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Journalism of Courage
A tracheotomy to put a breathing tube in the throat of an infant can be a risky procedure, says Dr Court Cutting, a leading plastic surgeon at New York University Medical Center; it runs the danger of cutting the superior thyroid artery, which can cause blood to spurt out as fast as it can be sucked up. The surgeon probably won8217;t make that mistake again, but it can be tough luck for the baby.
Talking with a pilot friend one day, Cutting realised that the way we teach surgeons is like training pilots by sending them up in loaded 747s8212;loaded mostly with poor people, since the affluent seek out experienced doctors as private patients. But pilots learn to fly on simulators. Why can8217;t surgeons practise on machines, instead of bodies?
How hard can that be? Well, equations exist to calculate how tissues will stretch or tear when a surgeon manipulates them, and how they will respond when they8217;re sutured up again. But on existing desktop computers they can take days to solve, says Joseph Teran, a UCLA mathematician who organised a conference on 8220;virtual surgery8221; at the university in January.
To show the effects in real time on a screen, you have to do the calculations in one thirtieth of a second. To create the illusion of actually wielding a scalpel or hook8212; using a device that simulates actual motion and resistance, analogous to the joystick on a flight simulator8212;requires reducing the lag time to one thousandth of a second. Essentially, you8217;d need to put the power of a supercomputer into a desktop. Cutting thinks this will be achievable, using multiple parallel processors and new algorithms Teran is developing, within a couple of years. 8220;You could have a patient in a small town scanned while a surgeon in the city practises the surgery,8221; Teran says. 8220;The patient then flies out for the operation.8221;
And none too soon to help Iraq War veterans who, thanks to improved body armour, are now surviving attacks that would have been fatal in earlier wars, but are left with severe wounds. Many other specialties could benefit as well, including cardiac, cancer and orthopedic surgery, and Cutting8217;s own field of cleft-lip and -palate repair; there are 40,000 cleft babies born every year in China alone. 8220;No two traumas or birth defects are the same,8221; says Teran. 8220;The surgeon makes a plan to repair the damage, only nothing goes according to plan.8221; Better, in that case, for the virtual patient to bleed on the screen8212;than the real one in the operating room.
-Jerry Adler Newsweek
