Over the past few years, technology—from video conferencing to virtual reality—has upended how people around the world have been able to interact and work together. At an innovative surgical teaching centre at Toronto’s University Health Network (UHN), this goes beyond online classrooms or meetings—they’re giving surgeons unprecedented hands-on training that’s expanding health care capabilities around the world.
The operating room inside the Temerty Advanced Surgical Education and Simulation Centre at UHN’s Michener Institute of Education looks like most other operating rooms, with one key exception—you won’t find any patients there. Designed as a learning space, the 15,000-square-foot training facility is a state-of-the-art simulation lab in which surgeons, surgical trainees and other members of the surgical team can experience and practice new procedures in a simulated environment.
“Traditionally, there was a ‘see one, do one’ mantra to teaching surgery,” says Dr. Allan Okrainec, director of the Temerty Centre. In other words, surgery was about learning by doing—after watching an operation, the expectation was that surgeons and students would be able to learn to perform parts of that procedure next time. “You’d be learning in real time on real patients,” Okrainec says. But while hands-on practice is valuable, the model is not without shortcomings—specifically the stress of mastering a new skill while a patient’s health hangs in the balance.
“Simulation offers the opportunity to learn in an environment that is outside of the operating room where the stakes are not as high,” says Okrainec. “When you’re in the lab, you can actually deconstruct the steps of an operation. You can learn to suture; you can tie surgical knots at the most basic level. As we expand capabilities with technology, we can use simulation to learn things like minimally invasive laparoscopic surgery and robotic surgery. We have virtual reality simulators where you can rehearse entire surgical procedures in a virtual environment and practise them over and over again.”
And the learning opportunities go far beyond tackling the basics. “At UHN, we have the opportunity to bring entire surgical teams together—the surgeons, the anesthesiologists, the nurses and other health care providers,” Okrainec says. “We can bring them all into our high-fidelity simulated operating room and actually rehearse operations or practise dealing with challenging situations that might be extremely rare. Should that event then ever occur, you would be able to manage it in a safe way because you already rehearsed it.”
These advanced learning opportunities are not just for beginners—they are enabling seasoned experts to break ground in other new ways. For example, one pioneering surgeon, Dr. Michael Zywiel, became the first Canadian to perform knee surgery with the Velys orthopedic surgical robot, a procedure he first mastered in the centre’s simulation lab.
“One concept I find really exciting is this concept of digital surgery,” says Okrainec. “That’s where we bring together surgical robotics, advanced imaging, augmented reality and artificial intelligence to really transform how surgery will be performed in the future. For example, one of my colleagues, Dr. Amin Madani, and his team are developing an AI algorithm that can provide surgeons with guidance and navigation during surgery, similar to a GPS for surgeons, to avoid surgical complications.” In the future, AI could also be used for coaching and feedback, giving insights into surgical performance that have until now been out of sight to observers.
These advances are bringing about improvements to surgeries locally and globally. Thanks to a concept called telesimulation, which uses the Internet and videoconferencing to link simulators, surgeons and trainees in facilities around the world can participate in virtual training remotely.
As Canada’s number one hospital network, UHN is home to Canada’s leading robotic surgery training ground. “There’s no way we could innovate without philanthropy and support,” Okrainec says. “It’s crucial to everything we do, allowing us to bring in the newest and greatest surgical technology and train surgeons across the country and beyond.”
You can support innovations like these, and hear more from Dr. Okrainec about how UHN is revolutionizing surgery, at UHN’s Serving Knowledge Supper Club from 6:00 p.m. to 9:30 p.m. on January 31 in the Amelia Room at O&Bs brand new steakhouse, Aera, on the 38th floor of the Well (8 Spadina Ave.). Tickets are $120 (plus taxes and gratuity), and $50 of your ticket purchase will be donated to UHN Foundation. Reserve your spot today.