Taking a cue from aviation, today surgeons are better prepared than ever before

NASHVILLE, TN – In the past, surgery simulation was a crude approximation of what doctors really encounter – and they needed to be close to a teaching hospital to even try it. But surgery simulation is finally coming of age, thanks to breakthroughs in mobility, cloud-based software, and 3D imagery.

“There are now simulation mannequins that actually sweat, bleed and talk,” said Mollie Condra, associate vice president of Nashville-based HealthStream. “We partner with Laerdal Medical, the Norwegian-based global leader in mannequin design. Our SimCenter family of products provides software ‘scenarios’ that can be downloaded into the mannequins, plus software to help manage the complex logistics of scheduling and certification.”

These simulations cover more than surgeries, Condra added. Moreover, they can be conducted anywhere from a large hospital to an ambulance. Many healthcare organizations have been trying to manage these programs using Outlook or Excel, and that just does not work as well, she said.

HealthStream’s SimStore is a cloud-based collection of about 2,500 simulations that work in similar fashion to Apple’s iTunes. HealthStream provides developers with the toolkit needed to create simulation content, and healthcare users simply download the content they need. “This makes it very affordable, even for small hospitals,” said Condra.

For hospitals that can’t afford to build a simulation center, mobile sim labs can drive right up to the doorstep.

Denver-based Medical Simulation Corporation delivered its SimSuite quality initiative programs to more than 50 hospitals last year via its Mobile Simulation Lab. “We provide a turnkey program that includes the physical space, simulators, clinical educators, and complete competency reports, freeing up capital and human resources to focus on the many other priorities of the hospital,” said Amy Shannon, MSC’s vice president of sales and marketing.

The American Board of Internal Medicine now allows interventional cardiologists to use SimSuite technology to earn points toward their maintenance of certification.

In some cases, simulated surgeries are becoming even more precise than the actual procedures.
Surgical Theater is a new company that began with a chance encounter between co-founders Warren Selman, MD, a Cleveland neurosurgeon, and Moty Avisar, who was working at Lockheed-Martin on an advanced flight simulator for the Israeli Air Force.

“We were using satellite images of the next day’s mission to let pilots ‘pre-live’ it,” said Avisar. “Dr. Selman was looking for that kind of capability in the operating room, so we created a system that turns a patient’s CT and MRI scans into highly realistic, 3D images.”

Using sophisticated 3D glasses and robotic controls, the physician can rehearse tomorrow’s surgery, viewing an aneurysm from many angles.

“In the past, a surgeon had to choose from more than 100 aneurysm clips while performing the operation, sometimes taking a dozen iterations to find the right clip,” Avisar said. “By ‘pre-living’ it, the surgeon knows which clip to use in advance, reducing the chance for a stroke during surgery.”

For most of medical history, there was no such thing as a “do-over.” But now surgery simulations let physicians practice a procedure repeatedly – and even in collaboration. At HIMSS 12, Surgical Theater introduced its new Collaborative Theater, which lets multiple physicians not just observe but take part in simulated surgeries. “It’s a wonderful training tool,” said Avisar. “After Doctor 4 does a procedure, the session leader can say, ‘OK, Doctor 6, you take a turn.’ We’re helping to ensure that doctors are better prepared than they’ve ever been.”