A project that started more than four years ago at East Tennessee State University is now giving OB/GYN residents the chance to practice difficult surgeries before ever touching a patient. The university’s new abdominal surgery simulator was first conceived in 2003 by Dr. Martin Olsen, chairman of the ETSU department of OB/GYN.
“Four years ago, I woke up in the middle of the night one night, trying to figure out how to give my residents more surgical experience, and I said, ‘Make a uterus,’ ” Olsen recalls. The next day, Olsen cobbled together a physical representation of his idea, using a cardboard box, a fake pear and rubber bands. He took it to Bill Hemphill, an associate professor in the department of technology and geomatics, to try to explain what he wanted to build.
The OB/GYN and engineering departments soon began working together to make Olsen’s idea a reality, and today the result is a tool ETSU officials say is the first of its kind anywhere in the country. The surgery simulator is the newest addition to the university’s patient simulation lab, where residents routinely practice their skills on mannequins that breathe and talk, complaining of various symptoms and responding to the students’ care with the help of professors who control the mannequins from a separate observation room.
The difference between the new simulator and the old ones is that this one is covered with fake skin that can be cut open, and students will find life-like organs inside that they must operate on. When the organs are cut, they bleed, and if a student takes too long to tie off an artery, the “patient” can bleed to death. Hemphill explained that the system “uses two separate pressurized systems for arterial and venous blood flow. So ... when you cut or rupture an artery, it’s going to spurt like an artery and will continue to spurt. We can control the pressure on it and actually watch the patient go into shock.”
The simulator also features tiny cameras that film the procedures, so residents can review their work later. “The cameras are dual spectrum cameras surrounded by an array of infrared LEDs and can illuminate things in the dark without providing additional light,” Hemphill said. “Actually, it’s a better teaching device than a real patient because the resident can sit down and review their work afterwards,” Olsen said. “They can say, ‘My knot wasn’t very good; I better work on that.’ Or, ‘I took a little too long on this.’ They can critique themselves.”
Creating the simulator was an interesting learning process, Olsen said, because it required medical experts and engineering experts to work closely together. “It’s so different that communication is actually an issue,” he said. “I can remember earlier one day I was explaining some really basic anatomy to Bill, and I was thinking to myself, ‘He looks intelligent. Why can’t he understand basic anatomy?’ But the next day, he was explaining basic engineering to me, and I thought, ‘Ah, now I know what it’s like.’ It’s difficult because he’s got his jargon and I’ve got mine.
“I think being an ETSU-type institution is really helpful for this (kind of project), because it’s big enough to have what you need but small enough that it’s easy to find people to help you.” Olsen and Hemphill are proud of what they have produced and hope other medical schools will be able to make use of the technology. The university is seeking a patent on the professors’ invention.
“ETSU will benefit from this long term,” Hemphill said. “If we can sell organs and sell the product, I think it will be a good revenue stream for the university.”