How do you train a resident surgeon to remove an appendix? As much preparation they get in school, they can’t master how to remove an appendix until they’ve done it. The problem is that unlike the board game Operation, you’re dealing with real people who don’t have multiple lives. So how do you give residents hands-on practice when human lives are hanging in the balance? How do you get busy, experienced surgeons to take the time to teach them? How can surgeons watch and effectively evaluate a resident’s performance in the operation room, when tensions are high and a patient’s life is on the line? These are questions being considered by a surgical robotics team at Johns Hopkins University.

Carol Reiley, doctoral research student in surgical robotics at John Hopkins University and Gregory Hager, professor in the computer science department at the university, are involved in research that looks at improving how residents are trained by using robotic surgical tools. The goal is to reduce the time and cost of having an experienced surgeon teach residents. Reiley and Hager outlined what technologies would be useful in training residents.

Computer-integrated surgery

Studies have shown that superimposing graphics and sound over the real-world environment can assist with training. Computer-integrated surgery involves using a robotic system with a video display, which can enhance human senses by providing additional information. For example, a the robot can use force feedback to prevent a surgeon’s hand from puncturing a beating heart.

Intelligent sensors

Robots with intelligent sensors can address human limitations like poor vision or hand tremors. Force-sensing surgical instruments can be used to measure the local tissue oxygen saturation on the working surfaces of surgical retractors and graspers so that tissue doesn’t become permanently damaged.

Steady Hand Robots

Specially designed robots can share control of the surgical instrument with the resident. This could reduce hand tremors and allow for precise and steady motion, which means that nervous residents could relax and talented surgeons afflicted with Parkinson’s Disease wouldn’t have to immediately give up surgery.

Automation of surgical tasks

Training models can be used to automate portions of a tedious task or to predict surgeons’ intent to automate an instrument change. With robots doing the less-skilled but time-consuming tasks, residents could focus on other parts of the surgery.

We’re nowhere near robots taking over the operating room and making humans obsolete, but there are many technologies that could give surgical training a boost. And with the robots gaining more and more experience from humans, they may make the real flesh and blood a thing of the past.

Photo Credit: Kelleher Guerin

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