ARCHIVED - Virtual Surgery: Real-Life Impact?

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July 07, 2007— Ottawa, Ontario

Healthcare systems are stretched, so technologies that can save precious hospital time, improve surgical procedures and better equip future surgeons are certainly welcome.

World-renowned experts recently gathered at NRC in Boucherville, Quebec, to discuss new ways that technology can do just that. Representatives from industry, universities and government joined medical professionals to discuss 3D simulation, computer-assisted surgery and other up-and-coming medical technologies at the Computer Simulation in Medicine (CompMed) Symposium.

Dr. Yves Starreveld, a surgeon at Calgary's Hospital (foreground) tests NRC's neurosurgical haptic system with researcher Vincent Mora.
Dr. Yves Starreveld, a surgeon at Calgary's Hospital (foreground) tests NRC's neurosurgical haptic system with researcher Vincent Mora.

"Surgeons could soon be required to train with 'virtual surgeries' before operating on real patients... the same way pilots train on flight simulators before flying a plane."

Robert DiRaddo, NRC

"The symposium comes at a time when three-quarters of cancer tumours are treated by surgery and further to that the medical profession is quickly moving towards less-invasive surgical techniques," says Dr. Robert DiRaddo of the NRC Industrial Materials Institute. The good news is that these new less invasive surgical methods help reduce hospital stays. The flip side is that these constantly evolving techniques also take time and effort for the surgeon to continuously learn.

Surgeons-in-training currently learn by assisting and performing hundreds of operations under the guidance of experienced surgeons. "Assisted surgeries often can take twice as long, and these surgical techniques can be so complex that surgeons don't have the opportunity to train other surgeons," Dr. DiRaddo says. As leading specialists and experienced surgeons prepare to retire, there are challenges regarding passing on the required expertise. That's where surgical simulation comes in: surgeons-in-training can rehearse complex surgical procedures without tying up costly operating room time.

Using software under development at NRC, surgeons-in-training will rehearse delicate brain surgery – before having to participate in real operations. The software creates a 3D "virtual neurosurgery" that both looks and feels as though the student is operating on a real patient. Users receive haptic – or touch – feedback, pressure as though they are actually cutting into flesh with a scalpel or scissors, describes Dr. DiRaddo. "NRC's haptic system, which is developed jointly with Montréal-based MPB Communications, has seven degrees of freedom of motion. It's unique in the world," he adds.

Beyond teaching medical students neurosurgical skills, the innovative training system would also allow more experienced surgeons to keep up with newer surgical techniques and developments, and could possibly provide hands-on instruction for surgeons working in remote communities.

From soda bottles to brain surgery

Experts rendez-vous at NRC

The CompMed Symposium, co-supported by the international Society for Simulation in Healthcare, attracted top surgical simulation experts and representatives from North America, Europe and Asia. Phillip Hassen, CEO of the Canadian Patient Safety Institute, opened the Symposium and guest speakers included Drs. Steve Dawson (Harvard Medical School), Gerald Fried (McGill University), Richard Reznick (University of Toronto) and Ken Cavanaugh (FDA).

The project is an excellent illustration of how NRC leverages existing expertise into new opportunities. The neurosurgery software evolved from NRC's existing angioplasty simulator that is currently being evaluated by a Toronto-area surgeon and will soon be transferred to industry.

"The first software we developed was to predict the fabrication of soda bottles and peanut butter jars," Dr. DiRaddo recalls. Since its development in the mid-1990s, the technology has primarily been used by the automotive sector to design better and environmentally friendly parts. Adding the biomedical sector to the mix began five years ago – and not a moment too soon. "My NRC colleagues in Calgary and Winnipeg, Mike Sowa and Boguslaw Tomanek, helped us tremendously in this transition,'' Dr. DiRaddo recalls. Surgeons could soon be required to train with "virtual surgeries" before operating on real patients," says Dr. DiRaddo. "The same way pilots train on flight simulators before flying a plane." In the United States, the Food and Drug Administration (FDA) recommended the use of virtual reality technology for surgeons training on carotid stenting.

"Strengthening Canada's position in this important and emerging field of surgical simulation is critical," he says, stressing the national, collaborative nature of this research. "It is an incredibly multidisciplinary field requiring surgeons, engineers, biologists, educators and computer programmers – who all have to work together."

Held May 16-18th, CompMed crossed borders to connect experts who are committed to making surgical procedures more accurate, efficient and innovative than ever before – improving success rates and potentially saving lives near and far.

The surgeries may be virtual, but the impact could be very real.

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