Reprinted
from JAMA, The Journal of the American Medical
Association, January 4, 1995.
AMA's Science Reporters Conference
Features Good
and Bad Medical News
JOURNALISTS WHO gathered for the American Medical
Association's 13th Annual Science Reporters Conference, held in Seattle,
Wash, received both good and bad news about the health of the nation.
Learning Videoendoscopic Surgery
Journalists at the science reporters conference made a
field trip to the University Of Washington Medical Center
for a hands-on demonstration of the latest training
techniques in videoendoscopic surgery. Using a new
surgical simulation system from Simulab
Corporation, Seattle, Wash, the reporters got to
play doctor trying to master some of the skills required
by this minimally invasive surgical technique.
The Simulab system consists of an
anatomical torso with multiple trocar placement options
and a variety of disposable organ packs that enable the
simulation of a variety of videoendoscopic procedures.
The system replaces live animals for a fraction of their
cost, says Carlos Pellegrini,M.D., professor and chair of
surgery and codirector of the university's Center for
Videoendoscopic Surgery.
"Trainees, especially practicing surgeons who have
returned to school to learn these new techniques, have to
realize that this is an entirely different kind of
surgery," Pellegrini says. Surgeons accustomed to
using the sense of touch have to learn to perform surgery
using a video monitor instead of direct vision, how to
compensate for reduced depth perception, and how to
distinguish nearly identical-looking structures.
"Videoendoscopic surgery is revolutionizing surgical
care," says Pellegrini. In addition to many
gynecological procedures and chest, abdomen, and
urological operations, videendoscopy is being used to
place feeding tubes into the stomach or intestine, take
biopsies, inspect for tumors, and correct some types of
infertility. "Within 5 years, 40% to 60% of all
surgeries will be performed using these techniques which,
for the patient, means far less physical trauma and
shorter hospital stays and recuperative time,"
Pellegrini predicts.
Pellegrini says University of Washington researchers are
working to create new videoendoscopy techniques for sinus
surgery, esophagus repair, fetal surgery, and
prophylactic breast cancer surgery. Surgeons and
bioengineers are cooperating to develop virtual reality
devices that will give surgeons the sense of actually
seeing and manipulating organs during a procedure.
In other collaborative projects, researchers are trying
to combine virtual reality with robotics that replicate
the surgeon's hand motions and convey tactile sensations.
These efforts hold promise for "telepresent
surgery" - a technique that may permit a surgeon in
Seattle to perform surgery on a patient in New York by
using the patients virtual image in Seattle to guide the
movement of a surgical robot in New York.
-by Charles Marwick
