Practice makes perfect, especially when it comes to highly-specialized skills such as performing surgery on a patient’s spine. To help meet the growing demand for simulation training of future surgeons, a cross-faculty team of researchers at the University of Calgary is rolling out a timely invention: a realistic type of synthetic bone. The research is within the Biomedical Engineering priority research theme: Engineered Novel Therapeutics.
Professor Carolyn Anglin and master’s student Aubrey Blair-Pattison, in collaboration with orthopedic surgeon Dr. Rick Hu, business professor Chad Saunders, and artist Christine Jansen, have created a new type of synthetic bone that will allow orthopedic residents to practise surgical techniques on more realistic models. The tactile models of vertebrae are a significant improvement over other available synthetic bones. They accurately replicate the hard outer layer and the softer interior of the bone, as well as their weight, resistance to instrument forces, and ability to be X-rayed.
“Currently, residents are learning in the operating room, so they are practising all their skills on patients,” explains Anglin. “Cadaver training does not work very well: it is expensive and does not provide the range of bone that would be seen in real surgery.” There are other synthetic bone models in use; however, there is considerable dissatisfaction with them within the medical community. That gap can be filled by Anglin and Blair-Pattison’s invention.
During spinal surgery, patients will often have rods inserted along the length of the spine, which are held in place with screws in the vertebrae. Surgeons must avoid hitting the spinal cord and surrounding large blood vessels, while securing the screws deep enough to hold in place. Accuracy is critical in operations of this kind.
“There are many screws being used during these surgeries, it is slow to learn, and there is a high rate of malplacement,” Anglin says. “There are not always problems from the malplacement, but 2.5 per cent of patients have neurological complications afterwards. If we can train the residents before they are working with patients, they can get used to the tactile experience and get past that learning curve, making the operation safer for patients.”
Potential for broad impact on surgical training
Anglin and Blair-Pattison incorporated input from surgeons as they created the bone models. They then tested the mechanical bone properties and validated the models by conducting training with six surgical residents. The training successfully reduced the number of malplacements during simulated surgeries and received positive feedback from residents. Next, the bone models will be developed and tested further in preparation for commercialization.
Anglin hopes that the project will have significant implications for competency-based training in medicine. “There is growth in physical simulation training, where they are actively using the instruments and learning what to look for,” says Anglin. “There is a rise in surgical skill or simulation centers. The educators want to determine what tests accurately judge if someone has good skills or not. We’ll be feeding into that.”
Anglin, Blair-Pattison, Saunders, Hu, and Jansen are creating a company to commercialize their invention with assistance from Innovate Calgary. “We decided it had commercial potential because it can go in so many directions,” Anglin says. “So far we’ve developed it for the vertebrae, but we could do knees, hips, veterinary medicine, product demonstrations or biomechanical testing. We could then add soft tissues, and be more and more similar to the human body as we move forward.”
Collaborative spirit fosters interdisciplinary achievements
“Part of the attraction of coming to the University of Calgary is the collaborative atmosphere,” says Anglin. “Biomedical engineering generally is very interdisciplinary and collaborative, and even moreso here.” The project began through discussions between Anglin and Hu. Hu continues to provide the surgical expertise necessary to develop the project, while Saunders will be leading business development in the soon-to-be-created spinoff company, and Jansen is optimizing the manufacturing of the models.
The co-operative spirit in the university’s biomedical engineering community encourages collaborative relationships like the one between Anglin and Blair-Pattison. “We put a lot of effort into our students and our grad program. There’s a dynamic feeling amongst the faculty and students working here who are excited about what they are doing,” Anglin says.
“I look around at my colleagues and see not only how hard they’re working on their own projects, but also how hard they are working to advance biomedical engineering here at the university,” she says. “Everyone in this program is so passionate about biomedical engineering, and loves what they do.”
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