NYU Langone Medical Center is now using a novel technology that serves as a "flight simulator" for neurosurgeons, allowing them to rehearse complicated brain surgeries before making an actual incision on a patient.

The new simulator, called the Surgical Rehearsal Platform (SRP), creates an individualized walkthrough for neurosurgeons based on 3D imaging taken from the patient's CT and MRI scans. Surgeons then plan and rehearse the surgeries using the unique software, which combines life-like tissue reaction with accurate modeling of surgical tools and clamps, to enable them to navigate multiple-angled models of a patient's brain and vasculature.

The SRP was developed by Surgical Theater of Cleveland, Ohio. This augmented reality technology may help improve safety and efficiency during surgeries for conditions including pituitary tumors, skull base tumors, intrinsic brain tumors, aneurysms, and arteriovenous malformations (AVMs), and could potentially allow surgeons from around the world to simultaneously collaborate on a patient's case in real-time.

 "We are excited to partner with Surgical Theater to bring their Surgery Rehearsal Platform to our institution," said John G. Golfinos, MD, chair of the Department of Neurosurgery at NYU Langone Medical Center and associate professor of neurosurgery at NYU School of Medicine. "The reaction of tissue in these 3D images is incredibly life-like and modeling of surgical tools is equally impressive. The SRP also will enhance the training of medical students, residents and fellows and help them hone their skills in new and more meaningful ways."

When using the SRP, surgeons can rehearse a specific patient's case on computer monitors connected to controllers that simulate surgical tools. For example, when rehearsing a surgery for an aneurysm, the SRP reacts realistically when the surgeon virtually applies a clip to the blood vessel. The surgeon then can assess the tissue's mechanical properties and view realistic microscopic characteristics including shadowing and texture to plan approaches, so that when the real surgery is being performed, doctors have rehearsed and already have a mental picture of what is being seen in the OR.

The SRP obtained clearance from the U.S. Food and Drug Administration (FDA) in February 2013 as a pre-operative software for simulating and evaluating surgical treatment options.

In addition, a newer-generation of this technology from Surgical Theater, the Surgical Navigation Advanced Platform (SNAP), has an application pending with the FDA to allow the tool to be taken into the operating room, so surgeons can see behind arteries and other critical structures in real-time.

NYU Langone's Departments of Neurology and Neurosurgery are ranked among the nation's top 10 programs in the 2013-2014 U.S. News & World Report's annual survey of "Best Hospitals" in America. The programs also rank #2 in New York State. The Department of Neurosurgery has 24 full-time faculty specializing in the research and treatment of conditions impacting the brain and nervous system, from head and spinal cord injuries to subarachnoid hemorrhage and vasospasm, intracranial tumors and minimally invasive approaches to intracranial neoplasms by computer-assisted stereotactic methods.