Experts at the University of Florida are developing a real-life version of the classic board game Operation. The difference is this technology is much larger and will be designed to better care for wounded soldiers overseas.
Dr. Samsun Lampotang, a professor of anesthesiology in the UF College of Medicine, is the lead investigator on this joint project funded by the Department of Defense. He is also the director of UF’s Center for Simulation, Safety and Advanced Learning Technology, which focuses on simulation in medicine.
Lampotang’s team was granted $1.7 million by the Department of Defense to develop simulators over the next five years to help military doctors. The goal of the simulators is to provide doctors an opportunity to practice techniques to better care for wounded soldiers. The five-year grant will help Lampotang and his team to create, test and validate five different simulators.
“We’re trying to marry the virtual and the physical,” Lampotang said. “We’re trying to make it practical. We take it from the lab, where everything is clean and ideal, into the real world.”
One simulator allows physicians to practice delivering anesthesia to a patient who may have broken ribs. The procedure requires precision in its delivery because one false step with the needle could puncture a lung or artery.
Another simulation has a section of a real patient’s spine scanned and reproduced with 3-D printing. It’s embedded in a thick gel and covered with a synthetic skin to be as realistic as possible. The reproduction is connected to a computer that shows each part of the model, including those that do not actually exist such as ligaments, arteries, veins and nerves.
The simulator tracks each minute movement made with the needle. In ways similar to the board game Operation, the “mixed-reality” model, alerts the user when the needle unintentionally hits a lung or artery.
David Lizdas, a simulation engineer at the UF College of Medicine, has been working with Lampotang since 2000 to develop mixed-reality simulators. He said each part of the model is designed to train those who use it and help correct any mistakes they may be making. The procedure can be played back to the user so they can understand exactly what they may be doing wrong.
“The ligaments are important because they have a particular feel with the needle, and there is a way you can use those to feel your way into the space,” Lizdas said.
As required by the Department of Defense grant, the simulators will be designed for use wherever soldiers are deployed. Lampotang said the concept behind the technology is “turnkey,” meaning the user doesn’t need to be trained by a person to use it; an ideal feature for doctors deployed in war zones. Conceptually, the equipment could even be airdropped.
The simulators will also be designed for a severe environment, much similar to what military medical personnel face while deployed. That could mean no internet connection, an unreliable or inaccessible electricity source and/or no cellphone service.
Lampotang said the 3-D printed bone structure also gives the model a realistic touch that would otherwise be lost with an artist’s rendering of a “perfect spine.”
“There are people who train on these simulators who get big egos. They are failing but claim there is a flaw in the model because they usually never miss,” Lampotang said. “But what I say to that is that this is a real person’s spine. So you’ve got to go talk to the guy upstairs about it.”
Lampotang said he and several of his colleagues were among the first to begin developing medical simulation technology at UF in the late 1980s.
They and their peers at Stanford University were among the pioneers in the development of this mixed-reality software. Lampotang also calls this “augmented reality” and says that anyone who has watched a football game on TV has experienced it.
“When you see the yellow line on your TV marking the first down, you’re experiencing an augmented reality,” Lampotang explained. “That line doesn’t exist in Ben Hill Griffin Stadium, but you can see it on your TV.”
“In the same way, you see on the computer screen this virtual spine is actually exactly located on top of that bony spine. But physically these nerves, arteries and veins do not exist.”
Lampotang said UF is filing for intellectual property of this technology. The team is required to test them to demonstrate they can improve a physician’s work and that they are cost effective, among other criteria.
“I am not a physician, so I cannot actually touch a patient,” Lampotang said. “But I think it will be very gratifying when we hear that patients’ lives have been saved by people who trained on these simulators.”