Telesim Cesarean Section Simulator

Use of perception, mechanism, set, guided and complex overt response motor skills for management of obstetric surgery complications, such as transverse lie with prevalence of 1 in 300 fetuses at the time of delivery, repair of cervical and bladder injury, etc, will be taught.

We target trainees (students, residents), general practitioners, obstetricians, physicians that will routinely perform obstetric surgery and may encounter complications during surgery.

The module uses 3D simulation to create a realistic surgical experience where participants have digital 360 view of the anatomy, to make all key decisions in real-time, to follow all essential steps, with built-in feedback mechanisms on performance.

Trainees will be evaluated on efficiency, accuracy of movement, surgical technique (appropriate incision, dissection, suturing), and timing of decisions made during management of complications. For example, during a uterine rupture, built-in instant assessment displays patient outcome based on both appropriate and inappropriate decisions/steps taken by a physician. 

Our module uses interactive 3D applications to teach anatomy, surgical technique and management of common complications via computer's mini storage devices like CDROMS for offline use. Using hemorrhage as an example:

Objectives:

Using input devices trainee will identify the relevant anatomy, procedure, common complications, and management of complications 

Lesson content: 

3D rendition of anatomy

-Surgical simulation including skin incision, dissection of tissue layers, uterine incision, proper closure of incisions.

-Simulation of hemorrhage due to uterine atony, tissue trauma, and placenta-related conditions (previa, accreta). 

-Simulated patient outcomes will depend on decisions made by trainee at each step based on inbuilt algorithms. 

Evaluation: 

Tactile feedback from input devices determine appropriateness of pressure, tension, surgical technique (incision, dissection, and suturing) on tissue, efficiency and accuracy of movement, timing of decisions made during management of complications. Feedback detailing patient outcome both appropriate and inappropriate decisions/steps by trainees and trainees response regarding ease of use and achievement of the stated educational objectives will be available at lesson conclusion.

Application will function offline via memory sticks, CD-ROMS with seize less than 90MB for low-cost and online sharing. It will be compatible with fourth Generation computers (2000-2010) while mouse and keyboard are used for real-time tactile feedback.

Complications to obstetric surgery. These include: Transverse lie, post-CS hemorrhage, uterine rupture, bladder injury, cervical tear, perineal tear, and emergency hysterectomy.

-Specific psychomotor skills include: 

Guided response, Perception, Mechanism, Set and Complex overt response

-Need for this surgical simulation

The number one cause of maternal death globally is postpartum hemorrhage, especially in low-resource settings in the developing world. ⅕ of all maternal deaths globally occur due to caesarean section.

Additionally, according to the WHO, deaths from caesarean section are “100 times higher in developing countries” than in high income countries.

Transverse Lie complication does not occur frequently enough for surgeons to be experienced enough to mitigate it (Prevalence of 1 in 300 fetuses at the time of delivery).

We serve Trainees (medical students, residents), General practitioners, Obstetricians, physicians that routinely perform obstetric surgery and may encounter complications during surgery. Our modules will focus on training surgical practitioners in these complications to improve maternal mortality rates.

Subsets of psychomotor learning are:

Guided response such as imitation, trial and error which will improve adequacy of performance. Perception, set and complex overt response will improve trainees ability to use sensory cues to guide motor activity and respond to different situations. Mechanism increases confidence and proficiency.

In many African countries, caesarean section rate is over 20%. Yet, few surgical practitioners receive extensive training. 25% of caesarean sections in low and middle income countries result in serious complications. Transverse has a prevalence of 1 in 300 fetuses at the time of delivery.

Partnerships with research institutes, medical educators, ministries of health, frontline healthcare providers to understand the gap we need to fill.

Our low-cost and accessible digital surgical simulation training will be available to boost first time surgeon’s need for confidence and proficiency through our simulator’s practice mode. 

Our simulation compatibility in fourth generation computers (2000-2010) and digital storage devices like CD-ROMS will improve scale of use in low-resource settings.

Ebube, Team lead, based in Nigeria, West Africa. Bachelor of Arts Degree in Educational Foundations (Educational Video Games and Software Developer).

Gjanje, Urologist, MD, MPH, (Johns Hopkins, Georgetown University).

Eugene, Anaesthesiologist, Medical Educator, Curriculum Creator, Entrepreneur. (Ohio Health, University of Rwanda).

Sergio, MBA, MD, (MIT, Oxford, Baylor)

Kirsten, Social Impact, International Development, and MAS Humanitarian Health candidate. (Johns Hopkins, University of Washington),

Mike, AR/VR, Web/Mobile Application Development  (IT Technology, Masters in Bioinformatics)

We are a diverse and cross-disciplinary team including experts from
Johns Hopkins, MIT, and Oxford Saïd Business School having led NGOs in
Africa, industry top leaders in security and IT, a finance expert from
MIT that has brought other startups to market, 3 physicians (including 2
surgeons and one is a medical education expert with PHD and MBA), and
highly skilled software engineers and a video game developer. All of our team members have worked extensively in Africa with excellent connections across the continent and understand the challenges and constraints to work in Africa.

Additionally, we have gathered a group of interns in Africa and India.