Jul 10, 2012
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If you’re looking for dramatic examples of how technology is transforming our lives, the field of surgical medicine is a pretty good place to start. One authority on the subject, Dr. Santiago Horgan, has made a career of innovating technologies to pioneer new surgical techniques. And as director of the Center for the Future of Surgery (CFS) at the UC San Diego School of Medicine, he and his colleagues are using the latest advanced technologies to inspire and train the next generation of surgeons.
During the past decade or so, the operating room has seen technology breakthroughs that previous generations could not have dreamed possible, Dr. Horgan explained. Working with Dr. Mark Talamini, Chairman of the UC San Diego Department of Surgery, Horgan made history in 2008, conducting the first no-incision appendectomy in the U.S.
Through a combination of cutting-edge technologies and revolutionary surgical techniques, Horgan and his colleagues at CFS are radically changing patient outcomes, reducing scarring, helping cut down on hospital stays and recovery times and, perhaps most important to patients, reducing the amount of pain associated with an operation.
One “aha moment” for Doctors Talamini and Horgan was the realization that with technology evolving at breakneck pace, “we need a dedicated place to develop tools and design surgeries.” With a vision for changing surgery and how it’s taught, they set out to build “a place where we can have the latest technology…to duplicate what’s happening in the operating room, so that the learning curve is not transferred to the patient,” Horgan explained.
That vision became a reality with the opening of the new center in September of last year, which features more than $40 million worth of high-tech equipment. To duplicate “real-life” settings for medical students and for veteran surgeons seeking to enhance their skills, CFS includes state-of-the-art operating rooms, a fully-equipped ICU and ER, a hospital room (complete with a family of high-tech training “dummies” that can be programmed to present a myriad of illnesses and injuries)—and some of the most advanced surgical simulators on the planet.
One of the high-tech dummies we tinkered with was the SimBaby by Laerdal. This robotic baby’s body is controlled by software running on a nearby laptop, which instructors can use to simulate various breathing patterns, torso motion, and trauma symptoms including airway obstructions. As part of their training, medical students are tasked with diagnosing and treating the SimBaby’s various ailments.
Straight out of a Bond flick, CFS has created a special space in their facility, officially designated as the “007 Room.” Here, device developers can test the next generation of tools and technology.
Among the sci-fi like offerings in the 007 Room are training simulators from Simbionix, which in many ways look and behave like flight simulators for pilots, complete with joysticks and “rudder” pedals. They literally look and feel like arcade games, but medical students use these ultra-precise controls to perform simulated surgeries, with help from a screen that displays a CGI view inside the “patient’s” body. Even us untrained doctors got a chance to go hands-on with the GI Mentor to perform a virtual endoscopy. The machine provided us with various readouts like the amount of airflow the patient was getting, and how much pain we were inflicting along the way.
We also performed virtual surgery using the LAP Mentor, guiding long-tubed joysticks through the “patient’s” body with help from an extremely “life-like” onscreen view that helped us visualize and navigate. This device even provides tactile feedback. Through the joysticks we could actually feel the sensation of resistance when our surgical tool came in contact with the gall bladder. It felt like rubbing against an inflatable balloon.
The equipment in these facilities would be the envy of any “real-life” hospital, and the behind-the-scenes infrastructure would make any geek salivate. All of the equipment is fully integrated through a master server system that enables teaching staff to program scenarios and monitor activities with a movie studio quality AV system, complete with zooms, tilts, and pans.
Most of the rooms have multiple LifeSize video cameras so that every angle of the room can be captured. All of the operating tables are also equipped with HD monitors and video cameras, so they can get close-ups on procedures and even have their footage displayed on massive LCDs mounted on the walls. A Switch Point Infinity 3 media router is used for switching between cameras and footage can be saved for later viewing, just like your home TV’s DVR.
Using streaming video and video conferencing, CFS shares knowledge remotely, providing classroom exercises and medical consults to learners and colleagues across the U.S. and to a growing number of foreign countries. With 250 courses now being taught, CFS has attracted visitors from all over the world, including Japan, China, Venezuela, Argentina, Chile, Germany, France, Hungary, Russia, Poland, Canada, Mexico, and England.
For many of the participants, the technology and training offered here is light years ahead of conventional approaches available in their home countries. As one visiting surgeon from China recently noted, “It’s like Disneyland for surgeons.”
Horgan, not one to make small plans, is determined to teach 500 courses per year, serving as many as 10,000 surgeons. “This is the place where we develop, reproduce and try out new surgical techniques. The paradigm shift is that we’re trying to take away learning curves from the operating rooms of the hospitals. We’ve got the best technologies. And there are no limits to what we can do.”