Bridging Technology and Education: The Development of a Telesimulator and Curriculum in Endoscopic Mitral Valve Surgery

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In this video, the authors share their latest educational innovations, including the development of a telesimulator and a telesimulation curriculum for endoscopic mitral valve surgery.



Mitral valve repair is a highly intricate procedure in cardiac surgery due to the valve's complex structure and the varied pathologies it can present. The challenges are further amplified when the repair is conducted through minimally invasive methods, whether endoscopically, under direct vision, or with robotic assistance.

Minimally Invasive Mitral Valve Repair (MIMVR) has proven to be both effective and advantageous for patients. However, its application is largely confined to specialized, high-volume centers and is performed by a limited number of surgeons. The skills acquired in open surgery are not sufficient for initiating a MIMVR program, surgeons must also become proficient in endoscopy and the use of long-shafted instruments. One of the most challenging aspects of endoscopic surgery is the manipulation of these long-shafted instruments, making the learning curve for MIMVR steep and often honed through patient cases.

Several years ago, the authors of this video developed a high-fidelity minimally invasive mitral valve simulator. The team has since refined the technology to include 3D printed mitral valves, validated suturing maps, and a specialized curriculum for endoscopic mitral valve surgery. They have offered over 80 courses globally, training more than 1,000 surgeons.

To further democratize access to this specialized training, a telesimulation platform was recently launched based on the high-fidelity simulator. This fully 3D printed, transportable platform can be easily assembled and connected to any smart device, offering live connectivity to the training center from anywhere in the world. The simulator features disposable mitral valves and papillary muscles, allowing for training in the repair of various mitral valve pathologies.

In addition to the simulator, the team has also developed and tested a telesimulation curriculum aimed at facilitating remote skills training. 

References

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8. Sardari Nia P, Olsthoorn J, Heuts S, Maessen J. Suturing map for endoscopic mitral valve repair developed on high-fidelity endoscopic simulator. Multimed Man Cardiothorac Surg. 2018 Jul 26;2018.
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10. Sardari Nia P, Heuts S, Daemen JHT, Olsthoorn JR, Chitwood WR, Maessen JG. The EACTS simulation-based training course for endoscopic mitral valve repair: an air-pilot training concept in action. Interact Cardiovasc Thorac Surg. 2020 May 1;30(5):691-698.

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