Week 4 Update

Hello everyone, just a quick update of things.

1) I've tweaked and modified the anatomy model with the following changes:

• Serratus anterior muscles and the long thoracic nerve are now anatomically correct;
• Thoracodorsal bundle and brachial plexus are made a bit more 'organic';
• Intervertebral discs and intercoastal muscles have been added.

2) Jodie, Michael have seen the revised version of the animatic, and approve of the pacing (with minor changes needed in certain steps). Tulin generally approves of the content, but I will discuss it further with her to nail down little details.


3) As discussed with Jodie this morning, the web content will be pushed till July, when the animation work is mostly done.


This week's goals:

• To create a rough 3D animatic, just to block in the movement of 3D models and have them in-sync with the narration.
• Revisiting the skin model, most possibly creating a new one, complete with arms.
• Continue experimenting on fat.

Marc has gone through a few options with me, and I think my job is to see which would be most fitting, or if a hybrid solution is possible.

Please let me know if there are any questions or comments. I will post up a revised timeline for June shortly.

Week 3 update

Based on the powerpoint slides posted a week ago, here is a new (hopefully final) version of the animatic. The introduction (with a short anatomy section) is not included, as I was aiming to figure out the surgical portion in this cut. I could add to it later to make a more complete version.




Also, here is a poster of the project I'll be presenting at the 33rd Annual Assembly of General Surgeons.

Inspiration

A piece I found on Youtube while searching for surgical animation references.

I particularly like the way the transition is made from surgery --> animation; it's a simple transparency change, yet it proves to be quite effective.

Week 2 Update

Hello all,

Sorry for the late update, I've been rushing all weekend to put up my personal website. Do drop by and take a look:

Click here.

Sad to say, MRP progress has been somewhat hindered by this. I've managed to come up with a draft layout for the web content, seen below. Click on the images for a larger view.

The last panel is the page that features the rotatable axilla model; on the left is the user interface, allowing the user to select the structures to be shown, as well as information on particular structures.

Colors, fonts and other aesthetic elements have not been incorporated yet; this draft is to show functionality and usability.

This week I will focus on tweaking the existing models, based on advice from Dr. Mike Wiley. I will also add a little bit more musculature to make the models a bit more complete. The skin model might need to be redone, as it doesn't really fit with the anatomy as of now. The arm will be created, and I could connect the hands I modelled earlier.

All in all, I'll be aiming for a complete upper torso model this week. Wish me luck :)

Week 1 Update

Hello all,

As agreed with Jodie and Michael, I will provide updates on my MRP progress weekly on this blog.

This week I've met with Tulin to further discuss details about the ALND procedure; we sat for an hour or so going through the DVD, and by the end of it I think I have a much better grasp of the story.

Based on this information, as well as the feedback I've gathered from last meeting, I put together a storyboard draft, in the form of Powerpoint/Keynote slides.

Powerpoint file here.

Keynote file here.

Please download, and pick it to pieces. If there's any inaccuracies or confusion issues, please let me know. I'm particularly concerned about transitions between surgery and anatomy, and could only provide a standard 'fade in/fade out' transition between the slides...

On another note, here are some new 3D models:

(top to bottom: Allis tissue clamp, Tissue forceps, Baby Jackson retractor)

Stay tuned on another post, regarding a meeting with Dr. Mike Wiley.

Timeline

I have constructed a rough timeline of my project progress. I have set up both weekly and monthly goals, and will meet with Jodie and Michael every Monday to discuss the previous week's work.

The timeline is available here in PDF format.

Axillary Lymph Node Dissection-----[Second MRP Committee Meeting]

Minutes from the 2nd MRP Committee Meeting

Date: Tuesday, April 27th 2010

Location: Department of Surgical Oncology Conference Room, Princess Margaret Hospital

Time: 9am - 10:15am

Attendance:

Dr. Tulin Cil (Medical Content advisor)

Dr. Gordon Tait (Non-voting member)

Prof. Jodie Jenkinson (Supervisor)

Prof. Michael Corrin (Supervisor)

Albert Fung

Update on project progress

- During the course of storyboarding, it seemed that separating the project into two aspects (anatomy and surgery) was a better idea, as including an overview of the axillary anatomy in addition to the surgery would be quite an ambitious goal.

- A separate website will be set-up to provide a detailed orientation of the axillary anatomy. The website would feature a interactive, rotatable 3D model of the human axilla, and textual information about each component.

- The surgery will be made into a computer animation, guiding students through key steps of the procedure, as well as provide a number of 'surgical pearls' to help students understand details of the surgery.

Presentation of work so far

- A series of 3D models built during the term were shown. Comments for the models are listed below:

- Baby-Jackon/Wide ribbon retractors are used instead of Doyen retractors.

- Underarm area in surface model seems a bit unfinished; surface markers are not prominent.

- Skeleton seems very robust for a female; same with pectoral muscles.

- A few inaccuracies with muscle texture found in the pectoralis major muscle.

- Include the 'pointer vessel' that branches off the thoracodorsal bundle.

- Since last meeting, numerous visits to the OR to observe surgery were made. Based on the information gathered, a 2D animatic was presented to the committee for feedback. These comments are summarized below:

Factual information

- Level III lymph nodes should be included in the introduction.

- Only 1 skin incision is made; the latter incision is made from the medial wall of the inferior surgical flap, effectively 'peeling the skin' off the axillary fat pad.

- Retraction should be more superior, close to where the pectoralis major muscle meets the axillary vein.

- 'Superficial to serratus anterior', instead of 'above serratus anterior'.

- Axillary fat has a different appearance compared to subdermal fat (e.g. color and smoother texture).

- The surgical field is at no time 'closed'.

- The fat pad is pulled laterally before palpating the long thoracic nerve.

- The thoracodorsdal bundle and the long thoracic nerve lie on the same plane.

- The animation should show the apex, as certain nodes that need to be cleared are present in that area.

- The patient's arm is raised to allow access to the apex.

Suggestions for better communication

- Anatomy of the area could be put in the beginning; that way users can access the information easily, and there would be no need for transitions between surgery and anatomy.

- An alternate solution is to show the relevant anatomical structure with transparencies (i.e. when the surgical field can only show a portion of a vessel, use transparencies to show the entire course of the vessel in the patient).

- When showing anatomy, try not to interrupt the flow of the surgery.

- After the initial incision, the camera can zoom in to the surgical field; the surface anatomy is irrelevant after the incision.

- Keep the camera stationary, as this is how surgeons would see the field in real life.

Other comments

- Have in mind the size of the web content; it is not always 1024 x 768 as browser toolbars take up space in the monitor.

- The active voice in the animatic is effective, but it must be consistent throughout.

Future directions

- Based on feedback/comments gathered today, a refined animatic will be produced during the first week of May.

- An anatomist (Dr. Mike Wiley) will be consulted for the accuracies of the 3D models.

- A timeline will be set-up to allow committee members to follow progress of the project.

- More O.R. observations can be set up during the month of May.

- Following the timeline suggestion, I will update committee members through email and this blog weekly, with relevant material available to download.