Virtual Touch Software Developed at UB Teaches Robot-Assisted Surgery

Using simulation and haptic (virtual touch) technologies, the training modules guide the hands of novice surgeons through every step of four common robot-assisted surgical procedures, helping them become proficient in these highly complex operations. The goal is to ensure patient safety and improve surgical outcomes.

Khurshid A. Guru, MD, director of robotic surgery at Roswell Park Comprehensive Cancer Center and UB clinical assistant professor of urology, and Thenkurussi “Kesh” Kesavadas, PhD, director of the UB Virtual Reality Lab and a professor of mechanical and aerospace engineering, created Hands-on Surgical Training (HoST) to harness the didactic potential of their Robotic Surgical Simulator, or RoSS.

The new modules are the first procedure-specific software applications for robot-assisted surgery. They are available for these four minimally invasive robot-assisted procedures:

• Prostatectomy, removal of the prostate gland
• Hysterectomy, removal of the uterus
• Cystectomy, removal of the bladder
• Complex extended lymph-node dissection

The four HoST modules were publicly demonstrated for the first time at the annual conference of the American Urological Association in Washington, D.C., May 14-17.

The HoST platform is the only interactive software that records and replays the precise hand movements of world-renowned surgeons during minimally invasive surgeries.

“HoST virtualizes every motion that a surgeon makes during an operation, down to the suturing,” explains Kesavadas. “All the actions are then converted into surgical principles based on HoST software, which brings a sense of touch to virtual reality. The trainee can sit on the RoSS platform and feel exactly how the expert robotic surgeon performed the procedure.”

“Isn’t that the holy grail of simulation for surgery—to learn and perform an actual procedure on the simulator with the master surgeon and not on the patient?” says Guru, an associate professor in Roswell Park's Department of Urology. “It’s this element that makes HoST such an important tool for both new surgeons just learning the techniques and experienced surgeons looking to hone their skills or ‘warm up’ before live procedures.”

Under Kesavadas’ direction, the UB Virtual Reality Lab has focused on ways to virtually transmit some of the most unique and difficult-to-imitate skills that humans have.

“Both the RoSS- and the HoST-based modules demonstrate how a surgeon who is training can learn the same skills that good robotic surgeons have,” notes David Parish, chief executive officer of Simulated Surgical Systems (SSS), the Williamsville, N.Y., company that builds and markets the RoSS. “These products merge UB’s virtual reality research with Dr. Guru’s expertise in robotic surgery to come up with an innovative approach for training.”

The modules incorporate detailed anatomical illustrations matching the magnification of the RoSS interface.

“I believe the illustrations will be constructive by allowing the surgeon to more clearly envision these complex anatomical surgical fields,” says John Nyquist, lead medical illustrator and clinical assistant professor of pathology and anatomical sciences in the School of Medicine and Biomedical Sciences, who contributed the illustrations.

The patent-pending HoST system was jointly developed by Roswell Park and UB and licensed to Simulated Surgical Systems, which Guru and Kesavadas co-founded in 2009.

“Ingenuity has been the hallmark of everything Doctors Guru and Kesavadas have created through their SSS partnership, so it’s no surprise to see how they’ve once again adapted technology to advantage in the surgical environment with these HoST procedure modules,” says James Mohler, MD, associate director, senior vice president for translational research, chair of urology at Roswell Park and UB professor of urology. “These are outstanding training tools that will no doubt help to reduce the risks associated with robot-assisted surgery, and they were made possible through a marvelous example of inter-institutional collaboration.”