Gerald Fried, MD

Minimally invasive surgery provides definitive and durable surgical care, without the injury of access to the target tissue. This is achieved by combining image-guidance (as opposed to direct view) with manipulation of long surgical instruments threaded through fixed ports into the body cavity. This requires a unique set of surgical skills, including extraction of 3D information from a 2D image, working with long instruments with limited degrees of motion placed across a fulcrum, thus limiting tactile information, amplifying tremor, and requiring the hands to move in opposite directions from the desired movement of the instrument tips. We are developing simulation-based training programs, validating metrics to verify proficiency, and assessing learning curves and transfer of training from simulation to reality. Further, we are developing patient-specific simulations from point of care images to allow surgical rehearsal. We are also assessing these innovative procedures in terms of patient outcomes, through novel measures of surgical recovery.