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Montefiore Medical Center Opens Futuristic Training Center For Laparascopic Surgery

NEW YORK CITY,NY (February 2001) -- Montefiore Medical Center today opened one of the nation's most advanced minimally invasive surgical training centers. The Montefiore Institute for Minimally Invasive Surgery (MIMIS) includes a Virtual Reality and Skills Laboratory, surgical work stations and a large, state-of-the-art conference room with global teleconferencing and telemedicine capabilities.

"Minimally invasive surgery is the new paradigm in the field of surgery, and Montefiore is the first academic medical center in the New York region to offer a formalized training program for all surgical residents," said T.S. Ravikumar, M.D., chairman of the Department of Surgery. "It is anticipated that this modern center, in addition to training Montefiore residents in a variety of minimally invasive surgical procedures (laparoscopic, arthroscopic and other endoscopic), will quickly become a regional center for practicing surgeons to learn new and advanced skills."

In the past ten years, minimally invasive surgery has replaced open surgery for many general procedures, such as gall bladder, knee and shoulder surgery, and is being used increasingly for more complex procedures in gynecological, cardiac and urological surgery.

Virtual Reality and Skills Laboratory
"Laparoscopic surgery requires learning entirely new skill sets," said Alan White, M.D., the director of MIMIS. "First, the surgeon must operate using tiny instruments at the end of two-foot-long, chopstick-like shafts. Second, his or her field of vision for the operation is a video image, which is two-dimensional. This is completely different from open surgery, in which the surgeon holds surgical tools in hand and has a 3-D image."

To help surgeons learn these new skill sets, the Virtual Reality and Skills Laboratory has ten work stations, each with a monitor and a range of laparoscopic instruments, including harmonic scalpels, for grasping, cutting and suturing. At some stations, a computer with virtual software programs is hooked up to the monitor, and students practice surgical skills by placing a "ball" in a "box" using laparoscopic instruments. At other stations, students practice suturing on simulated tissue samples, seen via the monitor.

"One key advantage of the virtual stations is that they produce an ongoing video of the student's abilities and progression in left and right hand orientation which, because it is counter-intuitive in laparoscopic surgery, is fundamental. The video can be reviewed and critiqued later with the instructor," said Dr. White.

First- and second-year surgical residents are required to have five, half-day sessions at MIMIS and are required to practice on their own time. Third- and fourth-year residents begin working at work stations with graded skill complexity.

Futuristic Conference Room
In addition to the Virtual Lab, the other main space in the 3,500-square foot MIMIS facility is the high-tech conference center, which has a full range of on-site and off-site teaching capabilities using links to local area and global communications networks.

Up to 35 students can sit in comfortable chairs at varnished wooden desks and, depending on the agenda for the day: listen to live lectures that use LCD projector displays on an 83-inch screen; view real-time surgeries, projected onto the room's four giant monitors, which are underway in Montefiore's surgical suites or anywhere in the world; attend a teleconference on the West Coast, or engage in a telemedicine diagnosis in India, where Montefiore has a memorandum of understanding to establish a formal telemedicine program that will encompass one of the most populous states.

The MIMIS facility is supported by grants from Ethic Endosurgery and Karl Storz, Inc., leaders in minimally invasive surgical technology.

Shalom Kalnicki, MD,

Chairman, Radiation Oncology

Montefiore is establishing new standards in radiation treatment for many cancers. For example, to treat lung cancer we use Image-Guided Intensity Modulated Radiation Therapy (IGRT), which allows unprecedented targeting of a lung tumor without harming surrounding tissue – even when the lungs move as the patient breathes.

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