Title: Paediatric Surgical Technologies
Funder: Department of Health and Social Care

Abstract: Overarching aim: Accelerating technology adoption in surgery The main thread running through the PST Theme strategy for improving surgical technologies, is to translate advances in other industries. Typically surgical technologies lag behind the consumer sector by a number of years due to the increased governance associated with producing medical devices. In many ways this actually makes designing surgical technologies quite simple as following the trends exhibited by faster moving industries is likely to be successful. To be able to shadow these technologies requires close partnership working with industries other than medicine. The Theme embedded within the CYP-TECH MIC will have access to a broad range of expertise including SME's, other Industry Partners, business support, funding support (including in-kind support from formal strategic partners), engineers, and scientists to accelerate the development , evaluation and delivery of paediatric surgical technology at scale. By having access to early stage prototypes and concepts the Theme can better guide the development of surgical technologies. Therefore a key component to our strategy is to free time and provide support for clinicians to visit and learn from other industries. This will allow us to match clinical problems to emerging technologies and reduce the lag in technology being applied to create a solution. There is a reciprocal component in this to ensure that industry can embed themselves within a hospital environment to accelerate the development of their technologies. The Alder Hey Innovation Hub is a key component allowing a neutral zone within a hospital to allow the intermixing of clinicians, patients, academics and engineers. Through the experience and work at Alder hey Innovation Hub, The PST Theme will be led by Mr Iain Hennessey, Director of the Innovations Hub at Alder Hey NHS FT with an intention to use the state of the art facilities at the Innovation Hub for the development of paediatric surgical technologies. The Hub will aim to collaborate with partners within CYP-TECH to support the rapid development of surgical technologies in the pre-, inter-, and post- operative surgical domains for children, providing a means of working to scale across paediatric specialist units, and supporting the rapid clinical evaluation and supporting the potential NHS procurement of surgical technologies for children. As with other Themes, the PST Theme will identify opportunities for cross-Theme collaboration. For example, Prof. Helen Cross, Theme Lead for the the Epilepsy, Myopathies and Movement Disorders Theme in CYP-TECH is a lead researcher in Paediatric Epilepsy Surgery and so cross-cutting collaborations may be supported, already demonstrating the benefit of working across specialties within the CYP-TECH MIC to extend the scope of technology development. In addition to this, we are aware of a MIC application being submitted from Leeds Teaching Hospital named Surgical Technologies and thus if this and the CYP-TECH applications are successful, we will explore opportunities to identify collaborative working between these MICs. Key areas of focus for the PST Theme: Sub-themes based upon the technologies available will be created to support the development of technology for paediatric surgery Sub-theme 1. Virtual reality Partner: Virtual Engineering Centre Pre operative planning: We have already produced a proof of concept (POC) visualisation of a congenitally abnormal heart that can be interacted with in a VR environment to better plan operations. Our plan in the next year is to produce more POC’s from different specialities. In 2-3 years we should be producing enhanced manipulation and modelling tools to increase the clinical relevance of the VR images created and a streamlined modelling process. In 3-5 years we aim to have functional models using high precision computing to allow virtual operations to happen and their outcomes predicted (for instance flow dynamics in heart surgery). Familiarisation: Virtual reality technology could be used to familiarise patients with their environment before children arrive in hospital for surgery. In the first year we would look to make a POC in the hub. In 2-3 years we would deploy to home environments. In 3-5 we would try and increase immersion using other modalities such as smell and haptics (depending on how technology progresses).Simulation: The simulation of clinical spaces is key in the design of hospital buildings. In 2-3 years would aim to have ability to recreate hospital spaces in VR lab. In 3-5 years the ability to simulate clinical scenarios in a VR environment with associated metrics that would allow for clinical workflow assessment. Sub-theme 2. 3D printing Partner: 3D life prints Pre-operative planning: At present we have POC operatable silicon models. In the first year we would expand the clinical range. In 2-3 years we would hope to have more functional elements (bleeding, contamination, movement). In 5 years we would aim for implementation of pre-operative warm up on personalised models. Sub-theme 3. Artificial intelligence Partner: Hartree centre, IBM, NHS England Natural language computing: As part of our digital patient engagement strategy we have created a standalone pre-operative chat bot in partnership with the Hartree centre and IBM Watson for in growing toe nail surgery. This incorporates standard hospital questions and disease specific answers. In the next year we hope to enhance and diversify topics. In 2-3 years to deploy natural language interfaces through our charity funded patient app to patient’s homes. In 5 years we hope to have a suite of knowledge modules to allow patients immediate tailored access to information. Sub-theme 4: Intraoperative imaging, cameras, imaging modalities, storage and displays Partner: Sony Enhanced theatre environments: In partnership with Sony Healthcare we are developing the applications of a truly integrated theatre environment. The current theatre complexes can transfer live high resolution video feeds within theatres, external venues and clinical storage. Our first year will involve integrating the video feeds with the electronic patient record. Year 2-3 will revolve around adapting workflows to leverage this technology to improve workflows and year 5 will hopefully see more advanced image analytics and metrics to evaluate clinical performance and perform black box functions in critical incidents.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: GENERIC HEALTH RELEVANCE