In 2011, the Nicholson Center invested $54 million in building the nation?s largest and most comprehensive medical education center of its kind: The Nicholson Center for Surgical Advancement (NCSA). Last October, the facility?s doors opened onto six da Vinci robots, 40 endoscopic surgical stations, an innovation and technology accelerator and a medical simulation center.
Back then, the NCSA expected to train 20,000 surgeons per year in minimally invasive techniques (it previously trained up to 8,100 doctors per year). Additionally, the area businesses that benefit from a steady stream of visiting surgeons, including hotels and restaurants, were anticipated to experience at least $13 million in annual growth as a result of the center?s increased capacity.
Now the simulation center has become the centerpiece of government sanctioned research into telesurgery, which should cause those numbers to double in the near future.
On July 5th, the NCSA announced a strategic partnership with Mimic Technologies, a Seattle-based robotic surgery simulation developer. The companies will collaborate on a set curriculum for training surgeons on how to operate using robotic surgical equipment.
In addition, Mimic?s dV-Trainer simulators?designed to recreate the look and feel of Intuitive Surgical?s widely utilized da Vinci Surgery System?are being utilized for research as part of a $4.2 million DoD grant aimed at better understanding how robotic surgery can be performed over long distances.
The technology for extremely remote surgery exists in systems like the da Vinci, but research into peripheral factors such as the motion delays created by operating across long distances have yet to be conducted in a controlled environment. As one would expect, the greater the distance between surgeon and patient, the slower the reaction of the robotic instruments.
Surgeons at NCSA are scored on their skill performing procedures on artificial tissues in a series of exercises. Then delays are inserted and the surgeons? performances are scored again. Delays ranged from tenths of a second to a full second in initial experiments. The research is testing the threshold for safe operating distances. Surgeons experienced difficulties that, at certain distances, would prevent them from operating safely if a telesurgical operating room were set up today.
Knowing the kinds of delays to expect at certain distances and training doctors to take the motion delays into account could save not only time, but the lives of future patients undergoing robotic surgeries in extremely remote locations such as third world countries. This research is an important part of preparing the medical field for a world-wide telesurgery network that caters to the long distance procedures experts expect to take place within the next decade.
Robotic surgery simulation has become a growing business for a number of reasons:
There are only a handful of companies developing simulators?Mimic Technologies, for one?and their curriculum initiative with the NCSA is particularly notable when one considers that training standards for robotic equipment are not regulated across the board in today’s medical field.
“If we are going to increase the success of our surgeries, we need partners nationwide to standardize the best simulation training possible,” said Vipul Patel, M.D., medical director of the Global Robotic Institute and editor in chief of the Journal of Robotic Surgery.
The standards vary by hospital and, ultimately, the ability to operate with a robotic system depends on the doctor?s own perception of his or her readiness before a live procedure.
According to Catherine Mohr, M.C. Intuitive Surgical?s director of medical research, everyone gets ?core training? that includes understanding the terminology and controls of the device, along with a day-long ?wet lab? in which the surgeon experiments on a live pig to learn how to dissect, sew and control bleeding using the device.
At that point, a surgeon who?s passed Intuitive?s basic requirements gets a certificate from the company. Many hospitals do require surgeons to be ?proctored? by experienced robotic surgeons during training.
Jeff Brinkley, Mimic?s CEO, chairman and founder, says the average training process (without a simulator) is not cost effective.
?On average [for] each surgery, instruments alone are about $2,000 a session,? Brinkley says. ?Then there?s the cost of brining in a team to set up the robot; a proctor who has to observe; training materials?physical models, animals; and then there?s the opportunity cost?if your robot is typically used for surgery, then you?re sacrificing surgery time to train with the real robot.?
Mimic has sold over 450 simulators at a price point of roughly $100,000 per machine. Comparatively, Intuitive Surgical has sold more than 2,200 of its da Vinci robots worldwide at a cost of $1 million to $2.5 million each, according to Reuters.
With telesurgery recognized as the wave of the future and new robotic systems gaining FDA approval every day, the surgical robot simulator market is one to watch for both patients and investors interested in medical robotics.Read More