Figure - available from: Journal of Materials Science: Materials in Medicine
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Photographs of Sugita cobalt alloy (07-940-18) (a and b) and titanium alloy clips (17-001-18) (c and d)
Source publication
Cerebral aneurysm clip blades crossing during surgery is well known as scissoring. Scissoring might cause rupture of the aneurysm due to laceration of its neck. Although aneurysm clip scissoring is well known, there have been few reports describing the details of this phenomenon. Quasi-scissoring phenomenon was introduced mechanically by rotating t...
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Titanium (Ti) alloys have been introduced in magnetic resonance (MR) safe implantable medical devices because the susceptibility of Ti is approximately 1/10 that of the Co-Cr-Ni alloy (Elgiloy), which was the previously preferred MR-safe material. The torque applied to metallic materials in an MR imaging (MRI) scanner is commonly believed to increa...
Citations
... It is smaller than the properties of Ti6Al4V, particularly the yield strength of 0.87 GPa and the tensile strength of 1.05 GPa. It means that the 3D printed result using titanium alloy can withstand the loading of blood flow rate that streams in the aneurysm area [24]. In the displacement simulation, the result expects to have a significant number of moving steps. ...
Aneurysm clips have helped hundred cased for brain abnormalities including the haemorrhagic strokes over the world, including Indonesia. As one of the contributors of a hundred trillion rupiahs for medical devices imports each year, the technology of aneurysm clips is expected to be self-manufactured. However, there is no study if the process can be done in the whole country of Indonesia. This study aims to conduct a preliminary study by using an approach of reverse engineering for the Sugita aneurysm clips as an effort to independently provide domestic medical devices. The methods consist of a 3D scanning process, a 3D printing process, biomechanical simulations, and tension measurements. The clip has been scanned and printed using SS316L and Ti6Al4V. Biomechanical simulations reach 0.054 GPa for the von Misses stress and deformation number of 4.0302E-6 mm. The tension measurement on the 3D-printed clip shows identical range numbers compared to the original clip. The experiment concludes that the acquired Sugita aneurysm clip can be reversed using a 3D metal printing and shows a significant similarity on geometrical analysis.
... Then, it places a titanium clip across the neck of the malformation, while avoiding the aneurysm dome because of the high risk of rupture. 5,6 Erroneous touching of nearby anatomical structures such as vascularities may lead to ischemic damage. 7 Multiple clips are used for large aneurysm with broad necks and complex anatomy. ...
Introduction:
Microsurgery clipping is one of the most challenging surgical interventions in neurosurgery. The opportunities to train residents are scarce, but the need for accumulating practice is mandatory. New simulating tools are needed for skill learning.
Methods:
The design, implementation, and assessment of a new hybrid aneurysm clipping simulator are presented. It consists of an ergonomic workstation with a patient head mannequin and a physics-based virtual reality simulation with bimanual haptic feedback. The simulator recreates scenarios of microsurgery from the patient fixation and the exploration of the brain lobes through Sylvian fissure and vascular structures to the aneurysm clipping. Skill metrics were introduced, including monitoring of gestures movements, exerted forces, tissue displacements, and precision in clipping.
Results:
Two experimental conditions were tested: (1) simple clipping without brain tissue exploration and (2) clipping the aneurysm with brain Sylvian fissure exploration. Differences in the bimanual gestures were observed between both conditions. The quantitative measurements of tissue displacement of the brain lobes exhibited more tissue retrieval for the surgical gestures of neurosurgeons. Appraisal with questionnaires showed positive scores by neurosurgeons in all items evaluating the usability and realism of the simulator.
Conclusions:
The simulator was well accepted and feasible for training purposes. The analysis of the interactions with virtual tissues offers information to establish differential and common patterns between tested groups and thus useful metrics for skill evaluation of practitioners. Future work can lead to other tasks during the intervention and the inclusion of more clinical cases.
... Then, it places a titanium clip across the neck of the malformation, while avoiding the aneurysm dome because of the high risk of rupture. 5,6 Erroneous touching of nearby anatomical structures such as vascularities may lead to ischemic damage. 7 Multiple clips are used for large aneurysm with broad necks and complex anatomy. ...
The development of simulation systems from surgical procedures has been a research topic in several areas in medicine and engineer applications because it supposes a novel alternative for medical skills acquisition, surgical planning, guide during surgery and postoperative control. At the same time, simulation systems represent significant challenges, regarding conceptual design, mathematical, numeric and computational modelling, and finally the validation of the system. In this paper, we present the advances and methodologies applied for the development of a virtual reality system for medical training in neurosurgery. As the case of study, we present the simulation of an aneurysm clipping procedure in two of the main stages: brain Sylvian fissure exploration and aneurysm clipping.
Intracranial and spinal implants are increasingly prevalent around the world, placed for a wide range of neurosurgical conditions. Patients with these devices, like many individuals, may have travel plans involving passage through metal detectors and other security screening devise. However, there are virtually no studies in the currently literature evaluating the safety and interaction of neurosurgical implants with these machines. This review of manufacturer information and existing literature serves as a compilation of this information, and our pre-travel recommendations for affected patients.
