A dress rehearsal for surgery

The Simbionix Uro-Mentor simulator.When vascular surgeons at Strong hospital, affiliated with the University of Rochester in New York, tracked a pain in Joyce Leopard’s leg to a clogged carotid artery in her neck, they decided to simulate surgery first.Using a …

The Simbionix Uro-Mentor simulator.When vascular surgeons at Strong hospital, affiliated with the University of Rochester in New York, tracked a pain in Joyce Leopard’s leg to a clogged carotid artery in her neck, they decided to simulate surgery first.

Using a state-of-the-art simulator developed by Israeli company Simbionix, they loaded a CT scan of Joyce’s neck onto the device, and generated a virtual 3D image. Using this image, the surgeons then carried out a full dress rehearsal of the operation, without a drop of blood being spilled.

“The Simulator identifies the pitfalls and problems and solves them on the machine,” said Dr. Karl Illig, chief of vascular surgery at the hospital. The actual surgery went like clockwork. “It is reassuring to the patient to know that there was good planning,” he added.

Reassuring indeed. Most of us would like to know that a surgeon performing an operation, or a doctor performing a colonoscopy for that matter, has logged in many hours of experience.

At a meeting in Madrid last September, vascular surgeons from the Imperial College, London, presented a study that showed a significant difference in psycho-motor skills between experienced interventionists in a two-day course on carotid artery stenting, before and after using the Simbionix simulator.

Simbionix, which is based in Lod and has offices in the US, was founded in 1997 by a group of individuals with backgrounds in marketing, software programming and 3D graphics.

Today, it leads the industry in providing a range of medical simulators that enable medical professionals to hone their skills without touching a real person, much as flight simulators enable pilots to learn how to fly before they take to the skies.

The simulators, which were developed in cooperation with premier medical centers such as the Cleveland Clinic and Mayo Clinic, are in use in more than 140 hospitals, clinics, and training centers around the world.

The company’s range of products include ANGIO Mentor, a simulator for interventional endovascular procedures that enables a surgeon to practice inserting a catheter into an artery, and perform a balloon dilation, using a stent or other device.

Next is the GI Mentor, the industry’s first computer-based simulator for training endoscopic procedure skills. This has gained worldwide acclaim. A recent study by the University of Texas validated the use of GI Mentor II for training colonoscopy expertise, and in April, the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) announced that it had chosen Simbionix as its partner in developing an endoscopic skill assessment system.

The LAP mentor is designed for laparoscopic surgery. It simulates the difficult technique of performing surgery using probes inserted through small, minimally invasive incisions in the body. Particularly successful is a LAP Mentor Module for Hernia Repair that includes the final meshing.

The newest LAP Mentor module, LAP GYN, was demonstrated at the AAGL Global Congress in November last year. Gynecologists were able to see the incredibly realistic visualization of the human anatomy during procedures such as ectopic pregnancy and tubal sterilization. They could also learn how to manage a number of emergency active bleeding situations.

Simbionix’s training systems use data from a large library of virtual patients. But the company also hopes to see its products increasingly used for pre-op, using the data of actual patients. The benefits of this are clear: shorter procedures, less X-ray time, and less equipment. “Patient-based simulation can significantly improve patient safety and increase the success rate,” said Dr. Giora Weisz of Columbia Medical Center.

At Strong hospital, the medical center originally bought the Simbionix ANGIO Mentor Simulator to train students, but Dr. Illig is already using it for pre-surgery rehearsals, and envisions creating a rehearsal studio in the operating room, “to use between operations.”

“Our mission is to accelerate best-practice medical training, advance clinical performance and improve patient safety,” Simbionix president and COO, Ran Bronstein, one of the company’s founders told ISRAEL21c.

Simbionix received startup financing from Koor Venture Capital. Early State Partners of Cleveland, Ohio (whose parent is Capital One Partners) made an additional $3 million investment in the company in 2007. The VC had previously invested $1 million (as part of a $4 million investment round) in 2000, when the company moved its international headquarters to Cleveland.

“Open surgery simulation has finally made the leap from science fiction to fact,” says Bronstein.