New surgical simulator provides true ‘feel’ of surgery

High-tech laparoscopic surgical simulator at Malcom Randall VA Medical Center to help train surgical residents

Fourth-year surgical residents Ivan Zendejas, M.D., and Nikki Kissane, M.D., work together on the new LAP Mentor surgical simulator located at the Malcom Randall Veterans Affairs Medical Center.

Fourth-year surgical residents Ivan Zendejas, M.D., and Nikki Kissane, M.D., work together on the new LAP Mentor surgical simulator located at the Malcom Randall Veterans Affairs Medical Center.

A new high-tech laparoscopic surgical simulator at the Malcom Randall Veterans Affairs Medical Center will not only help train University of Florida College of Medicine surgical residents, it will contribute to improved patient care and safety.

An open house celebrating the recent donation of the $180,000 LAP Mentor simulator by the VA medical center in Gainesville was held on Feb. 25 to “virtually” show faculty, students and staff the latest in surgical education.

“The old surgery dogma ‘see one, do one, teach one’ doesn’t really apply anymore in training for laparoscopic surgery,” said UF assistant professor of surgery Kfir Ben-David, M.D., who directs the lab and serves as director of UF’s minimally invasive surgical fellowship program.

Because of the complex nature of laparoscopic surgery, it is difficult to watch operations and learn. That’s why simulating hands-on practice has become such a useful training tool.

“We are now performing complex surgical procedures through small incisions that require precise and meticulous dissecting with the help of a small camera and special instruments,” said Ben-David.

Fourth-year surgical resident Nikki Kissane, M.D., is the first UF resident to take the newly created minimally invasive surgery elective program as part of her surgical training.

“The ability to operate before you actually operate in the OR is invaluable,” said Kissane, who plans to pursue a minimally invasive surgical fellowship after completing her general surgery residency next July.

She added that some of the simplest techniques are very difficult to learn, so the repetitive hands-on experience the simulator offers greatly enhances the learner’s experience.

Produced by medical simulation system developer Simbionix, the LAP Mentor simulates the use of different laparoscopic instruments and provides a range of virtual surgical procedures, including suturing, gastric by-pass and colectomy. The simulator tracks time and steps of the user, providing instructors very useful feedback on technique proficiency.

This system incorporates a variety of practice opportunities, and provides a laparoscopic training curriculum made up of basic skills, tutorials of procedural tasks, and simulation of a full procedure, said Ben-David.

Kissane said being able to feel the varying densities of different tissues makes the experience very real.

It is this tactile experience that differentiates the new simulator from current simulators in the lab. Ben-David said the other simulators are very helpful in teaching surgical residents how to work with the laparoscopic tools to become more proficient with the minimally invasive style of surgery. The LAP Mentor simulator provides resistance feedback via the surgical tools, providing a realistic feel of what each step would feel like as it is completed during surgery.

In 2010 all graduating surgical residents will be required to earn certification in the fundamentals of laparoscopic surgery before they can receive their general surgery board certification. The UF department of surgery training program ensures residents have time in their schedules to focus on the simulation training.

UF professor of surgery William Zingarelli, M.D., chief of surgical services at the VA medical center, said the surgical simulation laboratory is part of a larger initiative to expand the VA’s simulation resources.

In about three months the laboratory also will include nursing, anesthesia and internal medicine simulators.

“The VA is happy to support this initiative, as it will enhance the care of our patients,” said Zingarelli.