Simulating Surgery for Cleft Palate Repair
Dr. Dale Podolsky, a Plastic and Reconstructive Surgery resident at U of T and part of the Surgeon Scientist Training Program, is researching ways to improve the surgical process for cleft lip and palate repair. It is the most common birth defect and affects one out of every 700 births worldwide.
Cleft palate surgery is uniquely challenging due to the small confines of a baby’s mouth and the delicate tissues involved. To help improve this precise surgery, Dr. Podolsky has founded Simulare Medical to produce surgical simulators with the first product being a cleft surgery simulator. Initially created to develop new robotic instruments for cleft palate surgery, the cleft palate simulator also allows trainees to practice the procedure. He spoke with Faculty of Medicine writer Dan Haves about this project.
Tell me a little bit about the history of the cleft palate simulator?
I spent a lot of time developing the simulator initially at the Center for Image Guided Innovation and Therapeutic Intervention (CIGITI) at SickKids Hospital. I wanted to make it as realistic and life-like as possible, incorporating every anatomical detail possible. I worked with leading pediatric surgeons (Dr. David Fisher, Dr. Karen Wong, Dr. James Drake and Dr. Christopher Forrest). As a result, the simulator became very valuable not only as a method of developing and testing new surgical robotic tools, but also as a training tool in cleft palate surgery. Simulare Medical was created to translate this technology beyond the laboratory into the hands of individuals who could benefit most from its use.
How does the simulator work?
The cleft palate simulator is a physical model developed using 3D printing, adhesive and polymer techniques to create the most realistic simulation environment possible. Using real surgical instruments, a trainee performs all the steps of a cleft palate repair as if they were in an actual operating room. The simulator also enables easy video recording of the procedure to easily teach and provide feedback to trainees performing the procedure.
Before the simulator how would trainees learn to perform cleft palate repair?
The current method of training is to practice on actual patients. This is sub-optimal as more experienced surgeons make fewer errors, so supervising surgeons are often reluctant to allow trainees to perform this procedure. Mastering a complex surgical procedure requires significant practice and repetition. The simulator provides a platform for trainees or surgeons alike to practice multiple times in a low pressure, low stress environment without any risk to the patient.
What has been the response from those who have used the simulator?
The response to the simulator has been unbelievable. We officially launched the product in September and we have been receiving our first orders around the world. We have run pilot workshops at the University of Toronto and Stanford and we have more pilot studies planned. There has been significant academic recognition at local, national and international meetings. There is also significant interest from NGO's who provide cleft care to low and middle income countries. Access to surgeons who perform cleft surgery is often lacking in the developing world. The cleft palate simulator is a vehicle to train surgeons in these environments to better prepare them to provide this life changing operation to those who need it most.
What’s in the future for Simulare Medical?
We want to develop new simulators in other surgical areas. Our goal is to develop the most realistic, complex surgical simulators that for the first time capture the subtleties and the complexity of surgery that is required to master these procedures. We believe the cleft palate simulator is the most advanced physical simulator available across all surgical disciplines. We are striving to be leaders in developing this technology that shorten the surgeons learning curve and improve competence without compromising patient safety. Our ultimate goal is improving patient outcomes.