Mathematician develops surgery training method

A surgeon working at an operating table makes a crucial error and his patient dies. He pauses a moment and undoes the mistake, reviving the patient and continuing the surgery to a successful end.

Joseph Teran, a UCLA mathematician, is working on virtual surgery, a new technique that would enable such seemingly strange proceedings to occur, significantly aiding both the medical community and patients needing surgical procedures.

Teran, who joined the math department as an assistant professor three months ago, first began work on the technique when he was a postdoctoral student at New York University. While there he started collaborating with Court Cutting, a professor of surgery at the NYU Medical Center who was interested in using high-technology tools to teach surgery, especially in developing nations.

“We wanted a scientific simulation that would reflect what would really happen on a human being (during an operation),” Cutting said.

This is exactly what virtual surgery accomplishes, Teran said. The technique uses different scanning technology, such as MRI and CT, to produce images of body parts that are to be operated on.

Three-dimensional representations of the image are created on computer programs that show how skin and soft tissues such as muscle, fat, tendon and ligament respond to surgical operations and incisions.

The way soft tissue responds to these actions is related to numerous systems of partial differential equations, which are solved by mathematical algorithms that Teran helps create. These programs create a realistic simulation on which doctors can practice the same surgery they will later conduct on a live human.

“You can mess up, fail spectacularly, with no consequences,” Teran said.

Virtual surgery is a far better alternative to current training procedures such as operating on cadavers or animals, said Erik Dutson, an assistant professor of surgery and codirector of UCLA’s Center for Advanced Surgical and Interventional Technology.

Teran said that surgical simulations can also serve as a way to perfect new methods in various types of procedures.

One example is the improvement in reconstructive surgery for trauma cases, which arose from the use of virtual surgery.

Because of the specific nature of each patient, having the opportunity to try out different surgical techniques and perform the operation on a virtual representation would help decrease potential errors by the surgeon, Teran said.

“Patient-specific surgical simulation is the next big thing, particularly in operations where the surgeon is expected to invent procedures,” Cutting said.

There are a number of benefits to the development of virtual surgery, Dutson said.

“The idea behind virtual surgery would be fewer mistakes in the operating room (because) you would practice beforehand,” he said.

Dutson said fewer error would translate to fewer expenses in the health care system.

The new tool has already been implemented by many medical schools.

“Virtual surgery is becoming an increasingly large component of medical school training,” he said. “It’s fairly obvious that it’s the future.”

While virtual surgery will likely take a prominent place in surgical training soon, it is currently waiting for computer technology to catch up, Teran said.

Though current computer processors can solve each system of partial differential equations that run the surgery program in one-thirtieth of a second, computers with parallel processors are being developed that will work even faster, solving each system of equations in one-thousandth of a second.

“We will see more detail, more speed, more accuracy as technology increases,” Teran said.

Dutson said that he believed that once this progress has been made, virtual surgery will be readily embraced by the medical community.

“I think it will be mandated in the credential processes of surgeons as it becomes more and more accepted and usable,” he said.

While Teran is proud to make a contribution to the medical community, he said he was attracted to this project, which receives funding both from the National Science Foundation and UCLA, because of the impact it could have on humanity.

“I like that it’ll make a big difference in lots of peoples’ lives,” he said. “Applied math is the key to making that happen.”

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