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In 2013, the Department of Neurosurgery undertook an ambitious plan to change the way that Neurosurgery understands, utilizes, and interfaces with the most advanced digital technologies in surgical medicine. The plan established the Neurosurgery Simulation Core (NSC) within the Department of Neurosurgery, co-directed by Dr. Joshua B. Bederson, MD and Dr. Anthony B. Costa, PhD, with a simple goal -- to improve outcomes and reduce complications in patients undergoing brain surgery by leveraging novel simulation and visualization technologies in planning, education, and in the operating room. The program integrates research and technology development embedded within a clinical department and is motivated by surgical practice. The resulting bi-directional communication between R&D and the clinic has been a runaway success. Our program now deploys simulation, visualization, and other modeling tools on a daily basis into the clinic; develops new image analysis, visualization, and modeling tools; deploys in-house technologies to basic research questions; educates and trains residents, medical students, graduate students, and attending faculty; works with industry to improve technology globally; licenses technologies to companies; and leads the field of advanced digital tool use in surgery through frequent publication, international meetings, and first-of-their-kind practical courses and workshops.

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The growth of the program has been extraordinary, and not simply within the Department of Neurosurgery. During this time, the leadership and technical capabilities of the NSC have engaged other departments at Mount Sinai and beyond. We have established ongoing clinical or research projects with Otolaryngology-ENT, Pediatric Cardiology, Orthopedics, Plastics, the Institute for Next Generation Healthcare (INGH), the Translational and Molecular Imaging Institute (TMII), and Radiology. This list continues to expand. The growing interest from students and faculty in working with our team has enabled these continued relationships. More recently, the clinical component of these relationships has led to the establishment of the Medical Modeling Core, a fee-for-service group led by Dr. Anthony Costa and run by the NSC which provides clinical modeling (i.e., developing patient-specific virtual reality scenarios and 3D printing) services to departments at Mount Sinai and beyond.

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By late 2016, it was clear that the capabilities in modeling and simulation developed within the NSC had vast applications for improving clinical technology translation and patient care. Our clinical and research footprints continued to grow exponentially through interdisciplinary collaboration and extramural and investigator-initiated programs. At the same time, Dr. Costa, together with colleagues in Orthopaedics and Mount Sinai Innovation Partners, co-founded Monogram Orthopaedics, a thriving NYC medical device startup which at its core makes use of modeling, simulation, prototyping, and robotics to improve implants. As Drs. Costa and Bederson considered the future growth and impact of the NSC, this paradigm -- simulation and modeling-driven development of new, commercially relevant technologies and products -- became obvious as a clear opportunity, and an unappreciated and unmet need at Mount Sinai.

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In 2017, Drs. Costa and Bederson launched Sinai BioDesign, integrating the experience and capabilities of the NSC with re-tooled prototyping and engineering facilities at Mount Sinai, to build a project and engineering platform to enable physicians and researchers to take their ideas and research and turn them into commercially-relevant products. Sinai BioDesign is a full stack prototyping, simulation, and modeling facility together with active project management, guiding inventors through the process of actualizing their ideas to have the greatest impact on patients. Far from being absorbed by the new initiative, the NSC’s mission is now more important than ever, as it takes on the principal responsibility for clinical translation for this new initiative. The new, integrated team has broad capabilities in modeling, simulation, mechanical and biomedical engineering, project management, industrial design, clinical research, and surgical medicine. This group is ideally positioned to take the next step towards our ultimate goal: to translate the wealth of Sinai ideas and innovation potential directly to the patient.

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