Revolutionary Learning Tool Dr. David Zopf Develops High Fidelity Simulators to Enhance Surgical Education Once a year, Dr. David Zopf packs up his stuff and heads to Peru for a few weeks. One of his goals? To teach his South American colleagues complex medical procedures that change people’s lives. “That region of the world has one of the highest rates of microtia (congenital absence of most of the ear) and cleft lip and palate, which would otherwise remain untreated,” he said. “The people there are tremendously thankful for the work that we do.” With three young children of his own, Dr. Zopf can appreciate the hardship that comes with congenital birth defects, and wants to do everything he can to help those families. This is one reason why he has developed high fidelity surgical simulators that allow physicians in Peru and across the globe to practice the advanced reconstructive surgeries required to rebuild missing ears and to repair deformed noses and lips. Dr. Zopf and his team have developed curriculum to help accelerate and enhance surgical education, with a “Teach-to-Fish” mentality. To date, his surgical simulators have been deployed in rural Western Australia, Ethiopia, Guatemala, Haiti and Peru. They’re built using a unique mix of manufacturing techniques that include 3D printing, overmolding, old-fashioned manual assembly and hand-painting of facial features, a process that Zopf says is cost-effective over higher cost multi-material printers, despite the manual labor involved. “We build a detailed physical model that is remarkably close to real life, with different tissue layers made of silicone, for example, and 3D-printed bone structures,” he explained. “The really exciting thing about it is that you can use the same surgical equipment found in the operating room. You’re cutting, suturing, dissecting—performing all of the key portions of an advanced surgical procedure that will later be performed on an actual patient. It’s a revolutionary learning tool. I use these tools we’re producing to practice before complex procedures, sort of like basketball players warming up before a big game.” Zopf’s surgical specialty and one of his passions is pediatric otolaryngology—head and neck surgery. When not teaching physicians in other countries how to save children’s lives, he stays busy saving lives at the University of Michigan, where he is an assistant professor in otolaryngology and an affiliate professor of biomedical engineering. “I will feel fulfillment when the local surgeons we have trained are able to train other local surgeons in cutting-edge, life-changing surgical techniques. At that point we will have created a self-sustaining learning environment that can impact populations of people in need, essentially moving from a ‘Teach-to-Fish’ mindset—already a huge advancement—to a ‘Teach-to-Teach’ model.” David Zopf His work extends well beyond surgical simulation, however—he also leverages 3D printing to develop numerous novel medical devices and construct patient-specific, bioresorbable tissue scaffolds . He is developing these tissue scaffolds with Dr. Scott Hollister to perform complex reconstructive surgery, such as ear and other craniofacial reconstructions in the US. This is a technique he hopes to teach to his South American colleagues. “Today, for example, I would sculpt a new ear using the patient’s own rib cartilage,” he said. “The idea is having a 3D printed, patient specific tissue scaffold that the patient’s own cells would be seeded with, resulting in replacement of the patient’s own tissue.” The most immediate application he is preparing for is tissue engineering ear cartilage tissue, which is currently in preclinical testing. He and his team have also developed simulators for pediatric airway reconstruction, where narrowed trachea can be expanded in a High Fidelity experience to allow placement of a small piece of cartilage, “almost like adding a keystone to the St. Louis Arch.” Dr. Zopf has piloted new surgical courses at University of Michigan with surgical trainees, giving them unique and valuable advanced surgical experience in a no-risk environment. These are procedures that trainees would otherwise have limited exposure to, but now have unlimited access. “I tell our trainees at Michigan, they can practice and hone skills on as many simulators as they would like,” said Dr. Zopf. Here in the US, it’s easy to understand the potential benefit for surgeons to repeatedly practice on some of these advanced, oftentimes rare conditions, but in an international setting where resources are so much more limited, it could be even more transformative. “You'd be amazed at what these local surgeons can do given the right tools, the time and thoughtful innovative training,” said Dr. Zopf, “It’s going to be exciting for me to go back year after year and see how they have improved, and how their patients’ lives have changed for the better. It’s really the only way they can gain the experience of operating on a child without having to practice on a child. “The experience has been very rewarding to me,” he added. “I will feel ultimate fulfillment when the local surgeons we have trained are able to train other local surgeons in cutting-edge, life-changing surgical techniques. At that point we will have created a self-sustaining learning environment that can impact populations of people in need, essentially moving from a ‘Teach-to-Fish’ mindset—already a huge advancement—to a ‘Teach-to-Teach’ model.”
