Established in 2012 by Joshua B. Bederson, MD, and led since 2014 by Anthony B. Costa, PhD, the Neurosurgery Simulation Core at Mount Sinai includes students, residents, attending neurosurgeons, and researchers, all of whom are motivated by our ultimate goal: to improve outcomes and reduce complications in patients undergoing brain surgery by leveraging the potential of novel surgical training, pre-, and intraoperative simulation and visualization technologies.
The Neurosurgery Simulation Core works closely with industry partners to acquire and deploy the most advanced available simulation technology for our patients. We collaborate extensively with Surgical Theater, whose products the 3D Surgical Planner (SRP) and Surgical Navigation Advanced Platform (SNAP) provide advanced, patient-specific 3D visualization technology which we have integrated into our tumor and vascular case planning. The SNAP is now a standard feature in OR, providing surgeons with an intraoperative and patient-specific 3D environment in which to plan and understand surgical approaches. Together with our industry partners, we continually drive the development of the next generation of simulation and virtual reality technology which offers the possibility of truly immersive pre-operative planning and virtual reality surgery for every patient, in collaboration with our research and development focus within the Core.
While of fundamental importance to our clinical practice today, the current best-practices in interactive, 3D pre- and intra-operative neurosurgical planning are based on technologies that limit their applicability to some of the most complex cases where simulation can provide the most benefit to clinicians. Today, typically skull, large contrasting tumor, and arterial vessels are the only structures displayed using industry simulators, and these structures cannot be interacted with; they are displayed statically. Our development program is therefore focused on building novel simulators which are able to render more complex brain structures developed through novel volumetric image segmentation methodologies, providing high-fidelity (and therefore computationally efficient) interactivity with each segmented brain structure. Our long term goals include the integration of our structural segmentation and multi-volume visualization tools into a haptic simulation platform, providing for the first time a truly immersive pre-operative virtual-reality surgery experience on a patient-specific basis.
Validation of new tools is key to their broad adoption. At the same time, these tools open doors to answer new clinical questions. Our research program is dedicated to both aims. To date, basic limitations in our understanding of the application of simulation technology and its potential effect on complex microsurgery prevent wide-scale deployment of these important methods. We are currently leveraging our developed simulation tools to show that high-fidelity, interactive 3D representations of neuroanatomy increase knowledge and confidence of intraoperative decision. Our development of novel tools for measuring neurosurgical performance provide a mechanism to understand acceptable levels of skill in surgery, offering another mechanism by which to understand the application of simulation technology to neurosurgical training. Our novel segmentation platforms are being used in a variety of clinical research applications, especially where quantitative analysis of imaging data can provide key insights into neurologic disease. A current example is the volumetric and structural analysis of stroke patients, where cognitive and functional reliance may be a determinant of outcome.