Caption: Mr Greg Wynn BSc, MD, FRCS
Caption: Virtual reality bowel surgery
29 November 2010
A Colchester keyhole surgeon is pioneering a new technique for training bowel surgeons that uses state-of-the-art virtual reality (VR) technology.
VR simulators, which have improved over recent years, can be used by junior surgeons to practise laparoscopic (keyhole) operations.
They now even allow the surgeon to feel the tension of the tissues being handled and, if not enough care is taken, they tear and bleed as in real life.
Mr Greg Wynn, a general and colorectal surgeon based at Colchester General Hospital, is developing a training scheme that will use two £140,000 simulators at the Medical Simulation Centre at the Royal Free Hospital, London.
His ambition is for the same equipment to be provided at the ICENI Centre, the new training and research and development centre for laparoscopic surgery that has just been built at Colchester General Hospital. It opens in January.
Mr Wynn said that Colchester has six high-specification laparoscopic box trainers but the VR simulators were the "Rolls Royce" of surgical training equipment.
"They are programmed to provide the closest possible experience to the operating theatre with the same view you would see during a routine case," he said.
"Because the operations are all played out on a computer, patients cannot be harmed while inevitable mistakes are made during the early learning curve.
"Most importantly, however, the computer allows objective measurement of performance so that a trainee's progress along the learning curve can be assessed and analysed for efficiency and safety measures.
"In future, I will be able to say to my trainees that there are certain thresholds on the simulator that I expect them to reach before they can operate on a live patient."
Mr Wynn, who trained in London, said there was now evidence to show that simulator-acquired skills directly translate into a better performance in the operating theatre, which has helped to increase interest in VR techniques.
The ultimate aim of Mr Wynn's training scheme is to allow trainees to successfully complete a laparoscopic colectomy to a satisfactory standard.
The scheme is believed to be the first of its kind in the world. He has recently uploaded a virtual reality bowel operation onto YouTube as an example of the standard expected from his trainees (www.youtube.com/watch?v=9rjJCNGwrK0). This will mean that trainees have an on-line reference while practising on the simulators in their own time.
The two simulators at the Royal Free Hospital were paid for by charitable donations and it is believed that there are only a handful in the country.
Work began earlier this year on the £2m ICENI Centre at Colchester General Hospital, which will help to address the huge shortage of laparoscopic surgeons in the UK and abroad. It is the result of a partnership between Anglia Ruskin University and Colchester Hospital University NHS Foundation Trust.
Colchester General Hospital has one of the largest and most experienced teams of laparoscopic surgeons in the NHS and helped to pioneer the use of keyhole surgery in the UK. The team has built up an international reputation for its work - both in the operating theatre and in training other laparoscopic surgeons.
Laparoscopic surgery offers many advantages over traditional "open" surgery. It involves small incisions rather than large cuts so there is less post-operative wound pain, bleeding, and risk of infection. Patients spend less time in hospital and are able to return to normal activities sooner.
The Trust's laparoscopic team is led by Professor Roger Motson, who has been a consultant surgeon at Colchester General Hospital since 1984.