Russian Marriage of Medicine, Technology

By VANORA BENNETT

Oct. 27, 1997 12 AM PT

TIMES STAFF WRITER

MOSCOW —

Necessity was the mother of invention for doctors at the Vishnevsky Surgical Institute here. They found themselves with no cash, no future and too much time on their hands after the Soviet Union collapsed.

But instead of despairing, the surgeons and technicians began a radical project--combining the medical expertise they had acquired over the years with the Western technology slowly becoming available here to create what officials say is Russia’s first medical CD-ROM.

The result went on sale earlier this month in Moscow: a three-disc electronic encyclopedia packed with 3-D diagrams, operating-theater video and the best of Russian academic literature in the specialized field of pancreatic surgery.

“Something good came of those hard times after all,” said Ilya M. Buriyev, the surgeon who dreamed up the Russian project after going to Boston last year and seeing how Americans computerize their medical information.

At $800 a set, it’s not cheap. But in a sign of Russia’s gradual economic recovery and growing friendliness toward computers, two-thirds of the 1,000 Russian-language copies being issued have been snapped up by hospitals around the country.

Sponsors, including pharmaceutical companies Johnson & Johnson and Glaxo Wellcome Export, plan an English-language edition.

“There’s nothing quite like it in the world,” Buriyev said enthusiastically. “This kind of compact disc has been made in the West for a long time, but it’s the first time anyone in Russia has attempted it, and it’s also the first CD-ROM anywhere to deal exclusively with the pancreas.”

Buriyev and half a dozen colleagues have worked on “Surgical Pancreatology” since January, making videos of their operations and painstakingly working out the complexities of 3-D graphics.

The CD-ROM is intended to help medical students or surgeons who do not specialize in the pancreas to handle problems in diagnosing and operating on the tiny organ, which lies under the stomach and controls insulin production.

Every year, about 800,000 Russians, out of a population of 150 million, seek treatment for some sort of pancreas problem, Vishnevsky officials said. Operating on the organ is a delicate undertaking. Surgeons at the institute in central Moscow perform about 150 such operations a year.

“Up to now, if a provincial surgeon somewhere in Siberia found a case of pancreatic cancer, he might be nervous about carrying out such a specialized operation,” Buriyev said. “He would either perform a bypass operation that prolonged the patient’s life just a few months, or he would come to Moscow himself to spend months training how to do the full operation. The patient might even be forced to come to Moscow at enormous personal expense to be treated by us.”

With the CD-ROM at their disposal, Buriyev said, surgeons anywhere in Russia can now refresh their memories about the finer points of pancreatic surgery, read the latest literature and even run through videotapes of procedures, “a kind of rehearsal before carrying out his own operation.”

All 700 big regional hospitals in Russia are now equipped with computers, allowing doctors easy access to information.

“What happened until now? There were lots of specialist publications in our field but no central exchange. Either you’d read some relevant paper or article or you hadn’t, and you didn’t know how to trace it. Now it’s all here, and you can find it easily,” Buriyev said.

But Dr. Mital Sandeep, director of the American Medical Center in Moscow, has reservations about Buriyev’s product. Although he noted that CD-ROMs on anatomy and pharmacology are widely used by Western medical students, he said he is unsure whether complex surgery can--or should--be taught by computer.

“Pancreatic surgery is really specialized,” he said. “The pancreas is a very delicate organ. A malfunction can be life-threatening or reduce the patient to being diabetic. I don’t understand how a group of people sitting in one particular place can outline all the details for people in another place altogether to carry out an operation.”

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

THE TOP 10 / Interactive Medicine

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Title: Platinum Family Doctor

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Average Price*: $12.14

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Title: Mosby’s Medical Encyclopedia

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