ABSTRACT
BACKGROUND: Microsurgical preparation is limited by geometric and mechanical constraints. In preparation for clinical use, this study investigates performance, ease of handling and precision of a novel manipulator concept for microsurgery. MATERIAL AND METHODS: A group of 15 ENT experienced doctors, as well as a group of 17 medical students with low/non surgical experience participated in the study. Each of the subjects carried out 4 trials of simulated surgeries on a phantom with built-in force sensors. The task was to apply a defined force between 1.5 and 2 N using a Fisch micro perforator, 16 cm length, 0.4 mm (Storz) targeting holes with a diameter of 0.5 mm. For comparison, the Fisch micro perforator was moved manually or with the manipulator. RESULTS: Assessing the total number of errors proved a significantly lower error number (p<0.0001) and an improvement of the accuracy of 76% with the manipulator. The time requirement for the procedure with the micro manipulator is on average 2-3 times higher than with manual control (p<0.0001). But it is notable that this time requirement significantly decreases with training (p<0.0001). CONCLUSION: The study shows a significant reduction in the number of errors by using a new manipulator concept compared to the non-augmented human hand in an experimental setup. We observed a significant learning effect when subjects applied the micro manipulator, resulting in reduction of the time requirement while maintaining a constant number of errors.
Subject(s)
Ear, Middle/surgery , Micromanipulation/instrumentation , Models, Anatomic , Ossicular Prosthesis , Otitis Media/surgery , Otosclerosis/surgery , Robotic Surgical Procedures/instrumentation , Stapes Surgery/instrumentation , Surgery, Computer-Assisted/instrumentation , Adult , Female , Humans , Learning Curve , Male , Medical Errors/prevention & control , Operative Time , Otolaryngology/education , Students, Medical , Surgical Equipment , Telemedicine/instrumentationABSTRACT
A numerically implementable multi-scale many-body approach to strongly correlated electron systems is introduced. An extension to quantum cluster methods, it approximates correlations on any given length-scale commensurate with the strength of the correlations on the respective scale. Short length-scales are treated explicitly, long ones are addressed at a dynamical mean-field level and intermediate length-regime correlations are assumed to be weak and are approximated diagrammatically. To illustrate and test this method, we apply it to the one-dimensional Hubbard model. The resulting multi-scale self-energy provides a very good quantitative agreement with substantially more numerically expensive, explicit quantum Monte Carlo calculations.
ABSTRACT
Pairing occurs in conventional superconductors through a reduction of the electronic potential energy accompanied by an increase in kinetic energy. In the underdoped cuprates, optical experiments show that pairing is driven by a reduction of the electronic kinetic energy. Using the dynamical cluster approximation we study superconductivity in the two-dimensional Hubbard model. We find that pairing is indeed driven by the kinetic energy and that superconductivity evolves from an unconventional state with partial spin-charge separation, to a superconducting state with quasiparticle excitations.
ABSTRACT
We study the two-dimensional Hubbard model with nonmagnetic Zn impurities modeled by binary diagonal disorder using quantum Monte Carlo within the dynamical cluster approximation. With increasing Zn content we find a strong suppression of d-wave superconductivity and an enhancement of antiferromagnetic spin correlations. T(c) vanishes linearly with Zn impurity concentration. The spin susceptibility changes from pseudogap to Curie-Weiss-like behavior indicating the existence of free magnetic moments in the Zn doped system. We interpret these results within the resonating-valence-bond picture.
