3D-printed cleft palate simulator improves surgery training

Dale Podolsky

Dr. Dale Podolsky is a reconstructive surgery resident and PhD candidate in the Institute of Biomaterials & Biomedical Engineering (IBBME) at the University of Toronto. As a member of the U of T Surgeon Scientist Training Program, he is researching ways to improve the surgical process for cleft lip and palate repair, which is the most common birth defect worldwide. (Photo: Dan Haves / University of Toronto)

October 21, 2016 | By Dan Haves

A new simulator developed by U of T medical resident and IBBME PhD candidate Dale Podolsky may help doctors to better perform uniquely challenging cleft palate surgeries.

Cleft palate is a potentially serious birth defect that affects 400 to 500 Canadian babies each year. The tissue on the roof of the mouth does not join together completely during pregnancy and can lead to problems with feeding, ear infections and speaking. The surgery to correct this is straightforward, but difficult due to the small confines of a baby’s mouth and the delicate tissues involved.

Podolsky founded Simulare Medical to produce equipment to help surgeons practice — the startup’s first product is a cleft palate simulator. These simulators also help accelerate the development of robotic instruments for surgery.

What is the history of the cleft palate simulator?

I spent a lot of time developing the simulator initially at the Centre for Image Guided Innovation and Therapeutic Intervention (CIGITI) at the Hospital for Sick Children. I wanted to make it as realistic and life-like as possible, incorporating every anatomical detail possible. I worked with leading paediatric surgeons Dr. David Fisher, Dr. Karen Wong, Dr. James Drake and Dr. Christopher Forrest.

As a result, the simulator became very valuable not only as a method of developing and testing new surgical robotic tools, but also as a training tool in cleft palate surgery. Simulare Medical was created to translate this technology beyond the laboratory into the hands of individuals who could benefit most from its use.

How does the simulator work?

The cleft palate simulator is a physical model developed using 3D printing, adhesive and polymer techniques to create the most realistic simulation environment possible. Using real surgical instruments, a trainee performs all the steps of a cleft palate repair as if they were in an actual operating room.

The simulator also enables easy video recording of the procedure to easily teach and provide feedback to trainees performing the procedure.

Before the simulator how would trainees learn to perform cleft palate repair?

The current method of training is to practice on actual patients. This is sub-optimal as more experienced surgeons make fewer errors, so supervising surgeons are often reluctant to allow trainees to perform this procedure.

Mastering a complex surgical procedure requires significant practice and repetition. The simulator provides a platform for trainees or surgeons alike to practice multiple times in a low pressure, low stress environment without any risk to the patient.

What has been the response from those who have used the simulator?

The response to the simulator has been unbelievable. We officially launched the product in September and we have been receiving our first orders around the world. We have run pilot workshops at the University of Toronto and Stanford and we have more pilot studies planned.

There has been significant academic recognition at local, national and international meetings. There is also significant interest from NGO’s who provide cleft care to low and middle income countries.

Access to surgeons who perform cleft surgery is often lacking in the developing world. The cleft palate simulator is a vehicle to train surgeons in these environments to better prepare them to provide this life changing operation to those who need it most.

What’s in the future for Simulare Medical?

We want to develop new simulators in other surgical areas. Our goal is to develop the most realistic, complex surgical simulators that for the first time capture the subtleties and the complexity of surgery that is required to master these procedures.

We believe the cleft palate simulator is the most advanced physical simulator available across all surgical disciplines. We are striving to be leaders in developing this technology that shorten the surgeons learning curve and improve competence without compromising patient safety. Our ultimate goal is improving patient outcomes.