UCLA’s Dr. Erik Dutson recently instructed new surgeons in Milan, Italy, in advanced minimally-invasive surgical techniques — and he did it from a laptop computer while sitting at his kitchen table in Los Angeles.
Dr. Erik Dutson, sitting at home in Los Angeles, waves to students in Milan, Italy, who are watching him on a monitor that serves as the "head" of a teaching robot. Dutson taught them how to perform minimally-invasive surgery.
Using an android-like robot that he controlled from his home with joysticks, Dutson was able to interact with trainees and faculty in Italy and “move” around the room without actually being there. On a monitor that comprised the robot’s head, they could watch Dutson as he answered questions in real time from Los Angeles. On his laptop screen, he could see them, thanks to a camera mounted to the robot.
The technology, called the InTouch Health robotic system, has typically been used by doctors who want to check on hospitalized patients remotely. In fact, the Ronald Reagan UCLA Medical Center utilizes RONI, the robot, to do just that in its neuro intensive care unit. Virtual teaching experiences, however, are becoming increasingly popular as this technology becomes more available.
Dutson used a robot like this to teach students. Joysticks helped him move the robot around. A camera above the monitor allowed him to see them.
Dutson, an associate clinical professor of surgery at the David Geffen School of Medicine, said that it’s a way to enhance education around the world by bringing in leading experts virtually who may not be readily available in the flesh.
“It’s much easier to just plug in a laptop than get on a plane,” said Dutson, co-director of UCLA’s Center for Advanced Surgical and Interventional Technologies. “Such remote instruction saves time, travel costs and allows access to leading experts around the world.”
Looking at the robot’s computer monitor-head, the trainees in Milan could also see illustrations that Dutson provided, such as a drawing that showed them where staples should be applied to close a suture.
Combining robotics and surgery is nothing new for Dutson, who is in charge of the UCLA surgical residents’ curriculum for minimally-invasive surgical techniques and robotics. He is also the director of the UCLA Minimally-Invasive Surgery Fellowship.
The advent of minimally-invasive laparoscopic surgery has changed the face of the field. Rather than perform traditional surgery, surgeons are now doing many procedures by using controls similar to joysticks that manipulate surgical instruments inserted through tiny keyhole-size incisions.
In fact, to qualify for UCLA’s minimally-invasive surgical training program, Dutson has students play a Star Wars video game against him to help him gauge their hand-eye coordination, a skill that’s essential to effectively use these new tools.
Surgical residents are first taught standard laparoscopic techniques in training classes such as those held in Milan. Once these skills are mastered, many are also taught how to utilize a robot to perform surgery.
“Minimally invasive robotic surgery offers improved outcomes for patients with shorter recovery times due to reduced pain and trauma and also provides surgeons with a greater range of motion and access,” said Dutson
According to Dutson, almost every surgical area is utilizing minimally-invasive techniques, including urology, cardiology, thoracic, vascular, bariatric surgery and neurosurgery.
Dutson’s team is now working on several projects to enhance the students’ experience as they learn these new surgical skills. He is partnering with the UCLA Henry Samueli School of Engineering and Applied Science to develop a system that will help surgeons using robotic surgical instruments actually feel resistance to bone and tissue as if they were operating inside a body.
The team has also developed a new robot which features dual controls similar to those used in a car to teach driver’s education so that a surgical teacher can help guide a trainee over the Internet as he or she uses a duplicate set of standard laparoscopic tools.
“It’s essential to develop new methods of teaching these skills to help meet the demand for these latest procedures,” Dutson said.