Motorists usually steer clear of learner drivers, but what if the surgeon about to take out your gall bladder has an L plate and you are one of his first customers? Few would volunteer to be a practice dummy, but now computer generated "virtual patients" are being developed to help improve surgical skills before a real patient comes under the knife.
"We have been called the Nintendo surgeons because of this technology," explained senior surgeon, Mr Rory McCloy, of the Manchester Royal Infirmary. He has developed a surgical training system in conjunction with a specialist in virtual reality computer programming.
Mr McCloy makes extensive use of laparoscopic surgery, better known as keyhole surgery. "I would not have believed in 1989 that I could remove a gall bladder through a 12 mm wound and the patient would be home the next day, but this is now routine," he said.
Keyhole surgery required a whole new way of operating, however, with new tools and skills that combined hand and foot movements while watching pictures of the surgery on a nearby television screen. The challenge was to develop methods to help train surgeons to use these delicate techniques.
Training usually involved using the specialised laparoscopic tools to move Dolly Mixtures and sugar cubes about in a box. Chicken legs could be dissected this way and students could watch the television screen during actual surgery, but there was "a big jump from the basic simulators to an operation", Mr McCloy said. "We thought that there was a role here for virtual reality."
Trainees could have "Top Gun type competitions", he said, comparing their results. "It allows us for the first time to quantify surgical performance. It also allows us to test for aptitude. We have never selected surgeons on the basis of manual dexterity."
