by Amy Haddlesey
Editor’s Note: Lifebeat Newspaper is happy to present the first installment of our Spotlight on a Researcher series, which will feature articles on interviews we conducted with researchers across Canada and within Kingston about their work.
I worked with Dr. Rolando Del Maestro, a researcher at the Montreal Neurological Institute within the Neurosurgical Simulation and Training Centre. Dr. Del Maestro has made a lasting impact on the field of brain tumour treatment and care as a practicing neurosurgeon and a co-founder of the Brain Tumour Foundation of Canada, as well as through his contributions to brain tumour research. Currently, Dr. Del Maestro is working on research surrounding a neurosurgical simulator called the NeuroVR. Earlier in the year, I had the opportunity to interview Dr. Del Maestro to discuss what led him to pursue research, his current work on the NeuroVR, and what starting the Brain Tumour Foundation of Canada meant to him.
At the start of his career, Dr. Del Maestro attended the University of Western Ontario from 1967-1973 where he received his M.D. Over the next 5 years, he completed a rotating internship and his residency in neurosurgery without a lot of exposure to the area of research. During his time at Western, Dr. Del Maestro met with a researcher from Sweden, who was very influential in Rolando's decision to pursue a Ph.D. It was during his Ph.D. in Sweden that Dr. Del Maestro developed a new appreciation for what he calls the “complete arc” in medicine and science. The “complete arc” is a term he uses to describe the deep-rooted connection between research and clinical practice. He mentioned in particular that knowing the chemistry behind what he works on in his clinical practice made all the difference. From this experience forward, it became clear to him that to make a difference in his field, he would need to combine both his knowledge of surgical experience and research.
The combination of surgical experience and research has led Dr. Del Maestro to his current research focus on neurosurgical simulation. The "NeuroVR," the central tool of his studies, is a neurosurgical training simulator developed with the National Research Council of Canada (NRC). The simulator involves the use of haptic feedback (sense of touch) and virtual reality to create simulations that resemble neurosurgery, especially the resection of brain tumours. The possible use of simulation in the neurosurgical community became apparent to Dr. Del Maestro as he noticed during his career that there was a near standstill in how operations and training procedures were being conducted around the world. This observation caused him to ask himself "how do I make the field of neurosurgery better globally?" To do this, he looked to the already established global use of simulation in the aviation industry. At the time of the inception of the NeuroVR, the aviation industry had three key facets that were used to reduce the occurrence of accidents: 1) early warning signs (warning lights, control callouts, etc.), 2) flight simulators to train pilots before ever flying their first craft, and 3) group training, in which pilots learn from each other in a proper training environment. In the field of neurosurgery, the only facet that was present was the monitoring of early warning signs (blood pressure, breathing rate, etc.), and so Dr. Del Maestro concluded that the field of neurosurgery was decades behind where it could be. Instead of seeing this delay as an obstacle, Rolando saw an opportunity for rapid improvement by incorporating simulation into neurosurgical training using the aviation industry’s current practices as a model. As a result, his current projects focus on validating the NeuroVR as an accurate training tool for neurosurgery. The goal is to improve the training of young neurosurgeons and reduce neurosurgical disasters related to human error. These goals are modeled after the reduction in fatal aircraft accidents following the introduction of simulators in aviation training. Introducing an idea as novel as neurosurgical simulation training is not without its challenges. In our interview, Rolando described the disruption to current practices that new models cause as a necessary step in innovation, rather than a hindrance or reason to turn back.
Beyond his research efforts involving brain tumours, Dr. Del Maestro has also had a deep social impact on the area. During his career as a neurosurgeon and his wife Pamela Del Maestro’s career as a nurse, both developed a need to help those with and affected by brain tumours beyond the scope of clinical care. This passion to do more for their patients led Dr. Del Maestro, along with Pam Del Maestro and Steve Northey, to create the Brain Research Fund Foundation of Canada in 1982 (now known as the Brain Tumour Foundation of Canada or BTFC). The foundation acts as both a support system and a research fund. It organizes support groups and events geared towards empowerment, cultivating hope, and emotional support for people with brain tumours and their family members. BTFC has also funded extensive research into finding a potential cure and treatment for brain tumours. Dr. Del Maestro considers the BTFC one of his most important contributions during his life since it has allowed him to help those affected in a way that will continue after him.
Through the foundation, his neurosurgery career, and his research, Dr. Del Maestro has helped the field of brain tumours from nearly every angle. It is the same passion that fuels his research that started the Brain Tumour Foundation of Canada and allows Dr. Del Maestro to withstand adversity and skepticism in the emerging and new field of neurosurgical simulation. He mentioned that enacting change is always difficult and gradual, especially in the world of medicine. Instead of being overwhelmed or discouraged by this difficulty, Dr. Del Maestro is fascinated by complexity and challenge, a trait that seems to be a key ingredient to his success.