New Vision for Studying Human Body Taking Place

The new vision for studying the human body is taking place on the seventh floor of the new Jacobs School of Medicine and Biomedical Sciences building in downtown Buffalo with UB RISE (Research, Innovation, Surgical Simulation, Education), where collaborations take place between researchers and educators in fields that don’t often interact.

“This facility was purpose-built — not happenstance — to make these conversations flow,” says Tomaszewski, SUNY Distinguished Professor and the Peter A. Nickerson, PhD, Professor and Chair of the Department of Pathology and Anatomical Sciences. “It was planned out and driven from concept to construction.”

It also reinforces the school’s focus on pathology and anatomy, which is at odds with some trends in medical education.

Tomaszewski said there are medical schools that have been dismantling and de-emphasizing entire anatomy departments, focusing almost exclusively on digital approaches.

“We think that’s absolutely wrong,” Tomaszewski says. “There’s tremendous and important meaning in human structure.”

To develop and execute the concept, Tomaszewski was recruited from the University of Pennsylvania in 2011 and Schwaitzberg was recruited from Harvard University in 2015.

Tomaszewski has been at the forefront of advances in digital pathology and computational modeling, using the data these techniques generate to push the fields of integrated diagnostics and personalized predictive medicine.

Schwaitzberg, professor and chair of surgery, ran an innovation center at the Tufts University School of Medicine/New England Medical Center for nearly two decades, where he pioneered minimally invasive and robotic surgical techniques and developed a microwave blood warming technology approved by the Food and Drug Administration that is now in routine use.

Together, they see UB RISE as a multidisciplinary center that educates learners at every level — from medical students to practicing physicians and surgeons — about the human body in the most comprehensive way possible.

“Our facility has this integration of people: surgeons working with anatomists working with computational people and engineers,” Tomaszewski says. “It’s a whole team approach.”

Under Tomaszewski, pathologists and computational anatomists use experimental methods and digital technologies to generate and analyze biological data. Schwaitzberg and his colleagues apply that data to the innovation of new procedures, surgical techniques and instruments to improve those procedures.

The approach takes advantage of both hands-on and virtual techniques from advanced imaging and computational methods and phantoms, which are organs generated by 3-D printers and biological materials.

UB’s extensive anatomical gifts program — the largest in the state — plays a key role, not just in educating medical students but in providing simulation opportunities for researchers and industrial partners.

“This is what the future of medicine is all about: integrating anatomy and imaging from the cellular level to the whole body,” Schwaitzberg says.

That integration is already happening in the school’s Gross Human Anatomy course. In addition to the cadaver that every first-year medical student works on, each group also now receives high-resolution computational tomography (CT) scans of their cadaver.

“It’s all about learning how to use that data,” Tomaszewski explained. “It’s integrating the virtual representation of the body — the CT scans — with the physical representation of the body from human gifts in a very robust and formalized way.”

It’s not only students who benefit. In the center, clinicians and surgeons are learning new procedures and techniques through simulations with virtual or 3-D printed models generated by computational anatomists who study how musculoskeletal structure affects function.

A partnership with the School of Dental Medicine is yielding answers about how the shape of the jaw affects issues related to temporomandibular joint disorders. In addition, orthopaedists and bioengineers at UB are looking at computational models of how humans bear weight in order to improve implantable hips and knees in an aging population.

The integration of so many approaches gives the center major advantages over other facilities striving to do similar things.

“Simulation is an absolute requirement for the future,” Schwaitzberg says. “We will be creating anatomical models of the liver and gall bladder so that surgeons can practice their skills, do flexible endoscopy training and become more proficient at screening for colon cancer.”

The goal is simple: “When your doctors are better trained, you have better outcomes,” Schwaitzberg adds.

UB RISE includes four simulated operating rooms designed to support surgical procedure simulations.

They feature:

• 17 surgical tables for research and method development using preclinical models
  
• 21 computer workstations in the surgical skills area for research, teaching and simulations
• a 3-D printing facility
• a facility for engineering and structural scientists to collaborate
• a fully equipped structural science visualization room that includes a 12-foot, high-resolution touchscreen monitor, full videoconferencing equipment and software for working with human structural data.

The UB RISE spaces are adjacent to the facilities devoted to the teaching of gross anatomy and the anatomical gifts program.

Funding has been provided by a $1 million grant from Empire State Development and $1 million from the James H. Cummings Foundation.  

The center consists of four collaborating facilities:

• The Structural Sciences Learning Center, directed by Tomaszewski
• The Surgical Skills Simulation Center — which includes the Robotics and Advanced Surgery Suite — directed by Schwaitzberg and John M. Marzo, MD, clinical professor of orthopaedics
• The Behling Simulation Center on the sixth floor, where students learn and are tested on new skills using realistic mannequins
• The Clinical Competency Center, also on the sixth floor, where medical students work with standardized patients — individuals trained to simulate real patients with specific conditions — to build their interpersonal and examination skills
  

UB RISE has also developed partnerships with the university’s Buffalo Institute for Genomics and Data Analytics (BIG), the Jacobs Institute and the ATLAS (Applied Technology Laboratory for Advanced Surgery) Program at Roswell Park Comprehensive Cancer Center.