SURGERY IS STEEPED IN TRADITION
An intimate craft, knowledge of best practices and proven methods are
typically passed from seasoned veteran to a new initiate in a personal,
and often times, hands on fashion.
With all its complexities and nuances, efficiency in surgery is difficult to
measure, and many evaluations are subjective and relative. At the
Surgical Simulation Research Lab (SSRL), located on the University of
Alberta’s Northern Campus, researchers are investing ways to objectively
evaluate performance in surgery, and improve the learning process
through innovative training techniques.
Headed by Dr. Bin Zheng, Director and Endowed Research Chair in
Surgical Simulation, SSRL has been working a plethora of projects,
primarily focused on basic science and simulating different components
of surgery, both in the form of procedures themselves, and how people
learn and acquire the appropriate motor skills. These projects include the analysis of eye tracking in surgery, team cognition studies, the expanded use of haptic feedback based teaching devices, improving the assessment of surgical efficiency and innovations in simulated training exercises.
Applying haptic guidance to the learning process allows novices to replicate the motions experienced surgeons. Utilizing this teaching technique offers the potential to optimize learning and expedite competency in surgery. In SSRL, this information is conveyed via a kinesthetic interphase which is feedback adjustable based on a user’s level of expertise.
Innovations brought forth from the lab take several forms, including augmented reality, where images and information are superimposed in simulated settings through the use of advanced technology, such as the Microsoft HoloLens. The team has also utilized tools such as the Oculus Rift and similar devices to provide a live heads up display, allowing surgeons to have access to unrepresented amounts of information during procedures. These studies dive deep into best practices as well, and study when it is best to prompt a surgeon with information, and when it would simply prove to be distracting to the overall process.
SSRL is a frequent collaborator with other groups at the University of Alberta. When Dr. Wenjing He analyzed team cognition between pairs of surgeons, where one performed the surgery and the other maintained camera operation, computer science graduates were brought in to lend their expertise. By combining the two specialties, SSRL was able to better understand and analyze the elements of team dynamics, and study what influenced synchronization.
A recent study undertaken by Dr. Simon Bryns of SSRL focused on video gaming and how it affected laparoscopic box training. The team analyzed how three groups of people, those whose who played games on a Nintendo Wii, those who did traditional training, and those who combined the two, compared on standard laparoscopic box training. The results of this study, which are being submitted as a potential presentation at the 2016 Tom Williams Research Day on May 13, yielded interesting results that showed playing games had a positive effect on spacial awareness and the manipulation of tools in a laparoscopic setting.
Dr. Byrns has also been developing a project of significant importance as part of his master’s thesis that has implications of changing how we evaluate surgical skills. With patents pending, the technology behind the study remains secretive, but Dr. Byrns is working diligently to improve the way surgeons are assessed and evaluated through a combination of eye tracking, movement plotting, kinematic data, video and predictive algorithms, with the goal being to reduce the subjective nature of traditional evaluations.
In a field rich with history, such as surgery, bridging the gap between technology and tradition can be a challenging, daunting and ultimately rewarding process. The Surgical Simulation Research Lab, and its many efforts, stand as reminder that continuous improvement is a constant force in surgery.