Surgical Sam, A Beating-Heart Mannequin, Takes the Stage

We often see medical magic in Hollywood, but it’s not often we see Hollywood magic brought into medicine. Now, Boston Children’s Hospital’s Simulator Program and special-effects collaborators at The Chamberlain Group (TCG) have done just that.

Simulation has become a key component in team training, crisis management, surgical practice and other medical training activities. With simulation, medical teams can add to and hone their skills in an environment where people can make mistakes without risking patient harm—”practicing before game time,” says Boston Children’s critical care specialist Peter Weinstock, MD, PhD, who runs the Simulator Program.

Mannequins are a key part of simulation, and Weinstock’s team, working together with companies, designers and engineers, has developed eerily lifelike ones that can bleed and “respond” to interventions based on computer commands from a technician.

But there are some things Weinstock’s mannequins haven’t been able to capture up to now, like the movements of a beating heart.

That’s where TCG and a new mannequin called Surgical Sam come in.

From “bullet time” to training time

Founded by husband-and-wife team Eric and Lisa Chamberlain, TCG got its start in the movie business, designing special effects such as the iconic “bullet time” effect from “The Matrix.” But more than a decade ago, the Great Barrington, Mass.-based company saw an opportunity to shift from cinematic special effects to medical training and simulation.

“A medical company had heard that we were really good at making scale models,” recalls Lisa Chamberlain, the company’s managing partner. “We knew nothing about medicine or medical training but were interested in the intellectual challenge of it.”

Today, the company uses its special effects know-how to develop and manufacture high-fidelity medical training tools—hearts, blood vessels, internal organs, limbs, etc.—that mimic the touch, feel and resilience of actual tissues. Many of their products form the cornerstone of training and product development programs for hundreds of hospitals and device manufacturers.

Giving a mannequin a beating heart

Three years ago, Weinstock met the Chamberlains at a medical simulation conference. “I saw an adult beating-heart trainer they had developed and asked whether they would want to partner on the development of a pediatric beating-heart training mannequin,” Weinstock says.

The TCG team began working with Weinstock, cardiac surgeon Francis Fynn-Thompson, MD, and trauma surgeon David Mooney, MD, MPH, to design and create Sam, a pneumatically-powered, fully operable modular medical trainer. Fynn-Thompson helped guide the development of Sam’s life-sized “heart,” which accurately mimics the beating motions of a healthy heart, as you can see here:

At a technician’s command, Sam’s heart can also replicate abnormal motions that a surgeon might see in a child. It’s construction also affords surgeons the opportunity to practice heart surgery, cannulation, suturing and other techniques.

Sam, who was formally unveiled in April at a meeting of the International Pediatric Simulation Society in Vienna, Austria, is the first pediatric beating-heart simulator on the market. In addition, thanks to Mooney’s input, Sam’s abdominal cavity accurately reflects the anatomy of a child’s intestines and other organs, including a bleeding liver, affording pediatric surgeons the opportunity to practice realistic abdominal surgical scenarios, like this:

The technology built into Sam adds a new level of physical reality to simulation. “A lot of simulation is computer-based, where a team reacts to data or readouts, and many mannequins are designed to blink or breathe,” says Chamberlain “But with Sam we have built a host of simulation capabilities that allow technicians to cue up physical events like releasing blood into a body cavity or perforating a bowel, organ changes that the team must respond to.

“We can program Sam for just about any scenario for which there is data,” she adds.
Both Chamberlain and Weinstock see lots of potential for expanding Sam’s capabilities with plug-and-play adaptors for other surgical specialties, such as orthopedics and general surgery. They also see Sam’s broader potential for scenario-based clinical training, which is why TCG is now actively marketing Sam to other institutions.

“This partnership between The Chamberlain Group and Boston Children’s represents a way for us to leverage our clinical knowledge and simulation expertise to the benefit of patients everywhere,” says Raj Khunkhun, a licensing manager with the hospital’s Technology and Innovation Development Office.
“Simulation is becoming one of the most rapidly growing fields in medicine now,” Weinstock adds. “Sam is a significant advance in making pediatric simulation as realistic as possible and adds a new dimension to clinical and team training in some of our most high-stakes areas—the operating rooms.”

– Written by: Tom Ulrich

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