Surgery resident Rajalakshmi Nair, MD, (right) tests her surgical skills on the Fundamentals of Laparoscopic Surgery box trainer, which is used to help surgeons practice minimally invasive surgery techniques in a "real-life" setting.
The surgeon's face is focused; her hand precisely poised as she inserts the thin surgical instrument into an abdominal incision and monitors her progress on a video screen nearby. It's time to remove a troublesome appendix that has plagued this patient for the past few days.
Except in this situation the surgeon is in a lab and the "patient" is a fictional character created in a virtual reality simulator.
Welcome to the new world of surgical education.
UC's surgical residency program has expanded its laparoscopic and virtual reality simulator training curriculum to better prepare new surgeons to care for patients before they ever enter an operating room.
The enhanced program, which will be implemented in the new Woliver Laboratory for Simulation and Education in Surgery, is made possible by a donation from retired surgeon and 1939 UC College of Medicine alumnus Edward Woliver, MD.
The lab partners with the division of education in UC's surgery department.
Located on the ground floor of the College of Medicine's Medical Sciences Building, the Woliver Lab includes an array of simulation equipment designed to let surgical residents practice new skills outside the operating room.
Timothy Pritts, MD, PhD, says the lab is a major asset because it allows residents to try new techniques and hone their current surgical skills in a safe, faculty-mentored environment.
"Training under the time pressures of a real-life operating room setting can be very stressful for both the instructor and the surgical resident," explains Pritts, assistant professor and director of the UC surgical education division.
"The more experience residents get before stepping into the operating room, the better prepared they'll be to care for patients."
The Woliver Lab has both low- and high-tech simulation equipment, including simple models to simulate suturing vessels. It also includes sophisticated devices, such as the Simbionix Lap Mentor II virtual reality simulator, which incorporates haptics (sense of touch) and tracks a surgeon's performance during the training session.
Other equipment in the Woliver Lab includes:
A Fundamentals of Laparo-scopic Surgery box trainer, which is used to help surgeons practice laparoscopic (minimally invasive) surgery techniques and test learned skills;
Two Mentice VIST mannequin simulators, which will allow residents and fellows to practice inserting catheters, use fluoroscopy (moving X-ray images) to monitor the catheter as it travels up through the body and learn sophisticated manipulations of blood vessels; and
Numerous smaller simulated tissue models for practicing basic surgical tasks such as suturing, cutting and tying knots.
"Simulation has changed the way we approach surgical education. It allows us to address many training tasks before the resident surgeon ever enters the operating room," says Michael Nussbaum, MD, interim chair and professor of surgery.
"The Woliver lab complements existing educational resources within the department and allows us to expose surgical residents to all phases of clinical training."
Nussbaum says Woliver's generous support of efforts to improve resident education through simulation and advanced laparoscopic techniques is only natural.
"Dr. Woliver completed his surgical residency at the Cincinnati General Hospital (now called University Hospital) in 1944," says Nussbaum.
"During his career, Dr. Woliver was considered a master surgeon. He was the person that other surgeons sought out to learn good technique and to provide surgical care for themselves and their loved ones.
"We are pleased that he has decided to continue that legacy by supporting important surgical education efforts at UC," he adds.
Currently, the surgery department has 43 general surgery residents who will participate in simulation training opportunities in the Woliver Lab.