The aim of the NTT Project is to develop and prototype an anatomical training system of the spinal column, useful both for teaching surgical anatomy to medical students and for training experience of surgical techniques for youngsters and younger neurosurgeons. In fact, for medical and surgical students it is very important, and in some cases crucial, to practice dissection, especially as regards the study of anatomy, as well as for doctors in specialized training, mainly in surgical branches. The possibility to practice real surgery is fundamental for the development of particularly complex interventions and in the experimentation of new approaches, techniques, and technologies. In fact, although the recent diffusion of virtual surgery simulator with high authenticity, the learning process of the surgical gesture can't fail to include a physical training, in which the student learns how to dose strength thanks to the physical feedback of the manipulated tissue. Especially in Italy, the limited availability of cadavers for the purposes of study, scientific research and training often forces Universities to fall back on the use of animal species or to finance training activities in foreign facilities, with an important expense of economic resources. To fill this gap and to meet these needs, thanks to the multidisciplinary skills offered by Sapienza, the NTT project intends to develop an integrated and dynamic device capable of faithfully simulating a portion of the spine in terms of appearance and physical characteristics, and in terms of biological feedback that a live operation would require. The NTT project will be developed according to the applied research approach and it is structured in 3 main phases: - benchmarking on the state of the art of the equipment currently available and definition of medical user needs; - development of the technological-performance characteristics of the product/service; - design and development of the prototype and its validation.
The NTT project, thanks to the originality of the system to develop, expects to have a remarkable impact first and foremost considering that this innovation will find a direct request by the national health system, starting from the two large hospitals managed by the Sapienza University of Rome: Policlinico Umberto I and Policlinico Sant'Andrea where the donation program for anatomic study and surgery training sees less than 15 donors and only up to then 5 bodies received until the 2017. It is worth reminding that in Italy the practice of dissecting corpses for the purposes of study, scientific research and training, is quite difficult, in addition to the economic aspect of maintenance and management of bodies, due to the scarce spread of a culture of donation of bodies. This situation compels many surgeons to go abroad to learn new techniques or perfect themselves with an impact considerable in financial terms on local health resources (1). In the national context, the NNT project would solve these limitations through the development of a completely synthetic system but able to perfectly simulate the physical and mechanical characteristics of portions of the human body. Furthermore, the use of this system would have substantial economic and ethics effects also at global level, reducing management and maintenance costs of cadavers and the widespread use of animal in surgical practices.
In terms of SCIENTIFIC IMPACT for the Research team in Sapienza, this can be measured on three levels:
1. Increase in funding opportunities and in new research staff; thanks to the possibility to activate Post-Doctoral Research Grants, the Research Team will develop new skills in the field of Advanced Design and Technologies for Neurosurgery, these new researchers can lead both further research projects in collaboration with interested Companies and reply at the Regional and National Research call (PON, POR and Regional Calls) and European Calls foreseen by the new program Horizon Europe;
2. Apply for patent for the system that will be obtained or for parts of it; this is allow the Research Team to obtain the intellectual property and possible economic return from the industrialization of the surgical training tool by the interested companies; in coherence with the purposes of the academic research, these economic returns will be invested in new Research Grants in the specific field of experimentation;
3. Enhancement of the reputation of the Research Team and Sapienza in the specific fields (neurosurgery, advanced product design, material engineering) - with positive effects also on the Regional and National System of Scientific Research - through dissemination activities of the project results as (i) call for participation at international conferences; (ii) publications in Scientific Journal or sectorial magazines both in the medical field and in the various scientific fields involved in this project to this project (Design for Healthcare, Design and Performance, Material Engineering for medical purpose, Experimentation and Prototyping, Augmented Reality and Human Computer Interaction etc.).
In terms of PROGRESS BEYOND THE STATE OF THE ART, the NTT project contributes to the advancement of knowledge according to the three areas of expertise involved:
1. Neurosurgery
The anatomical/surgical training system of the spinal column developed by the project will couple, in a completely new way, the benefits of Human performance simulation and Virtual reality surgical Simulation integrating physical feedback with the guidance of augmented reality tools;
2. 3D Modelling and Virtual Representation
The process of translating diagnostic images into a three-dimensional digital model first, and then physical, will allow the expansion of this technology contributing to adapt the same process to other medical disciplines that need surgical training (i.e. orthopaedics, ophthalmology, etc.).
3. Advanced and Human-centred design for Healthcare The phases of prototyping and usability validation and the convergence of the different disciplines involved in the project, allow to move from a Product-Centred approach to a Human-Centred approach transforming the product into a product/service with a systemic perspective.
(1) DDL, 1° AGOSTO 2018, n°733, concerning Arrangement of one's body and post-mortem tissues for the of study, training and scientific research purpose.