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Virtual reality could help train surgeons


High Techsplanations, a Rockville company that develops computer-assisted training programs, has been awarded a prestigious science grant to break a technological barrier so that the emerging field of virtual reality can be used to train doctors for surgery.

In theory, the computer software tool the company hopes to develop might replace, or at least supplement, the tradition of training medical students on cadavers and patients in the operating room.

Virtual reality, which is widely used to train aviators, uses computer graphics to simulate actual experience.

"It's a very risky venture, but it holds great promise for medical education," said Michael Baum, a spokesman for the National Institute of Standards and Technology, sponsor of the grants.

High Techsplanations, a privately held company founded in 1987, is one of only 10 companies and organizations nationwide selected for the grants this year. The awards, announced this week, are aimed at assisting scientific research into technologies that could improve how health care information is stored, protected and shared. Mr. Baum said 68 companies and nonprofits applied this year.

High Techsplanations will receive $560,000 from NIST, which is part of the Department of Commerce, so the company can move forward on developing a computer software tool known as an authoring program.

The company estimates the total cost of the project, which could take up to three years to complete, to be about $1.8 million.

Called Teleos by the company, the tool the company hopes to develop could prove a pivotal link in developing virtual reality programs for surgical training, said company executives.

"This technology would revolutionize medical training as we know it," said Gregory Merril, a co-founder of High Techsplanations with his brother, Jonathan Merril, an expert on computer applications in medicine.

It could also mean big profit for the small company, which employees about 25 people.

Mr. Merril said the company estimates the potential market for Teleos to be at least $300 million annually in the United States -- about the same amount that software authoring tools for computer games generate.

High Techsplanations would market the Teleos program to surgeons and medical educators, who would then write their own virtual reality training programs, said Dr. Gerald Higgins, director of bio-medical visualization for High Techsplanations.

The company also expects to form partnerships with medical educators and surgeons to develop a library of its own virtual reality surgical training programs for the marketplace.

Virtual reality is used for entertainment purposes and has most notably been used successfully to provide flight simulation for airline pilots and military aviators. NASA has used it to prepare astronauts for walks in space.

But those seeking to develop its use for medical training, particularly surgery, have been stymied because of the extreme need for anatomical accuracy and the exact reactions of human tissue to surgical procedures in real time.

"If you are trying to teach someone how gall bladder surgery is done, and you have to wait for the computer to catch up and replicate a bleed when a mistake is made, the program has little use," Dr. Higgins said. "The reactions of the body have to occur realistically."

High Techsplanations won't have to confront one major barrier that has held back research in the field until just recently: the lack of a complete image library that documented the thousands of nuances the human anatomy presents. That has been solved, at least in part, now that the National Medical Library has completely cataloged the entire male anatomy using advanced imaging technology in its Human Body Visible Project. The female anatomy is almost completely documented.

Initially, the company plans to focus on developing Teleos so it could be used to write virtual reality training programs for laparoscopic surgery, in which a thin, lighted instrument is threaded through small incisions so that organs and other parts of the inner body can be viewed.

Whether the medical community in the United States would embrace virtual reality training for surgeons and other medical professionals remains to be seen.

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