RESUMEN

Postoperative pancreatic fistula (POPF) is a major cause of morbidity and mortality after pancreatoduodenectomy (PD), and previous research has focused on patient-related risk factors and comparisons between anastomotic techniques. However, it is recognized that surgeon experience is an important factor in POPF outcomes, and that there is a significant learning curve for the pancreatic anastomosis. The aim of this study was to review the current literature on training models for the pancreatic anastomosis, and to explore areas for future research. It is concluded that research is needed to understand the mechanical properties of the human pancreas in an effort to develop a synthetic model that closely mimics its mechanical properties. Virtual reality (VR) is an attractive alternative to synthetic models for surgical training, and further work is needed to develop a VR pancreatic anastomosis training module that provides both high fidelity and haptic feedback.

Asunto(s)

Anastomosis Quirúrgica , Páncreas , Humanos , Páncreas/cirugía , Pancreaticoduodenectomía/educación , Fístula Pancreática/etiología , Fístula Pancreática/prevención & control , Realidad Virtual , Modelos Anatómicos

RESUMEN

The development of accurate and rapid techniques to produce nanophotonic structures is essential in data storage, sensors, and spectroscopy. Existing bottom-up and top-down approaches to fabricate nanophotonic devices are high cost and time consuming, limiting their mass manufacturing and practical applications. Here, we demonstrate a strategy to rapidly create 25-40 nm thick 1/2D Au-Ti nanopatterns using holographic direct laser interference patterning (DLIP). Pulses of an Nd:YAG laser (1064 nm) in holographic Denisyuk reflection mode were used to create ablative interference fringes. The constructive interference antinode regions of the standing wave selectively ablated a Au-Ti layer in localized regions to controllably form nanogratings. Varying the laser exposure parameters allowed for rapid patterning of 2D square and rectangular arrays within seconds. Controlling the distances between the laser source, recording medium, and the object, allowed for achieving a 2D spatial grating periodicity of 640 nm × 640 nm. Diffracted and transmitted light spectra of 2D nanostructure arrays were analyzed using angle-resolved measurements and spectroscopy.