Computer-guided Surgery: a New Dimension to Student Research

	PROJECT DESCRIPTION Sixth form students were able to observe and make contributions to the development of a computer-guided surgical system.	AREAS OF SCIENCE Astronomy Chemistry Computing Engineering / Technology Environment Interdisciplinary Life Science / Medicine Physics	WHERE School Other institution Field / Expedition WHEN In curriculum Extra curricular Work experience	SCHOOL TYPE Primary Secondary to 16 Post 16 Independent Maintained Sixth Form College Further Education
	PROJECT ORGANISERS Professor Colin Besant, Department of Mechanical Engineering, Imperial College. Dr Eric Albone, Clifton College/Clifton Scientific Trust.

Project Participants

Membership was open to the sixth form on a voluntary basis as an extra curricular activity. The final voluntary team comprised 16 final year students at Clifton College.

Science Programme

Following initial contact in Bristol, Professor Besant invited the student team to be his guests at Imperial College to see his department at work and to meet his research team.

Professor Besant had recently obtained funding to develop a computer-guided system to assist surgeons in the orthopaedic surgery of the spinal column. He explained in detail the problems he faced in developing the system, particularly with regard to the robotic arm to be used in the system, and invited students to develop and contribute possible solutions.

This they did over the ensuing year in their own time at school, reporting back and discussing progress with Professor Besant on his occasional visits to Bristol. No constraint was imposed on the ideas which could be offered and students were free to develop the project as they thought best.

The computer-guided system Professor Besant wished to develop sought to assist surgeons in achieving precision in operations where the vertebrae have been crushed and where the treatment involves screwing a brace into the spine and anchoring it by drilling holes through two adjacent sound vertebrae. The correct positioning of these holes is very difficult.

In the system proposed, data from computerised tomography/magnetic resonance imaging scans would be read into a computer graphics workstation and the surgeon would use these to plan cutting profiles. In the operation, an 'operating-room-friendly' robotic measuring system was required to measure the position and orientation of the surgeon's tool, together with a dynamic referencing device which, with the cutting profile data, would enable the surgeon to conduct the operation guided by the work-station. The robotic arm was to be passive, and provide no force of its own on the cutting tool.

The school student team was invited to suggest and develop ideas for the design of such a robotic measuring/dynamic referencing system. They had no prior special knowledge, but understood clearly the difficulty the surgeon faced in positioning two screws very precisely into the small part of the vertebra which would be visible during the operation. The patient's body is itself flexible of course! The school student team divided itself into four small project groups, one concerned with robotic arm design, one with computing, one with interfacing and one with mathematics.

Professor Besant's commitments prevented him visiting the student team in Bristol more than a few times. However, his enthusiasm was very real and its presence was always with the students. This experience emphasised that it is the quality rather than the quantity of direct contact in a partnership which is crucial.

Personal Development

The school students were greatly motivated by having their ideas taken seriously and by being asked to contribute to a piece of real frontier development work. The project used the ideas the students had encountered in school, but took them far further than they could have imagined. They were intrigued by what they learnt, both of the world of robotics and of the world of the surgeon, in the context of a real challenge. They knew that it was quite possible that they might come up with a new way of looking at the problem, which could be incorporated in the Imperial College programme.

Outcomes

A presentation was made by four school students at the 42nd Medical Artists' Association Annual Conference in Bristol, an event for medical artists and surgeons. The student team had learnt much more than they at first imagined, as was apparent when they presented their findings rather reluctantly (they felt they had not made enough progress to warrant a presentation) at this public meeting at the end of the year. The audience was particularly impressed by the depth of understanding the students had gained (without realising it) of the problems the surgeons were facing in their work. The students had learnt to apply their school knowledge to the solution of a real problem and they had experienced working together and communicating their findings to a professional audience.

Professor Besant had been impressed by the progress the students had made and by the way they had been enthused by the experience. He was particularly interested in the non-contact guidance systems one student had suggested. He has also been greatly encouraged to facilitate the formation of more school-university partnerships. A particular concern which he felt that such encounters address successfully (in a deeper way than a more casual single contact) was the school students' awareness of and appreciation of the role of science and engineering in the community.

Project Origin

Initial contact was through an interested Clifton College parent who collaborates with Professor Besant. Professor Besant was intrigued by the idea being developed at Clifton of exploring working partnerships between students and professional scientists and asked to share in this work.

Resources

Access to computers and other standard resources in the school technology department was required. Some preliminary work was done with Lego.
Imperial College loaned a number of small items.
Pupils worked in their own time. Some used their own PCs.

Contact

Professor C B Besant, Professor of Computer-aided Manufacture, Dept of Mechanical Engineering, Imperial College of Science, Technology and Medicine, Exhibition Road, London SW7 2BX
or
Dr Eric Albone, Clifton Scientific Trust, c/o 49 Northumberland Road, Bristol BS6 7BA.
Tel: +44 (0) 117 9247664.