Doctors deliver high-tech training to Central America

Kang, Wiet train students, doctors with surgical simulation program

Columbus, Ohio (February 8, 2011) - Two surgeons from Central Ohio recently traveled to Nicaragua on a humanitarian mission to treat children with serious ear, nose and throat conditions. However, this year they brought along some help in the form of high-tech equipment designed to appeal to a generation that grew up playing video games – not to entertain the children, but to train the local doctors and medical students.

Kang



Drs. D. Richard Kang and Gregory Wiet, pediatric otolaryngologists from Nationwide Children’s Hospital and The Ohio State University (OSU), visited Escuela Hospital Antonio Lenin Fonseca in Managua, Nicaragua, in January. This was their fourth annual trip to the facility, which serves as the country’s focal point for medical and surgical training.

Upon arrival, the two surgeons conducted their typical schedule of a day of outpatient evaluation, followed by several days of delicate surgeries, including airway and middle ear procedures. In addition, they provided training to otolaryngology residents and attending physicians, through both lectures and the surgical procedures they performed.

Wiet

The unique aspect to this year’s visit, however, was Kang and Wiet’s presentation of a “virtual temporal bone dissection” course. Participants were trained on the unique Virtual Temporal Bone surgery simulation system, developed at Nationwide and OSU in conjunction with the Ohio Supercomputer Center (OSC), through funding from the National Institutes of Health (RO1-DC006458).



“The system creates real-time, interactive computer simulations for surgeons to learn the difficult and delicate surgical techniques associated with ear surgery, which involves drilling into a bone in the skull called the temporal bone,” explained Don Stredney, senior research scientist for biomedical applications at OSC, whose team helped develop the simulation. “Because the temporal bone lies close to a major artery and critical nerves for the face, learning to perform the surgery can be tricky.”

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Otolaryngology residents in Nicaragua recently took turns honing surgical skills with a simulation system developed at Nationwide Children's Hospital, The Ohio State University and the Ohio Supercomputer Center.
 
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The drill and suction/irrigation device are depicted in a screenshot of the Virtual Temporal Bone surgery simulation, which gives students valuable experience in the early stages of developing surgical techniques. 
 
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Dr. Gregory Wiet tests the Virtual Temporal Bone surgery simulation system. The system, its developers believe, will advance training in surgical intervnetion - a key element in improving the control of hearing and balance disorders and enhancing the health of many. 



Without a virtual simulation environment, medical residents would learn this surgery by working on cadavers and through apprenticeships in an operating room. Through multi-institution validation studies, Stredney and Wiet believe that this simulation technology will increase the efficiency of a resident’s training while also raising his or her proficiency. Ultimately, they assert, this innovation could provide a safe, cost-effective way to provide students with experience in the early stages of developing surgical technique.



The system makes use of a laptop computer with powerful graphics processing capability and a “haptic device,” which provides force feedback. This feature simulates for the surgical trainee the feel of the drill interacting with the temporal bone, the portion of the skull just behind the temples and above the ear.



“With this type of training, surgeons are not only learning with their eyes, but also with their sense of touch,” noted Wiet. “This could be an important tool in the learning process for surgeons to develop all their senses in order to guide their surgery.”



A pilot phase of the system received the prestigious “Dr. Frank H. Netter Award for Special Contributions to Medical Education” from the Vesalius Trust for Visual Communication in Health Sciences in 2008. The award recognizes “the person or persons who have recently developed visually oriented educational materials with either proven or potential impact on the way health sciences are taught and/or practiced.”



Kang and Wiet plan to continue to return to Nicaragua on a regular basis, not only to provide care for the population, but also to deliver training – including the virtual temporal bone dissection course – to the region’s otolaryngology community to ensure long-term impact.



“This is an excellent example of how surgical simulation technology can greatly impact training in countries where traditional methods, such as using cadaveric material is not available,” said Wiet. “It can give students life-like demonstrations before even turning over the knife.”



 

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The Ohio Supercomputer Center (OSC) is a catalytic partner of Ohio universities and industries, providing a reliable high performance computing and high performance networking infrastructure for a diverse statewide/regional community including education, academic research, industry, and state government. Funded by the Ohio Board of Regents, OSC promotes and stimulates computational research and education in order to act as a key enabler for the state's aspirations in advanced technology, information systems, and advanced industries. For more, visit www.osc.edu.



As one of the largest and most comprehensive pediatric hospitals and research institutes in the United States, Nationwide Children’s Hospital is a resource for every child and parent in central Ohio. In fact, in a typical year, we see patients from across the country and around the world. They come to Nationwide Children's Hospital for our expertise and outstanding clinical programs that include: The Heart Center, Neonatology, Hematology/Oncology and Gastroenterology. For more, visit www.nationwidechildrens.org .



Founded as a federal land-grant institution in 1870, The Ohio State University's main Columbus campus is one of America's largest and most comprehensive. More than 56,000 students select from 170 undergraduate majors and more than 250 master's, doctoral and professional degree programs. As Ohio's best and one of the nation's top-20 public universities, Ohio State is further recognized by a top-rated academic medical center and a premier cancer hospital and research center. For more, visit www.osu.edu .