Practice in the virtual flesh


If you've ever tried to tie off a knot after repairing a tear in your clothes you'll know that it's a technique that needs a bit of practice to perfect.
Now imagine you are a new surgeon busy learning how to make the knots needed to tie off stitches while your patient is lying on the operating table. You grasp the thread… you lose the thread… try again… now the knot doesn't work… The nurse gives you a smirk, the anaesthetist keeps pointedly glancing at his wristwatch and your flawless surgery is now in jeopardy because you can't tie a knot.
This is exactly the type of procedure that post-grad medical students can now practice over and over and over again on the new laparoscopy simulator purchased by the University of the Free State (UFS).
Dr Mathys Labuschagne, head of the clinical simulation and skills unit at the UFS faculty of health, says the R1,2-million LapSim simulator is not supposed to replace training on patients, but will help registrars in acquiring basic laparoscopy skills. 
He says laparoscopic surgery is conducted by making small openings into the abdominal wall, then putting long instruments and a camera through the openings and conducting the surgery via the image on a screen or monitor. He says it could be a more technically difficult procedure than conventional open surgery and says that students need to practise skills including depth perception, hand-eye-coordination, instrument handling, precision and speed.
"We are so excited about this… this simulator has haptic feedback so you can actually feel what you are doing… You have the instruments in your hand, you look at the screen, but you can feel as you touch tissue, you can feel a needle, you can feel resistance…"
He says the LapSim, which is imported from Sweden, is useful for training in several different medical disciplines, including surgery, obstetrics, gynaecology and urology. "We can even recreate a complete operation, for example a laparoscopic sterilisation or a myomectomy."
The UFS is currently one of a selected few universities in the world, and one of only two institutions in South Africa, that owns such a simulator. 
The LapSim is the latest addition to the clinical simulation and skills unit. Labuschagne says the UFS is the only institution that has an entire simulation 'hospital' available to train students on virtually any conceivable medical procedure or condition. This ranges from a heart attack simulation on a hi-tech manikin, to the even more impressive mannikins in the maternity ward that actually give birth. – Sabrina Dean