Pushing Boundaries: Students Develop a Novel Approach to Surgical Markings

uvmmedicine blogger Zach Ehret '20
uvmmedicine blogger Zach Ehret ’20

I’ve always wondered what it would be like to stand in front of the Sharks on Shark Tank. For those who don’t know, it’s the hit TV show where budding entrepreneurs can pitch their ideas to potential high caliber investors, the Sharks. Given that I am in medical school, it seems a plausible way to get there is to steer my creativity towards something innovative within the healthcare field. What about a completely new imaging technology that would make MRIs and CTs obsolete? How about a new EHR system that hospitals around the country would miraculously agree to use for the sake of ease and integration? Both seem rather difficult to accomplish in a shorter timeframe and probably something even the Sharks would find too expensive to fund.

Instead of attempting to change something I have little experience in, I’ve used what I do know to potentially reduce operation time by more accurately drawing surgical markings in plastic and reconstructive surgery. I can’t take all the credit because none of this would have come to fruition withoutfellow Larner College of Medicine students Ross Sayadi and Mustafa Chopan, who both recently graduated. Congratulations!

Our idea emerged from our experiences observing plastic surgeons operate. We saw that surgical markings for flap reconstructions were drawn free-hand to the surgeon’s best estimate and could therefore be less accurate. Flap designs have specific parameters that are described in literature to correct a defect as efficiently as possible by using the least amount of skin. The dimensions of each flap are specific to their respective shape, angle, and length. Drawing markings by eye can surrender this precision and lead to a lesser result compared to markings drawn to exactness. After all, we’re human and can’t possibly draw complex designs with 100 percent accuracy every time… right?

We’ve developed a way to make this happen by projecting the image of flap designs directly onto the skin’s surface that can be traced without breaking sterility. Not only do the projected markings provide geometrically accurate dimensions, but they also reduce the time spent drawing and may lower patient risk by lowering operation time. Of course, every defect is different in terms of shape and size, so we’ve made it possible to manipulate the orientation of each flap design to fit a particular patient while retaining geometrical precision. The surgeon also has the ability to choose the flap he or she wants from a database we’ve created including most flaps currently used in plastic and reconstructive surgery. We have had multiple plastic surgeons test our projector on cadaver tissue with success, and we hope to soon bring our invention into a clinical setting.

We presented our research at UVM’s annual Student Research Conference in April alongside hundreds of undergraduate, graduate and medical students all showcasing their own work, and came away with even more enthusiasm for our project.

Medicine thrives on tradition, but nothing is set in stone. With some creativity and innovation, anything can be improved. We are very grateful to have the opportunity to attend a school that promotes this sort of imagination, and we are thankful for the faculty who are willing to push boundaries beside us. Our goal is to promote efficiency in the surgical setting that will benefit both the surgeon and patient. Hopefully the Sharks will share a similar view.

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