this study, two trained interventional radiologists (one consultant and one final year trainee (SpR / Registrar)) and one physician in training performed 39 procedures in 6 sessions.…”

Section: Methodsmentioning

confidence: 99%

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Preclinical feasibility of a technology framework for MRI-guided iliac angioplasty

et al. 2014

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Purpose Interventional MRI has significant potential for image guidance of iliac angioplasty and related vascular procedures. A technology framework with in-room image display, control, communication and MRI-guided intervention techniques was designed and tested for its potential to provide safe, fast and efficient MRI-guided angioplasty of the iliac arteries. Methods A 1.5T MRI scanner was adapted for interactive imaging during endovascular procedures using new or modified interventional devices such as guidewires and catheters. A perfused vascular phantom was used for testing. Pre-, intra- and post-procedural visualization and measurement of vascular morphology and flow was implemented. A detailed analysis of X-Ray fluoroscopic angiography workflow was conducted and applied. Two interventional radiologists and one physician in training performed 39 procedures. All procedures were timed and analyzed. Results MRI-guided iliac angioplasty procedures were successfully performed with progressive adaptation of techniques and workflow. The workflow, setup and protocol enabled a reduction in table time for a dedicated MRI-guided procedure to 6 min 33 s with a mean procedure time of 9 min 2 s, comparable to the mean procedure time of 8 min 42 s for the standard X-Ray guided procedure. Conclusions MRI-guided iliac vascular interventions were found to be feasible and practical using this framework and optimized workflow. In particular the real-time flow analysis was found to be helpful for pre- and post-interventional assessments. Design optimization of the catheters and in vivo experiments are required before clinical evaluation.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Preclinical feasibility of a technology framework for MRI-guided iliac angioplasty

et al. 2014

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“…DES is the method most used for the simulation of operating room workflows [6], [34]. For example, in the domain of intraoperative process optimization, Fernández-Gutiérrez et al used DES methods in order to find the optimal development of new complex procedures in multimodal imaging environments [45] and for resource optimization of medical equipment [46]. Khoshkenar et al used DES to model the traffic flow in the OR for the improvement of the OR layout based on the distance walked by the OR staff [47].…”

Section: State Of the Artmentioning

confidence: 99%

Surgical Workflow Simulation for the Design and Assessment of Operating Room Setups in Orthopedic Surgery

Neumann

Angrick

Höhn

et al. 2020

Preprint

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Abstract Background: The design and internal layout of modern operating rooms (OR) are influencing the surgical team’s collaboration and communication, ergonomics, as well as intraoperative hygiene substantially. Yet, there is no objective method for the assessment and design of operating room setups for different surgical disciplines and intervention types available. The aim of this work is to establish an improved OR setup for common procedures in arthroplasty. Methods With the help of computer simulation, a method for the design and assessment of enhanced OR setups was developed. New OR setups were designed, analyzed in a computer simulation environment and evaluated in the actual intraoperative setting. Thereby, a 3D graphical simulation representation enabled the strong involvement of clinical stakeholders in all phases of the design and decision-making process of the new setup alternatives. Results The implementation of improved OR setups reduced the instrument handover time between the surgeon and the scrub nurse, the travel paths of the OR team as well as shortened the procedure duration. Additionally, the ergonomics of the OR staff were improved. Conclusion The developed simulation method was evaluated in the actual intraoperative setting and proved its benefit for the design and optimization of OR setups for different surgical intervention types. As a clinical result, enhanced setups for total knee arthroplasty and total hip arthroplasty surgeries were established in daily clinical routine and the OR efficiency was improved.

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“…In the domain of intraoperative process optimization, Fernández-Gutiérrez et al used DES methods in order to find the optimal development of new complex procedures in multimodal imaging environments [35] and for resource optimization of medical equipment [36]. Khoshkenar et al used DES to model the traffic flow in the OR for the improvement of the OR layout based on the distance walked by the OR staff [37].…”

Section: State Of the Artmentioning

confidence: 99%

Surgical Workflow Simulation for the Design and Assessment of Operating Room Setups in Orthopedic Surgery

Neumann

Angrick

Höhn

et al. 2019

Preprint

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Abstract Background The design and internal layout of modern operating rooms are influencing the team’s collaboration and communication, ergonomics, as well as intraoperative hygiene substantially. Nevertheless, there is no objective method for the assessment and design of the personnel and table positions for different surgical disciplines and intervention types available. The aim of this work is to establish an improved OR setup for common procedures in arthroplasty. Methods With the help of computer simulation techniques, a method for the objective design and assessment of enhanced OR setups was developed. In this work, new OR setups were designed, analyzed in a computer simulation environment and evaluated in the actual intraoperative setting. Results The implementation of improved OR setups reduces the instrument handover time between the surgeon and the scrub nurse, the travel paths of the OR team as well as shortens the procedure duration. Additionally, the ergonomics of the OR staff were improved. Conclusion The developed simulation method was intraoperatively evaluated and proved its benefit for the design and optimization of OR setups for different surgical intervention types. As a clinical result, enhanced setups for total knee arthroplasty and total hip arthroplasty surgeries were established in daily clinical routine and the OR efficiency was improved.

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Framework for detailed workflow analysis and modelling for simulation of multi‐modal image‐guided interventions

Cited by 14 publications

References 28 publications

Preclinical feasibility of a technology framework for MRI-guided iliac angioplasty

Preclinical feasibility of a technology framework for MRI-guided iliac angioplasty

Surgical Workflow Simulation for the Design and Assessment of Operating Room Setups in Orthopedic Surgery

Surgical Workflow Simulation for the Design and Assessment of Operating Room Setups in Orthopedic Surgery

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