Accentus Medical (United Kingdom)

Abstract Aim To assess the impact of simulated laparoscopic trainers on improving surgical trainees’ technical ability in completing a laparoscopic appendicectomy by measuring effect on completion time and distance travelled with standard instruments. Method Six CT1 (early-stage) trainees with little prior operative exposure were selected from the North-West of England Deanery to perform x10 appendicectomy simulated exercises with the Augmented Reality Laparoscopic Simulator (LapAR™), interspersed by x3 Lapass exercises. Metrics including ‘Time of completion’ and ‘Distance travelled’ were collected by the simulators and analysed. Results Repeated laparoscopic appendicectomies with the LapAR™ improved performance time for 100% of trainees, with an average of 55% (Regression coefficient -0.65) and improved distance travelled for 75% of the trainees with an average improvement of 39% (Coefficient -2.67). Improvement in instrument smoothness, acceleration and ambidexterity were also observed. Conclusions LapAR™ use has improved all performance metrics for most surgical trainees and proves to be an invaluable tool for surgical training.

A reaction mechanism has been developed that is appropriate for the plasma aftertreatment of diesel exhaust gas. It is based on a simulated gas mixture containing propene, nitric oxide, nitrogen dioxide, oxygen and nitrogen. The reaction mechanism has been used to determine the end-products from the plasma processing and their concentrations using a chemical kinetics modelling procedure. It has been validated by a range of experiments using the same gas mixture with a packed bed, a dielectric barrier plasma reactor and a wide range of end-product analysis techniques. Using a wide range of experimental conditions has enabled us to validate the model and its predictions and to critically evaluate several alternative reaction mechanisms for the oxidation of propene and the formation of end-products in a more systematic and reliable manner than before.