The seated man: geometry acquisition and three-dimensional reconstruction.

A three-dimensional (3D) virtual human body in seated position can be used in a wide range of applications such as basic or clinical research. A male cadaver placed in the driving position in a car cockpit was frozen. Strictly parallel 5 mm thickness serial sections were then performed. Both sides of the slices were photographed, scanned and analyzed by anatomists with software tools, in order to produce accurate contours of the identified anatomical structures. A 3D reconstruction of organs, based on the marching cubes method, was achieved except for thin structures. This allowed an anatomical validation of these reconstructed elements. The result of this work is a complete geometrical database of a seated human body in the driving position including skin, all bones, internal organs and main muscle groups.

A visco-hyperelastic model with damage for the knee ligaments under dynamic constraints.

The aim of this study was to identify the behaviour laws governing the knee ligaments, accounting for the damage incurred by the structure under dynamic constraints. The model is developed using a thermodynamic formulation based on the coupling between a viscoelastic model and a damage model. Identification is carried out using the results of dynamic traction tests performed on a bone ligament/bone complex to which traction velocities of around 1.98 m/s were applied. The results show the ability of the model to account for the brittle and ductile failure processes occurring in the cruciate and lateral ligaments, respectively.

Intestinal retractor for transperitoneal laparoscopic aortoiliac reconstruction: experimental study on human cadavers and initial clinical experience.

BACKGROUND: We set out to design a bowel retractor for use during laparoscopic transperitoneal reconstruction of the infrarenal aorta and of both iliac axes. METHODS: This study was performed on five cadavers. After the insertion of four trocars, a pneumoperitoneum was created, and the bowels were gathered to the right flank. On each cadaver, the following four measurements were made: the distance between the Treitz angle and the aortic bifurcation (L1), the distance between the aortic bifurcation and the right internal inguinal ring (L2), the angles between L1 and L2 in the axial plane (A1), and the angles between them in the sagittal (A2) plane. These measurements enabled us to create a bowel retractor. The device was composed of a malleable metallic rod with a 2.5-mm diameter that was fixed to the operating table and whose intraabdominal section was designed to follow the outline of the mesenteric root in addition, a 25 x 12 cm polypropylene net was slipped around the rod. The infrarenal aorta and both iliac axes were then dissected. Secondarily, the bowel retractor was used in eight patients (seven men and one woman; mean age, 56 years; range 44-76) during laparoscopic aortoiliac reconstruction for occlusive (n = 6) or aneurysmal (n = 2) disease. RESULTS: The statistical analysis of the measurements performed on cadavers showed a significant correlation between body height and L1 (r = 0.8769; p < 0.05) and L2 (r = 0. 9706; p < 0.01) distances. It was then possible to design the shape of two metallic rods (one small and one large) so that they would be adaptable to the height of the patients (<1.65 m and >1.65 m). During our clinical experience, all laparoscopic procedures were completed in a mean operative and clamping time of 266 min (range, 215-360) and 54 min (range, 18-90), respectively. Mean postoperative hospital stay was 6 days (range, 3-13). CONCLUSION: Our experimental study allowed us to develop a bowel retractor that can make it easier to perform laparoscopic transperitoneal aortoiliac reconstruction in humans.

Left subpancreatic transplexus exposure of the proximal abdominal aorta.

The authors report their experience based on the anatomical study of the celiac region and on the practice of abdominal multiorgan removal for transplantation. They particularly concentrate on the limits and the content of the celiac region of Luschka and particularly: -the position of the celiac axis in relation to the median arcuate ligament of the diaphragm, -the relations of the collateral branches of the abdominal aorta, -the place being taken by the celiac plexus and its situation in relation to the left renal v. From these elements, they describe an original transplexus surgical exposure of the origins of the celiac axis and of the superior mesenteric a. They show the importance of this approach in abdominal vascular surgery and during abdominal multiorgan removal in transplantation.

Anatomy of the seated position: methodologic approach and initial findings.

The aim of this research was an anatomic study of the seated position in order to reply, in particular, to various questions raised in certain industrial situations as to this position and the reciprocal adaptation of the human being and his seat. The methodology adopted was based on obtaining reference serial sections from an entire subject frozen in the seated position, as well as on computerised three-dimensional reconstruction. The difficulty of the undertaking led us to specify this methodology, which must be strictly adhered to. Different types of visualisation were then considered, showing the feasibility of the method, which can effectively respond to the demands of industrial situations by allowing the creation of a data bank, and also by opening up new perspectives in the field of anatomical teaching.

[Non-invasive dynamic studies of the cervico-thoraco-brachial pathway. Anatomo-clinical correlative study]. / Explorations dynamiques non invasives de la traversée cervico-thoraco-brachiale. Etude corrélative anatomo-clinique.

Based on a computer assisted analysis of the anatomic and biomechanic features of 200 subjects, the authors propose a dynamic approach to the exploration of the cervico-thoraco-brachial pathway. Results are given for 70 healthy and diseased subjects. Ultrasonic evaluations of the arterial component, dynamic echography of the axillo-subclavian venous component, electrophysiology including conventional electromyography, somesthesic and motor evoked potentials, and advanced imagery provide a panel of complementary diagnostic techniques.

[Anatomic basis of the harvest of abdominal organs for organ transplants]. / Bases anatomiques des prélèvements d'organes abdominaux en vue de transplantations d'organes.

The abdominal organs removals, with a view to transplants, are complex surgical operations which require a perfect knowledge of visceral vascular anatomy. The common point of these removals is the "birenal en bloc excision", whose we have codified the development. This removal has induced us to revise many points of surgical anatomy and particulary: the connections between the liver and the right kidney; the importance of the mesoduodenum; the relative orientations of the portal vein and inferior vena cava axis; the ureteral vascularisation; the topography and the number of renal arteries; the connections between renal arteries orifices and superior mesenteric arterial orifice. When we have to remove, besides the kidneys, the liver or the pancreas or even the small intestine, surgical problems are the same, but then, the dissections concern also the celiac axis and the superior mesenteric artery. These multiple removals raise also many questions to the anatomist, the most interesting concerning: the multiple hepatic arteries; the connections between celiac branches of the abdominal aorta. All these notions are envisaged not only by the light of the anatomical preparations but also by reference to the clinical experience of the authors.

Macroscopic study of the adult thymus.

The dissection of 48 cadaveric specimens has been compared with operative findings for a review of the shape, size and site of this gland in the adult. The structure of the thymic compartment and the relations of the thymus, particularly with the vessels of the superior mediastinum and the base of the neck, were studied. The relative positions of the inferior parathyroid glands and the thymus were identified, with respect to the influence of this topography on the surgery of these glands. The arterial suply to the thymus, which is still very abundant in the adult, presupposes a functional organ whose physiologic involution is slow.

From classical to modern anatomy or computer-assisted biomechanics.

The authors describe their methodology - dissection, photography, informational - permitting a biomechanical approach together with the study of the changes in the topographic anatomy of a region during movement.

[Anatomical studies of Luschka's gland]. / Recherches anatomiques sur la glande de Luschka

In that work, the authors determine precisely the classical outlines relating to the formation described by LUSCHKA in 1859. The morphology, the situation in relation with the medium sacral artery, the exact topography of what is wrongly called "gland of Luschka" are successively analysed. Otherwise, notions which emerge about is histological conformation are referred to.