At Paul-Brousse Hospital, they are thinking about the future of operating theaters.

Eric Vibert is a Professor at the Hepatobiliary Center of Paul-Brousse Hospital in Villejuif.

With a multidisciplinary team, he has undertaken long-term projects to develop the operating room ecosystem. Their goal: to foster dialogue between the humanities and technology to find solutions that benefit both practitioners and patients.

THE “AUGMENTED OPERATING ROOM” INNOVATION CHAIR

The BOpA Innovation Chair comprises a multidisciplinary team, combining healthcare professionals, surgeons, anesthesiologists, and paramedical staff, as well as experts in the humanities, social sciences, and mathematics. Their objective is to identify the needs within the various operating rooms of Paul-Brousse Hospital, and more specifically those related to hepatobiliary and pancreatic surgery.

A 150 m² space and a mock operating room equipped with artificial intelligence tools are available to them. The space is also located near a real operating room where the experimentation of solutions can be extended.

BOpA has two objectives: First, to change the way surgery is performed by capturing operating room data that is currently underutilized by patients, surgeons, anesthesiologists, and paramedical staff. This aims to improve patient safety by enabling the understanding of when problems and unexpected events occur and to identify situations where operating room staff might need assistance. The second objective is to empower operating room medical staff by enabling them to work with digital technology tools.

This innovation chair is structured around five thematic areas, referred to as “bloks”: Human Factors (the anthropology of the operating room), IoT (the Internet of Things), Data Stream (data flow management), Green (the ecological approach), and Data Collection (data security). Each entity has several working groups dedicated to a specific issue.

For example, the Blok Human Factors group, which examines the anthropology of the operating room, is exploring communication between doctors and patients: “How can we improve doctor-patient communication so that clinicians can provide not just medical information, but knowledge?” explains Eric Vibert. He adds: “Doctors struggle to explain precisely what they are going to do and to convey the principle of uncertainty. In fact, doctors are facing increasingly complex situations in terms of decision-making. Previously, for a patient with liver cancer, there were no solutions other than surgery. Now, there are many more options: surgery, local ablation, radiotherapy, etc. The decision is therefore more difficult than before, and explaining to the patient why the doctor chooses one operation over another is crucial.”

One of the applied experiments compares two methods of explanation: hand-drawn diagrams and the use of a dedicated liver surgery simulation application.

The group is also exploring the question: what constitutes a well-functioning operating room? Using the data integrator, the operating room’s true “black box,” how can we measure its performance?

A project on this topic will begin in September 2023. The experiment will involve using a CareSyntax system to integrate all operating room data onto a single timeline for all operating room staff.

The Blok-Avatar project is also exploring augmented reality, notably by experimenting with the use of digital twins that correspond to digital, anatomical, hemodynamic, and organizational representations. “The goal is to be able to use a digital representation of reality that can serve as a common reference point for making decisions when faced with a problem,” explains Professor Vibert.

BOpA operates within a university and research network ecosystem: APHP (Paris Public Hospitals), Institut Mines-Telecom, Université Paris-Saclay, the CNAM (National Conservatory of Arts and Crafts) Chair in Humanities and Health, and the French National Institute for Research in Computer Science and Automation (Inria).

This chair is both a place for research in the humanities and social sciences and a hub for innovation. The solutions sought sometimes already exist on the market. In this case, meetings between industry professionals and operating room specialists are organized to assess needs. When these exchanges are successful, a prototyping phase begins. This is followed by co-development, supported by financial and skills-based sponsorship.

FROM BOPA TO THE BOPEX CAMPUS

Eric Vibert’s goal was also to share the experience gained within Paul Brousse’s BOpA Innovation Chair with the 38 hospitals of the AP-HP (Paris Public Hospitals).

He therefore created the BOpEx Campus, a consortium bringing together the AP-HP, various universities in the Île-de-France region, and Medicen, to structure and unite innovation in the operating room within a shared space.

More specifically, this campus allows for the evaluation of digital solutions for the operating room by conducting acceptability, usability, and optimization tests for all AP-HP operating rooms. The medium-term objective is to award a “Digital Experimentation Hub” label to a project, whether or not it has been pre-evaluated within BOpA, with the ultimate goal of supporting its development.

The BOpEx Campus will soon be located on the Broussais Campus site (Broussais Hospital, Paris 14th arrondissement), near the future School of Surgery and the AP-HP’s 3D printing platform, essential for advancing the prototyping of technological solutions.

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