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http://www.azcentral.com/news/articles/0119wii0119.html

With Wii bit of technology, surgeons hone their skills



Kate Nolan
The Arizona Republic
Jan. 19, 2008 12:00 AM

Surgeons training at Banner Good Samaritan Medical Center are hooked on Wii game technology - all the better to sharpen their surgical skills, a new study shows.

Wii, the Nintendo gaming console, uses a motion-sensitive control to produce a virtual-reality experience.

More typically used to play sports or drive monster trucks than to manipulate scalpels, Wii consoles can be found in Phoenix hospitals where trainee surgeons play between stints in the operating rooms. But they're not just for fun.

Wii technology boosts surgical skills, say Kanav Kahol and Mark Smith, Banner medical educators.

They ran a study that found surgeons who warmed up using a Wii game called Marble Mania performed strikingly better in a simulated surgery than those who didn't.

In the study, eight trainee surgeons played the game for an hour before performing simulated gallbladder procedures. Using a tool that tracks a surgeon's movements with "cybergloves" as they operate, Kahol and Smith were able to assess each doctor's performance.

Scores for the doctors who played the game averaged 48 percent better than those who did not play.

"This is hard science," said Smith, a surgeon and medical director of Banner's $2 million simulation center, where the surgical training is done. An earlier study in New York suggested electronic games could help hone the fine motor skills required in surgery, but the Phoenix study measured the impact.

Kahol, a professor of bioinformatics at Arizona State University, developed the project on a hunch.

"I bought the Wii for myself on a whim because I was convinced it was the next generation of gaming," said Kahol, 28, who grew up in India playing Atari and Nintendo.

"You can either design applications that replace humans or ones that work with humans. Wii is based on human skills," he said. Kahol found Smith, 60, an eager collaborator on Marble Mania, once the surgeon discovered its demands for delicate hand movements.

"It's a game that drives you crazy, where you roll a marble along pathways and ledges. You make it go where you want it to go by tilting it very slightly," Smith said.

In July, residents heard they could train on Wii and jumped at the chance.

"What do you expect from a group of men and women in their 20s?" said Smith, who also ran the test on himself.

"I wasn't all that bad, but I wasn't the best performer," he said. Smith learned surgery more than 20 years ago on real patients.

The test scenario included clamping off and lifting a gallbladder, the first step in removing it from atop the liver. The trick is to lift the organ and balance it while trimming it away from the liver.

In addition to working faster and with more accuracy than the control group, the Wii-trained surgeons performed well with both their left and right hands, suggesting Wii encourages ambidextrousness. Results were gender-neutral.

Smith and Kahol see more Wii in their future if games are developed to simulate complete surgical procedures.

In contrast to the $10,000 surgical simulators used at Banner, the relatively cheap Wii console (about $250) would make for a fine home simulator.

The low cost would also make it a promising learning tool for doctors in the developing world, they said.

Smith and Kahol plan to present the study results at the Medicine Meets Virtual Reality Conference in California at the end of January.