Simulation system helps hone surgical skills

By Rosie Lombardi

dale-podolskyPractice makes perfect, but surgical trainees need a method that allows them to practice and learn from their mistakes without compromising patient safety while they develop their skills. To this end, Simulare Medical Corp., a Toronto-based start-up, has developed a novel simulator system that helps reduce surgical errors. “Our first system is a simulator that allows a trainee to practice cleft palate surgery on a physical synthetic model before they operate on an actual patient,” says Dr. Dale Podolsky (pictured), founder and CTO of Simulare, adding that the company intends to develop models for many other types of surgery.

One out of every 700 babies is born with a cleft lip and/or palate, and corrective surgery is typically done within the first year, explains Podolsky. “It’s a very challenging operation because you’re operating within the small confines of an infant’s mouth with delicate tissues. However, expert surgeons are often reluctant to allow trainees to do the procedure so new surgeons may not get the experience they need before they perform the procedure on actual patients.”

The Cleft Simulator is an actual physical model of an infant’s head with a cleft palate, he says.”It’s created using polymers, 3D printing and adhesive techniques to simulate the anatomy, complete with multi-layered tissue plains, to really allow trainees to practice the procedure and work through the subtleties of the operation.”

There are other surgical simulator systems available in the market, but most of these are too simplistic, he adds.

“I don’t believe other systems really capture the intricacies of the anatomy. The Cleft Simulator is the first simulator, across any surgical discipline, that allows you to perform a complex operation from start to finish in a highly realistic physical environment. The actual operation takes two hours to complete, and so does the simulated procedure.”

Podolsky first developed a prototype simulator system in conjunction with leading pediatric surgeons (Dr. David Fisher, Dr. Karen Wong, Dr. James Drake and Dr. Christopher Forrest) at the Hospital for Sick Children at The Center for Image Guided Innovation and Therapeutic Intervention (CIGITI), a lab that specializes in surgical simulation and robotics. The simulator was developed as part of his PhD in Biomedical Engineering with an initial goal to use the model to develop a surgical robot to perform cleft palate surgery. However, the simulator was a hit when presented at academic meetings for use as a training tool. To commercialize it, he then took it to the Biomedical Zone, which is a business incubator that joins forces from St. Michael’s Hospital and Ryerson University to develop healthcare solutions.

“The Cleft Simulator has been well received by the medical community, and Simulare recently received a grant from the CMA’s Joule to help it grow its business,” he says. The company has run workshops at Stanford University and the University of Toronto, and several academic centres and NGOs have expressed interest in buying Simulare’s systems.

At present, the Cleft Simulator is sold as a kit, he says. “It has a base and a cartridge. The cartridge has to be replaced after each use because you’re cutting into the tissue and you’re suturing so you can’t use it again. The kit includes one base and five cartridges, a full set of instruments, sutures, training video, and we’ve also developed a method of video recording intra-orally so people can watch the video and provide feedback on the quality or the technical ability of trainees who use it.”

Beyond cleft palate corrections, there is a need for simulators to help train surgeons in virtually every type of operation. It took two years to develop the first model for cleft palate surgery, but future models will take less time now that the core components of the system have been established and tested.

“People are very excited about our Cleft Simulator because it’s a particularly difficult operation to learn. We’re going to focus on launching this product first and then gradually start focusing on other products.

Our ultimate vision is to have a repertoire of products for the most difficult surgeries that trainees need to learn to perform.”

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