Education, Training, and Research

Laparoscopic surgeon Ronald H. Clements, MD, directs UAB’s Alabama Institute for Minimally Invasive Surgery (AIMS). “During the last 15 years, minimally invasive surgical techniques have revolutionized traditional operations and influenced all surgical specialties. Fueling this exponential growth are advances in fiber optics, miniaturization of video equipment, and increasingly sophisticated robotics,” he says.

AIMS provides patient care and offers comprehensive training and research opportunities for surgeons in every specialty. “The institute trains medical students, surgical residents, postgraduates, and seasoned surgeons using innovative methods to assure acquisition of requisite skills,” says Mary T. Hawn, MD, the center’s codirector for training.

Minimally invasive techniques pose interesting challenges. Surgeons must contend with restricted vision and mobility, delicate instruments requiring precise manual dexterity and hand-eye coordination, absence of tactile perception, and video cameras lacking depth perception. “Operating on a three-dimensional body using a two-dimensional image makes it difficult to assess tissue depth,” Clements says.

“Through AIMS we have a comprehensive approach to teaching high-tech procedures,” he says. Students and surgeons first observe procedures in UAB’s state-of-the-art West Pavilion Conference Center Board Room. High-definition images from both surgical and overhead cameras in UAB operating suites display real-time operative procedures. Students practice techniques on inanimate simulators and then move on to animals and human cadavers.

All UAB surgeons have access to AIMS’s training facilities. Postgraduate courses involving laparoscopic bariatric surgery, laparoscopic colectomy, flexible endoscopy, and laparoscopic hernia repairs are offered to practicing surgeons in the region.

UAB surgeons are using the da Vinci robotic-assisted surgery system, which offers improved dexterity and visualization, for hysterectomy and prostatectomy and are expanding approaches for benign uterine fibroids and pelvic masses. Future applications may include more challenging pelvic procedures, fertility-sparing surgeries, and transoral robotic surgery for head and neck cancer.

Funded by an AIMS grant, UAB head and neck oncologic and reconstructive surgeon Eben L. Rosenthal, MD, plans to use the da Vinci robot to treat pharyngeal and tongue-base tumors, sparing patients the ear-to-ear incisions that often require splitting the lip and jaw to gain access. Transoral robotic surgery should allow for complete tumor removal while preserving voice and swallowing functions. Patients experience less bleeding and pain and recover faster.

Other novel uses of minimally invasive techniques under development in the United States include endoscopic gastric bypasses in animal models and natural orifice transluminal endoscopic surgery, in which the surgeon advances flexible endoscopic instrumentation through the gastric wall into the peritoneal cavity to perform various procedures such as liver biopsy, cholecystectomy, splenectomy, and tubal ligation. “In the future most operations will include minimally invasive techniques,” says Clements.

For more information
Dr. Ronald Clements
1.205.934.7877
Dr. Mary Hawn
Dr. Eben Rosenthal
1.800.UAB.MIST
mist@uabmc.edu