Richard H. Feins, Co-founder, and Scientific Advisor
“Teaching in an OR has become progressively more difficult,” says Richard H. Feins—a surgeon with over 30 years of experience and the past Chairman of the Board of Thoracic Surgeons —as he engages in a dialogue about the improvement of surgical training using simulation. Inspired by the risk-free simulated training methods of naval aviators and with an aim to train, engage and deliver deliberate practice of surgical skills required for the clinical setting, Dr. Feins searched for the most realistic surgical simulators, but found most lacking. Consequently, he co-founded KindHeart to develop simulators that uniquely combine animated real tissue perfused with simulated blood with a synthetic human form factor to offer a realistic and reproducible surgery experience. At the core, “Our lifelike simulators utilize the real tissue which can be preserved for a prolonged period, and is reanimated appropriately by placing it in a human mannikin,” says Feins who has been described by peers as the “father of modern simulation”.
KindHeart’s first simulation system was a cardiac model which replicates a human heart with a system of pumps and valves that are perfused with blood and is animated with the assistance of computer-controlled balloons inflated as per the desired heart rhythm. The surgeon has total control over what happens to the model, creating different scenarios including adverse events, which are not feasible in the current “gold standard” – live animal surgery. This simulator is a core component of the Thoracic Surgery Directors Association’s Cardiac Surgery Simulation Curriculum, developed by leading medical schools across the country.
The KindHeart simulators were developed with academic institutions in mind but soon attracted clientele from medical device companies. “Our simulators can be described as a wet lab in a dry lab setting,” states Sam Drew, Chief Operating Officer.
It is real surgery, so much that we are slowly replacing the word ‘simulation’ with ‘emulation.’
“They provide the animation and bleeding of a live animal with the anatomical accuracy of a cadaver, with none of the associated overhead”. The thoracic and abdominal (colorectal and hernia) models can be set up in a conference room as there is no spillage.
The company ensures consistency in models by digitally controlling the movement, the perfusion, and replication of the tissue to offer the same experience with every usage. “Our systems are software driven, based on industrial process controllers which makes the repetition highly precise,” adds Andy Grubbs, president, and co-founder of KindHeart. This stability is highly beneficial for deliberate practice and for manufacturers during device development. The company regularly upgrades the surgical techniques applicable to a simulator to keep pace with the rapidly evolving technological landscape.
KindHeart’s newest offering – the Sensored Patient – provides the initiation platform for artificial intelligence and machine learning (AI/ ML) applications. Highly repeatable surgery events allow KindHeart to offer medical device companies the experience of building data sets concerning the movement of tools and tissues. The difference between the forces applied to the tissue versus the force absorbed by patients’ body is also taken into account with the help of sophisticated sensors, providing a closed loop of data that is multi-channeled, conditioned, and ready for analysis. Moreover, by offering specialty systems for a particular operation, KindHeart models can be adjusted to capture the specific data that is important to the customer.
Currently, KindHeart is looking forward to launching its product for telesimulation of surgery, which will allow remote access to the simulators using hand controls from a robotic surgery device. The surgeon will be able to manipulate the controls from a distance of thousands of miles, similar to a computer game in the cloud. “It is real surgery, so much that we are slowly replacing the word ‘simulation’ with ‘emulation,’” concludes Grubbs.