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Simulation, Training and Robotic Surgery Center
TRAINING FACILITIES AND CURRICULUM
Surgeon training is rapidly undergoing change. Limited resident work hours, economic pressures of operating room time, and patient safety concerns have reduced the surgeon-in-training's ability to efficiently acquire surgical skills. Additionally, the advent of minimally invasive surgery has pushed the need for psychomotor skills training. There are challenges that the surgeon faces in performing minimally invasive surgery. Compared with traditional "open" surgery, the minimal access technique requires operating in a 3D field with 2D visualization, longer instruments, muted tactile feedback , and the "fulcrum effect," whereby the instruments and scopes are limited in movement by the fixation point of the abdominal wall.
In the Center's Simulation, Training and Robotic Surgery Simulation Lab, surgeons and residents gain proficiency in basic and advanced laparoscopic procedures and robotic techniques. The Center provides surgeons residents with innovative training in a new and comprehensive educational and research facility for minimal access and robotic surgery. Residents will participate in regularly scheduled animate labs to learn on live tissue. Inanimate training video towers are available 24 hours per day for resident use. Virtual reality simulators, similar to those used in aviation, compliments training and provides research opportunities to prepare the next generation of minimally invasive surgeons. Training in minimally invasive skills with a virtual reality simulator a llow students to practice repeatedly with immediate feedback and without supplies, gain familiarity with anatomy and instrument utilization in safe and reproducible environment. The curriculum our residents provides them with skills and exposure to technology to prepare them for the challenges of the 21 st century.
Training modules on the LapSim:
Instrument & camera navigation
Grasping
Cutting
Clip applying
Lift and grasp
Suturing
Precision & speed
Cholecystectomy dissection
Dissect peritoneum & fatty tissue
Apply clips to duct & artery
Cut duct & artery
Also, the Center has acquired an extensive digital video-library, whereby students and residents can review laparoscopic surgical strategies and techniques at any time.
Minimal Access Surgery Training program
Lectures, labs, digital video library and 24 hour access to simulation training
Computer didactics
Library of computer based CD instruction on various minimal access procedures.
Inanimate Training
Four "box" trainer with instruments, and full video towers. Each exercise will be timed, and evaluated for errors.
Virtual reality simulation training
Animate training
Week 1 Introduction to instruments & video (1.5 hours)
Week 2 Access and Camera navigation
Week 3 Laparoscopic Appendectomy
Week 4 Laparoscopic Cholecystectomy
Week 5 Laparoscopic common bile duct exploration
Week 6 Endoscopy
Week 7 Laparoscopic hernia repair
Week 8 Laparoscopic suturing and tying
Week 9 Laparoscopic feeding tubes/ bowel resection
Week 10 Laparoscopic management of GERD
Week 11 Laparoscopic nephrectomy/ solid organ
Week 12 Laparoscopic colectomy
Week 13 Laparoscopic bariatric surgery.
Week 14 Robotics
Research:
The department of surgery is actively participating in research exploring the impact of minimally invasive surgery on patient care and surgeon training.
Current projects include:
1. Flight path analysis and machine learning using the DaVinci robot
2. Predictive image based modeling of lung anatomy and physiology
3. Analysis of a new rating box for the assessment of resident training using the LapSim
4. Simulator for chest tube insertion on the Virtual Human
5. Effects of thoracic cavity insufflation during robotic surgery
6. Left ventricular mapping using tissue Doppler imaging during robotic biventricular pacing
7. Prospective, randomized trial of robotic epicardial left ventricular lead implantation versus transvenous coronary sinus left ventricular lead insertion for cardiac resynchronization
8. Effect of TDI-mapped left ventricular pacing for the treatment of hypertrophic cardiomyopathy
9. Validation of the LapSim simulator in resident and surgeon training in minimally invasive surgery
10. Analysis of the LapSim simulator versus inanimate training curriculum in surgeon training in minimally invasive techniques
11. Using the LapSim as a "warm-up" tool for live surgery
