'My virtual surgery helped medics'

By Jane Elliott
Health reporter, BBC News

Donald felt confident about his surgery

It is the ultimate dummy run - practising complex surgery on a patient before their operation.

Obviously the real patient cannot be used, but London surgeons have the next best thing - the Angio Mentor, a virtual reality simulator.

It works by taking the CT scans of an individual patient's anatomy and transforms them into a 3D model.

Clinicians can then insert real-life tools into a workstation, which then mimics the anticipated reactions of the patient's body.

'I was not worried'

Donald Lightbody recently became the first patient in Europe to test the new system for his high-risk vascular operation.

The day before, the surgical team at St Mary's Hospital in London were able to rehearse putting a stent (a tiny tube used to hold open the diseased blood vessels) into his carotid artery after his hardened and narrow arteries in his neck put him at risk of a stroke.

Being able to rehearse a complicated procedure like this means we are able to minimise any technical difficulties before the patient reaches theatre Professor Nick Cheshire

But the procedure itself carries a 2-4% risk of causing a stroke.

"It was reassuring to know they had done a dummy run," said Donald, aged 70, from London.

"It was the first time that they had tried it, but I was not scared as they explained everything.

"I felt confident and comfortable going into theatre and this procedure has given me a whole new lease of life."

Teaching tool

Professor Nick Cheshire, vascular surgeon and a researcher in the department of surgical technology, Imperial College London, said simulators like the Angio Mentor had provided a new and important tool.

Staff with the simulator

"The evidence suggests that junior doctors learning to do procedures benefit from practising in a simulated environment.

"A simulation can involve a human actor, rehearsal rubber models or cadavers but perhaps the most attractive is computer-based simulators because they can be repeated.

"The idea we have with this machine is to take it a step further and not to just allow us to train or judge, but to say for a specific patient 'let's import their information and test the procedure before we do it for real'."

Future hopes

And Professor Cheshire said Imperial College would be leading a multi-centred trial to see what impact the dummy run has on outcome.

He said it may be possible to fine-tune use of the simulator, investigating areas such as if it is worth testing out just part of the procedure and how many medics need to be there.

In Donald's case the dummy run did not reveal any problems, but did show that using a different surgical tool for part of the procedure would have better results.

He added: "With patients like Donald we have to balance the risk of surgical intervention versus the patient's risk of stroke due to their condition.

"Being able to rehearse a complicated procedure like this means we are able to minimise any technical difficulties before the patient reaches theatre, making surgery even safer."

Prof Mike Larvin, Director of Education, Royal College of Surgeons said: "Although simulation training is excellent for preparing surgeons for real life scenarios, it is no substitute for actual training in the operating theatre and in the wards and clinics.

"It is, however, an excellent means of providing trainees with the vital skills and strategies for dealing with the unexpected."