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Frontiers of cardiac surgery

2023/12/13

Fusing advanced simulation training with novel surgical techniques, NUHCS is pushing the frontiers of medical education and cardiac surgery—promising safer, more effective patient care.
Issue 1 | June 2023


Frontiers of cardiac surgery
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Just as trainee pilots hone their skills in simulated environments before ever taking to the skies, the field of surgery is embracing a similar revolution. The advent of medical simulators has allowed theory to converge with practice, creating ‘virtual operating rooms' for aspiring surgeons to safely navigate the intricacies of the human anatomy.

The Cardiac, Thoracic and Vascular Surgery (CTVS) Simulation Centre, an initiative by the National University Heart Centre, Singapore (NUHCS), with the support of the National University Hospital (NUH) and NUS Yong Loo Lin School of Medicine (NUS Medicine), stands as Southeast Asia's beacon in this transformative wave.

The centre is equipped with over 20 types of digital and mechanical simulators, mirroring the experience of an actual operating theatre—bridging the gap between classroom learning and the real-life surgical environment.

"The centre's simulation capabilities provide an effective and realistic training ground, enabling practitioners to master complex cardiac procedures like mitral valve surgery. This, importantly, sharpens their skills without compromising patient safety," says Professor Theodoros Kofidis, who leads the centre. Prof Kofidis concurrently holds distinguished positions as head and senior consultant in the Department of CTVS at NUHCS, and professor at the Department of Surgery, NUS Medicine.

The long-standing theory that 10,000 hours of deliberate practice equates to expertise can now be clocked up in these simulators, rather than on actual patients. "Not only does this expedite the learning process, but it also instils confidence in surgeons to execute modern surgical techniques in a real-world scenario," shares Prof Kofidis.

Such innovative shifts are welcomed by the next generation of medical professionals, eager to accelerate their learning curve. "As we strive to bolster Singapore's position as a major medical hub, embracing these technological advancements in medical training is crucial," says Prof Kofidis.

The heartbeat of innovation: reimagining mitral valve surgery

While looking to the future, Prof Kofidis urges a reassessment of the present. He has honed his focus on current techniques used in mitral valve repair surgeries, launching a number of novel techniques and surgical tools, as well as further developing others, such as endoscopic and minimally invasive heart procedures.

"The current techniques are not standardised, which might result in inconsistent patient outcomes for similar diagnoses, potentially undermining patient trust," explains Prof Kofidis. "Such uncertainty has driven many, particularly inexperienced surgeons, to opt for full valve replacement rather than repairing it—a decision not without its risks."

Laser-focused on challenging the status quo, Prof Kofidis developed "The Singapore Correction", an array of 12 novel mitral valve surgery techniques. These intuitive, reproducible methods provide more consistent patient outcomes post-surgery.

"We envision that these techniques will empower surgeons globally, enabling them to perform solid repairs in both open and keyhole surgery settings," says Prof Kofidis.

With its commitment to cutting-edge simulation training and innovative surgical techniques, NUHCS is at the forefront of exciting medical advancements. This dedication not only promises better patient outcomes, but also fosters a thriving learning environment for surgeons to evolve, innovate and excel.


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