Neurosurgery Over The Shanghai Airwaves

PNI’s neurosurgery educational partnership exchange with Fudan University in Shanghai, China moves to the next level with a new live stream videoconference.

By the Yangtze River on China’s central coast, looking out over the East China Sea, sits the city of Shanghai, a shining jewel steeped in rich history while at the same time embracing the 21st century. Bustling with more than 24 million people, Shanghai is the home of the prestigious Fudan University, which was founded in 1905. Through many transformations it became affiliated with the Shanghai Medical School in 2000. Most famous for its neurosurgery program, 15,000 neurosurgical operations are performed here each year in areas including brain tumor, trauma and vascular disease.

The Pacific Neuroscience Institute began a collaboration with Fudan University in 2012 when PNI director Dr. Daniel F. Kelly and Dr. Mao Ying met at a conference. As a pioneer in the field of neuroendoscopy, Dr. Kelly proposed the idea of a specialized Fudan University International Fellowship Program for neurosurgeons to come to the United States and learn minimally invasive endoscopic neurosurgical skills.

In May 2013, Dr. Hua Wei (Dr. Harvey) became the first Fudan University International Fellow at PNI. “I was honored to be the first one,” he says. “I was doing half my training with Dr. Kelly, on clinical observation, data collection, video editing, and anatomical training as an international fellow, and also was doing half in Dr. Dave Hoon‘s lab, on molecular biomarker investigation and scientific research on gliomas as a post doc. My fellowship lasted 13 months and I was even named the employee of the month in May, 2014!” he adds.

Wishing to push this experience to the next level and to include more participants, Dr. Kelly worked with Chester F. Griffiths, MD, FACS, and Garni Barkhoudarian, MD, FAANS, to begin a live streaming surgical videoconference seminar.

Live Stream Neurosurgery

“We ran a live video test in 2016 and December 2017. There were many factors and difficulties, such as the time difference,” says Dr. Harvey. “Finally, we overcame all of our challenges, and did a successful video streaming operation in January 2018.”

“Seeing is believing. It is hard to describe the benefit,” he says.  He adds that as most neurosurgeons know, there are many finer points that become clear while observing a live surgery, for example, adjusting the position of patient for optimal neurosurgery. “So, it was great to see exactly how Dr. Kelly’s operating theatre is set up. There is a Chinese saying: It is better to see once than to hear a hundred times.”

Because of Dr. Mao’s efforts, the Shanghai government now supports this project and the doctors will be able to keep the live videoconference program going. “Hopefully, we can do this in a mutual way,” says Dr. Harvey. “Next time we hope to do an endoscopic surgery in Shanghai with Drs. Kelly, Griffiths and Barkhoudarian observing from Santa Monica.” In this way, feedback can be given in real time benefitting both the patient and the operating neurosurgeons.

Four years after his fellowship at PNI, Dr. Harvey remembers his experience with Dr. Kelly and the team very fondly. More importantly his experience has translated positively to his role at Fudan University and Shanghai Medical School. “I knew very little and had no experience with endoscopic techniques before I went to LA. The experience was great,” he says. “I learned a lot from both the clinical team and scientific team. I am quite good at neuroendoscopy in Shanghai, and Dr. Griffiths’ rescue flap procedure is working well for me, which is the main concern in neuroendoscopy.”

“We have also tried some successful new approaches here. I love neuroendoscopy and these techniques have helped many patients. The research experience on epigenetics has also helped as we applied this to our glioma research and we have done quite a few papers together.”

There have been a total of eight Chinese neurosurgeons who have attended PNI’s Fudan University International Fellowship Program: Drs. Hua Wei (Harvey), Zhu Wei, Shou Xuefei, Zhang Xin (Vincent), Zhao Fan, Wang Xiaowen (Apollo), Song Jianping and Huang Xiang (Fabio).

The most recent Fudan University International Fellow, Huang Xiang, MD, PhD (Dr. Fabio) finished up his 8-month fellowship in February 2018. An attending physician at the Department of Neurosurgery, Huashan Hospital when back home in Shanghai, China, Dr. Fabio also attended the first videoconference in January from the PNI side. “It was an amazing experience to connect through a large format TV screen and share neurosurgical techniques across the world with my colleagues in Shanghai. State-of-the-art endoscopes are readily available in China and many surgeons have endoscopic capabilities now. I’ve learned a tremendous amount in the fellowship program and the videoconferencing component to train neurosurgeons in minimally invasive endoscopic techniques is really necessary for continuing success in the Chinese surgical setting.”

“We’re very pleased with this next milestone in physician education,” says Dr. Kelly. “The commitment from Harvey and Professors Wang Yongfei and Mao Ying in organizing our first trans-oceanic, intergalactic, hi-def videoconference between Fudan Neurosurgery and PNI has been wonderful! I think it went very well.”

Equally enthusiastic about this new endeavor, Dr. Griffiths says, “Success! We hope to build on the momentum and plan for a videoconference every other month, with both lecture and live surgery simultaneously. It will truly be transformation for all involved, utilizing technology for innovation and collaboration. A dream come true.”

Zara Jethani, MS, MBA, is the marketing director for the Pacific Neuroscience Institute. Her background is in graphic design, molecular genetics research and healthcare marketing.