Engineering And Plastic Surgery



Engineering And Plastic Surgery

Abstract

Plastic surgery today is a nearly unrecognizable discipline when compared to its origin as a subspecialty 80 years ago. As new engineering have developed, laparoscopic and otherwise, the concept of practice and competence assessment has become more important. Cadavers and live animal models were accepted for practicing surgical techniques; however, the ethical and cost constraints of these models have become overwhelming to most institutions.

Engineering Aspects Of Plastic Surgery

There is a fantastic engineering revolution changing the way we learn and practice surgery. Over the last two decades virtual reality, haptics, simulators, robotics and other "advanced engineering" have emerged as important innovations in medical learning and practice. Reports on simulator applications in medicine now appear regularly in the medical, computer science, engineering and popular literature. The goal of this article is to review 1) the emerging intersection between advanced engineering and surgery and 2) how new engineering is being utilized in several surgical fields, specifically Plastic Surgery. We will end with how plastic and reconstructive surgeons can benefit by working to further the development of multimedia and simulated environment engineering in surgical practice and training.

The Emergence Of Advanced Engineering In Surgery

Modern engineering has integrated into academics through popularity and as a natural extension into the visual and tactile world of surgery. In his 1912 Presidential address to the Southern Surgical and Gynecological Association, Rudolph Matas correctly predicted that the "picture machine" would revolutionize surgical training. Prior to the 1950s, the operating room represented the only place to visualize surgery outside the classroom. The introduction of film allowed learners to build and integrate verbal and pictorial representations of disease.

In the early 1990s, the first surgical simulator ) was designed by the NASA Ames Research Group to investigate the biomechanical consequences of tendon transfer based on the force generating properties of the muscles and the geometry of the bones and joints. Coincident with advances in engineering, the last two decades have seen dramatic changes in surgical training programs. Instructors are under increasing pressure to perform procedures in a more cost-effective manner, including shortening operating room times and improving outcomes. In addition, many teaching programs are experiencing decreases in number of available patients for teaching. And the increasing demands on attending surgeons are decreasing their availability as the expert educator in the operating room. These new demands have both stimulated the growth of engineering in medicine and highlighted our lack of understanding as to how surgeons learn. For example, with the introduction of laparoscopic surgery, thousands of practicing surgeons graduated from abbreviated courses and returned to their practice to perform their first solo laparoscopic procedure days later. The variation in complication rates of these new laparoscopic surgeons brought the issues of surgical competence and patient safety to public attention.

As new engineering have developed, laparoscopic and otherwise, the concept of practice and competence assessment has become more important. Cadavers and live animal models were accepted for practicing surgical techniques; however, the ethical and cost constraints of these models have ...