Virtual Patient: Show And Tell

Virtual Patient: Show And Tell

CREATED Sep 24, 2013

JACKSONVILLE, Fla. (Ivanhoe Newswire) - Do you ever find it challenging to understand what your doctor or surgeon is trying to explain to you? If so, a visual can be extremely helpful--especially if it's your body in 3D.

Complex conditions and procedures described in multi-syllabic medical terminology can be difficult to decode, creating stress and confusion about your healthcare options.

 "Our biggest challenge as surgeons is getting people to understand exactly what we are doing and not only what we are doing, but how difficult it can be," Mayo Clinic, Urologist Doctor David Thiel, MD, told Ivanhoe.

Virtual dissection tables like this one at Mayo Clinic could help bridge the communication gap between doctor and patient.

"We can take a thin slice CT of any patient we want and we can virtualize them in six to twelve minutes and we can have them on the table," Mayo Clinic, Tech Specialist Conrad Dove, told Ivanhoe.

In life-size 3D. Doctors can show you—not just tell you—about a trouble spot on any layer of your body, down to the bone

"Three dimension is so much more real to people. If I show someone a picture of something on a sheet of paper or I show them a pop-up book, which one makes more sense? Even a child gets more out of a pop-up book," Dove explained.

Mayo Clinic surgeon Doctor David Thiel agrees.

"This type of model would allow you to see where the tumor is, here is where we need to cut, here is where we need to reconstruct and it kind of gives you an idea of what we are trying to do," Doctor Thiel said.

Doctor Thiel also expects to use this technology to help his surgical team—including nurses and medical technicians—prepare for a complex procedure. The technology is part of Mayo Clinic's New Simulation Center.


VIRTUAL DISSECTION TABLE:  The new virtual dissection table takes advantage of 20th-century technological advancements in imaging, such as X-rays, ultrasound and MRIs, and combines them for use in a 7-foot by 2.5-foot screen.  The table is being tested as a way to further enhance that age-old teaching method — the dissection of human cadavers.

The table is designed as a complement to other anatomical educational devices, with the added benefit of allowing users to easily explore hard-to-reach parts of the human body. Its creators refer to it as something of a reusable cadaver.

The images morph magically from soft tissue to hard tissue. The tissue can be sliced much like actual tissue on cadavers in the dissection lab next door, but no knife is needed — just a single slide of a finger will do. Then, with the press of a button, the entire body is restored instantly.

The touch screen allows users to investigate a realistic visualization of 3-D human anatomy and to delve inside the human body. CT scan images are augmented with 3-D modeling and annotation enabling physicians to give their patients visuals.

(SOURCE: http://med.stanford.edu)


David Thiel, MD, an Urologist and Medical Director of the Multi-Disciplinary Simulation Center at Mayo Clinic in Florida, talks about a new 3D technology that enables doctors to see the body in a whole in way.

I am blown away by what looks like a really large I-Pad table. Tell me, why do you think it is useful? How are you using it?  

Dr. Thiel: This type of 3D imaging, we initially purchased it with the intent of training our medical students, nurses, physicians on anatomy.  Then what we realized is we tried to make this applicable in the surgical environment, so as an Urologist, one of the things that I do, for kidney cancer, is to actually cut out the tumor and leave the kidney behind. We do that in a minimally invasive fashion using the robot or the surgical robot.  It is very difficult surgery.  It is bloody.  We need to know where exactly the blood vessels are that go to the kidneys, so our idea was to use this type of 3D imaging for the physicians, the nurses and everybody on the surgical team to go over the plan of attack; look at the vessels, look at the blood supply to the kidney; instruct everybody on what we are going to be doing; overall surgical planning for that particular case and then see if that helps us in the actual surgical realm in the operating room.  

Have you found that it helps? 

Dr. Thiel: It does, but the technology, it is new.  It is infancy so we are the pioneers in looking at this. There are some bugs that we still need to work out and that is why we have smart guys here like Conrad and so on, to work through these things to get it where it is flawless for us to use for surgical planning. 

Is it exciting for you because it just kind of changes the way you work?

Dr. Thiel: It can change the way we work. The big focus now with medicine is two things; one, team based training – is not only does the physician know what they are doing, but does the whole team know what is going on.  This type of technology allows us to plan with the entire team; not just the physicians, but the nurses, the techs and everyone. The second thing that is a focus of medicine now is individualized medicine and what we envision is taking these type of 3-D images and making it, using a 3-D printer to make an actual image of your kidney with the tumor and show it to you as the patient; here is where we are going to be cutting, here is where the defect will be; here is where the repair will be and so on. We take something that is very abstract to you and put it in your hand as a model and it would be your kidney; it would be a model of your individual kidney to show you exactly what is going on and we think that will improve the patient experience and let them understand exactly what we are doing.

When trying to explain to a patient what's going on with them; what do you find the most challenging?

Dr. Thiel: Our biggest challenge as surgeons is getting people to understand exactly what we are doing and not only what we are doing, but how difficult it can be.  A lot of people know they are having surgery and they get the basic premise of what we are doing, but they don't understand why there are potential complications.  This type of model would allow you to see, hey, here is where the tumor is, here is where we need to cut, here is where we need to reconstruct and it kind of gives you an idea of what we are trying to do and some of the difficulties that are posed in the surgery.

Would you have liked this as a med student?    

Dr. Thiel: I would have loved it.  I would have loved every bit of simulation as a medical student. When I was a medical student, we learned on actual real patients or watched other people work on real patients, but the first time I did anything as a medical student, or a trainee was to real people. Simulation itself offers a safe environment where you can come learn things without actually learning it on real patients. So, I would have loved all of simulation when I was a medical student.


Cynthia Nelson Weiss
Mayo Clinic Florida
904-953-0464 (direct)
904-953-7339 (asst)