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Dartmouth’s Center for Surgical Innovation Open for Business

By Anna Fiorentino
December 2014 • Thayer By Degrees: PhD

Dartmouth’s Center for Surgical Innovation (CSI) opened in September as the nation’s first surgical facility dedicated to translational research. This joint venture between engineers and clinicians uses real-time image-guided surgery to solve complex medical problems.

It’s a boon for both patients and medical research and now, with plans to offer a surgical track for Thayer School's Ph.D. Innovation Program students, the CSI is also a boon for the next generation of engineers.

Developed by Keith Paulsen, Dartmouth’s Robert A. Pritzker Professor of Biomedical Engineering, Dr. Sohail Mirza,
Medical Director of CSI and Chair of Orthopaedics at Dartmouth-Hitchcock, and Dr. David Roberts, Chair of Neurosurgery at Dartmouth-Hitchcock, the CSI takes advantage of Thayer School expertise in biomedical engineering, imaging, and computation combined with clinical expertise at Dartmouth-Hitchcock and Geisel School of Medicine.

CSI at Dartmouth-Hitchcock

Paulsen hopes to launch the Ph.D. Innovation Program's surgical track by fall of 2015, with research funding for four students. “These Ph.D. Innovation students would rotate through different surgeries at the CSI, shadowing procedures and when one catches their eye, pick up a specific project that would become the basis for their thesis,” says Paulsen, who hopes to bring on six students after the first year and eight the following year.

Students in the Innovation Program fulfill all Ph.D. requirements plus they receive specialized training in technical innovation. Surgical track students would work with engineering, clinical, and entrepreneurial mentors to commercialize their research.

Meanwhile, the CSI’s two adjoining operating rooms feature mobile computed tomography
 (CT) scanning and magnetic resonance imaging (MRI) systems that make it possible for surgeons to conduct real-time image-guided procedures. Roberts is using fluorescence-guided surgery to improve the treatment of brain cancer. Mirza recently performed spinal surgery on 13-year-old Amanda Shadowens — born with a rare form of dwarfism called chondrodysplasia which prevents skeletal bones from forming correctly. She received a two-part spinal fusion surgery in the CSI to prevent future paralysis.

According to Paulsen, the CSI made a major difference in Shadowens’ 
case. “The pediatric neurosurgery and orthopedic surgery team removed some additional bone after using the intraoperative CT,” he says. “Dr. Mirza showed me the images during the case and pointed to a small area of bone in the cervical spine. He told me we never would have known that we needed to remove it if we didn’t use the CT during surgery. He also showed me the intraoperative MRI and said the OR team was able to confirm that they achieved their goal of decompressing the cord. Having both the intraoperative CT and MRI was really critical to the success of this very complex and demanding procedure.”

In addition to its surgical suites, the CSI has two diagnostic imaging rooms for nonsurgical or minimally invasive procedures, patient holding spaces, control rooms, offices, and labs.

“For surgeons, going into the CSI is like entering a brand new house that has the latest and best of every modern convenience,” Paulsen says. “Dartmouth surgeons have been able to do things to help patients in our region who would otherwise have to go to specialty facilities in Boston, for example.”

“I don’t know of any other operating rooms anywhere in the country that have Intraoperative MRI and CT together in one room,” he adds.

For patients, surgeons, and researchers — including Thayer engineers — the CSI is accomplishing its mission: accelerating new surgical treatments for medicine’s most challenging cases.

Tags: engineering in medicine, facilities, faculty, innovation, innovation program, research

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