Preserving a Hands-on-Knowledge Base of Essential but Rare Surgical Procedures

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DESCRIPTION (provided by applicant): To efficiently communicate key points of a surgical procedure to less experienced surgeons and senior residents, we propose to create a low-cost, computer-based multimedia-authoring system (environment), called TIPS (Toolkit for Illustration of Procedures in Surgery). The expert surgeon-author can upload and modify anatomical organs and vessels, place soft tissues and move through the 3D anatomy with tactile force feedback via a haptic stylus interface. Additionally, the surgeon can embed information in the 3D scene ranging from scanned images to video-clips of the real procedure. TIPS documents can be shared by e-mail or download to facilitate collaborative authoring. Ease of use is a primary focus since the aim is to place the expert surgeon at the center of the creative process. For the proof of concept our team member (experienced surgeon) will create a laparoscopic adrenalectomy illustration that will provide convenient, repeatable, validated interactive learning for senior residents and practicing surgeons exposing them, for example, to the key points and anatomic variations of safe removal of the adrenal gland. The first learning stage will guide the learner's hand(s) along paths in a 3- dimensional, sparse but richly annotated virtual anatomy that the author has created. The second stage records and evaluates the learner's motion and force when replicating the specialist's procedure. The TIPS modules will be validated by specialist surgeons at the Department of Surgery University of Florida. Modules and their associated metrics will undergo peer review and also will be validated by a metric-driven validation of residents. TIPS documents open a completely new channel of communication between surgeons that addresses the pressing need for convenient, effective continued education for practicing surgeons. The improved training may reduce the number of referral cases, reducing paperwork, medical costs and delays. The TIPS environment differs from surgery training tools teaching basic techniques to novices in that the specialist surgeon is the author and practicing surgeons are the audience. This makes authoring more highlevel and removes a level of indirection (the computer programmer) that easily leads to wrong emphasis in illustrating complex procedures. Our long-range goal and vision beyond this proposal is to create record and preserve procedures whose practice is declining due to infrequency of the disease and a decreasing number of specialists that have performed such cases. The infrastructure will be placed in the public domain to maximize the dissemination and trigger further collaboration of computer and surgical specialists to develop libraries and shared repositories and create an unprecedented body of knowledge.