Click and Cut

Talking with a pilot friend one day, Cutting realised that the way we teach surgeons is like training pilots by sending them up in loaded 747s—loaded mostly with poor people, since the affluent seek out experienced doctors as private patients. But pilots learn to fly on simulators. Why can’t surgeons practise on machines, instead of bodies?

They already do, but existing devices all have shortcomings. Cutting himself has developed a videogame-based system for teaching cleft-lip and -palate repair, and there are programs for cardiac surgeons to practice threading catheters up the femoral artery to the heart. But those are based on generic anatomical models. Cutting wanted the ability to rehearse an operation on a virtual model of a real patient’s actual anatomy, based on CT or MRI scans. And he wanted to be able to do it in real time, interactively, on a model incorporating skin, muscle, nerves, organs, bones—and blood.

To show the effects in real time on a screen, you have to do the calculations in one thirtieth of a second. To create the illusion of actually wielding a scalpel or hook— using a device that simulates actual motion and resistance, analogous to the joystick on a flight simulator—requires reducing the lag time to one thousandth of a second. Essentially, you’d need to put the power of a supercomputer into a desktop. Cutting thinks this will be achievable, using multiple parallel processors and new algorithms Teran is developing, within a couple of years. “You could have a patient in a small town scanned while a surgeon in the city practises the surgery,” Teran says. “The patient then flies out for the operation.”

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