Sentinel Node Biopsy-----[First MRP Committee meeting]

Minutes from the 1st MRP Committee Meeting

Date: Tuesday, May 12th
Location: Department of Surgical Oncology Conference Room
Time: 3-4:00pm

Attendance:
Dr. Tulin Cil (Medical Content advisor)
Gordon Tait (Non-voting member)
Jodie Jenkinson (Supervisor)
Michael Corrin (Non-voting member)
Albert Fung

General overview of project
- While the Sentinel Node Biopsy (SNB) procedure is becoming more common, the Axillary Lymph Node Dissection (ALND) procedure is becoming more obsolete; however there are certain cases where ALND is performed, especially in breast cancer patients that are in an advanced stage.

- Residents/fellows are expected to perform the ALND procedure if necessary, but due to minimal exposure to the actual procedure (as there less ALND procedures done these days), it is difficult for residents/fellows to gain the necessary training

- An online interactive training module would be beneficial to residents/fellows, to learn both the anatomy of the axilla/breast, as well as the surgical procedure

EIT Summer project
- We propose that the online framework of the training module could be done as part of the EIT Summer initiative. This could provide me with a headstart to the project.

- A part of the EIT summer project would also involve 'reviving' the existing SNB training module Jodie, Nick, Linda and Meaghan have constructed in 2001. Tasks would include update the references to Pubmed abstracts instead of full-text articles, as well as bringing the website out to the public webspace instead of being confined in the Continuing Professional Education framework, which is password-protected.

Visual Problems
- There would two main features in the training module:

1. A short 3D animation that explains the spatial anatomy of the axilla/breast and the underlying lymphatics,
2. Surgical video clips that are accompanied with 3D animation clips, with an interactive component (click-on-the-answer type quizzes etc)

- It would seem too ambitious to complete both features for an MRP; thus there is a choice between doing the 3D anatomy animation, or the surgical procedure videos interwined with 3D animation clips

- Following that logic, I would have to choose to either go into the 3D Visualization stream (to make the anatomy animation), or the Media Design stream (which I would focus more on presenting the surgical procedure and the interactive component)

- In addition, I would also have the choice of employing Maya 2009, or Cinema4D. Both are powerful 3D programs that could create excellent visuals, but both choices come with pros and cons.

- For example: Maya 2009 has a steep learning curve, but both Marc and Eddie would be dedicated instructors if I have any problems. Cinema4D is relatively easier to navigate, but I will have to search for help on my own.

Funding and Miscellaneous
- Dr. Cil is willing to pitch in $10,000 for funding
- The EIT initiative would be funding $4,000 for the summer

- For the surgical videos, we may have to contact Dr. David Adams at the Mount Sinai Hospital in New York for his specialized camera equipment

- In addition, if I were interested in observing the surgery myself, I only have until mid-June to go into the OR and observe Dr. Cil; she will be focusing mainly on research work after that date

Next Steps
- I will have to make a choice between doing an animation or constructing the surgical videos module

- Dr. Cil mentioned that I may be able to proceed into the Women's College Hospital OR to observe the procedure; I will have to do this before mid-June

- As the EIT paperwork is processed, I will follow up for a list of tasks to be completed this summer

- A final research proposal will be drafted by the end of June; we will meet again at that time