Dr. James "Butch" Rosser
Chief of Minimally Invasive Surgery
Beth Israel Hospital, New York
"Video Games and Simulation of Safe Surgery"

Dr. James C. Rosser, Jr. was born in 1954 in Rome, in Sunflower County Mississippi. He grew up in Moorhead, Mississippi where he attended James C. Rosser, Sr. Elementary School. He graduated from Indianola Gentry High School in Indianola, Mississippi. He received his undergraduate degree in chemistry and biology from the University of Mississippi. He was the third African-American to graduate from the school and then go on to medical school. He completed his medical degree at the University of Mississippi School of Medicine before going on to complete a five-year surgical residency at Akron General Medical Center, where in 1984-85 he served as Chief Resident. After his residency, Dr. Rosser began an academic/private surgical practice at Akron General Medical Center and accepted a position as Assistant Professor of Surgery at Northeastern Ohio Universities College of Medicine, where he received the 1991 "Golden Apple Professor of the Year" award for his outstanding contributions to medical education.

Early in his career, inspired by Dr. Herbert Awender ,an early proponent of endoscopic techniques being utilized by the general surgeon, Dr. Rosser realized the potential of endoscopic and minimally invasive surgery. He went to Europe to work with thought leaders in minimally invasive techniques and based his initial investigative and teaching efforts out of the Academic Medical Center in Amsterdam. His travels took him all over the world and served to kick start his career in this fledgling arena. Since that time, he has pioneered a number of minimally invasive procedures and techniques. The most notable is the Rosser Top Gun Laparoscopic Skills and Suturing Program. This edutainment based surgical educational module was just featured on the hit ABC network series "Grey's Anatomy" complete with the senior surgeon imitating Dr. Rosser by suturing with his eyes closed. The University of Southern California Department of Surgery spearheaded this crossover debut of this program; they have been historically diehard practitioners of the curriculum. The program has been featured on every major television network over the years and major print and electronic media. Rosser's Top Gun program has a database of over 5,000 surgeons that have taken the course since it was first launched in 1991. Dr. Rosser can provide percentile rankings of the participants compared to their peers. Top Gun has been featured at the American College of Surgeons Clinical Congress, SAGES, and SLS for many years. Pilot programs with the American College of Surgeons and SAGES seek to investigate the possibility of Top Gun being used in the evaluation of skill erosion in senior surgeons and its usage in fulfilling the SAGES FLS program-suturing requirement. Over 50 institutions around the world are currently using it. A recent upgrade has brought economy of motion errors into the performance parameters that are recorded. In 2004, Dr. Claude Organ and the Archives of Surgery announced that the 1997 and 1998 papers on this subject were included in the top 50 most requested papers over the previous ten years.

Most recently, Dr. Rosser has conducted a study to determine if a significant correlation exists between video game experience and proficiency at laparoscopic surgery. He has always believed that his own affinity and skill at video games was directly related to his success performing surgery and suturing with laparoscopic tools. Dr. Rosser and his researchers found that indeed current video game skills and past video game experience were significantly more indicative of a surgeon's laparoscopic surgical proficiency than number of cases previously performed and years of training. These findings were presented at the Medicine Meets Virtual Reality Conference and the first investigation results have been accepted for publication by the Archives of Surgery and will be released later this year. Recently, the results of a second study with over three hundred participants reaffirmed with more statistical power the first study, and in addition it suggested a twenty minute warm-up period with over the counter videogames could be beneficial to surgeon performance in the laparoscopic arena. Rosser feels that a "simulation for safe surgery" movement must take hold in order to protect patient outcomes and he feels that the only way to produce sustainable med/surg simulator business plans is by the fusion of videogames for fun with serious modeling and simulation. To assist in this effort he has introduced the Top Gun 4 Kids program. This program, along with its Top Gun 4 Teens and Top Gun U counterparts use scientifically validated over the counter videogame competition, the Top Gun surgical simulator competition and a cognitive challenge on topics associated with subject matter in science, engineering, technology and healthcares. It has been described as a combination of a hip-hop National Spelling Bee meets the X Games. It is hoped that this can served as a recruitment conduit to draw children into making career choices in these under represented areas, especially for women and minorities. This is the first program to be deployed to kick off a Games 4 Good initiative that seeks to harness the power of pop culture icons to contribute more than just entertain. Pilot programs have already been conducted in several cities and the city of New York has just awarded a large grant to showcase this in their public school system.

"Butch", as he prefers to be called, has also distinguished himself clinically by performing laparoscopic cholecystectomy procedures on some of the youngest individuals in the world (15, 17, and 19 months), which earned him Kent State University's "Minority Achievement Award." He has also pioneered other surgical techniques and tactics that bear his name including the Rosser Gastric/Jejunal Feeding Tube Insertion, Open Laparoscopy technique for the establishment of the pneumoperitoneum, trocar closure technique and the Rosser laparoscopic adhesion classification. He is the holder of two patents and the lead inventor of several products. To simulate an actual procedure performed in an operating room scenario, Dr. Rosser developed an inanimate model to train surgeons how to explore the common bile duct laparoscopically. He also designed a special video trainer to aid in teaching laparoscopic suturing as well as a laparoscopic skills and suturing kit for the establishment of a mobile skills lab. Other Rosser influenced innovative products include a restraining device for instruments to decrease the number of surgical team members required to perform laparoscopic cholecystectomy, surgical drapes and camera holders, the Rosser Signature Series laparoscopic suturing devices, and a full line of ergonomic laparoscopic cholecystectomy instruments. In addition he has developed an infrared localization and sizing device for laparoscopic esophageal procedures and laparoscopic irrigation/ aspiration instruments.

In spite of the expanse of his interests, his first love has always been education. In 1994, Dr. Rosser joined the Yale University School of Medicine faculty and was appointed Associate Professor and Director of Endo-Laparoscopic Surgery, where he dedicated 8 years to his goal of helping to revolutionize training methods in the field of minimally invasive surgery. He has conducted over 250 post-graduate courses and courses worldwide over his twenty-year career. Yale Laparoscopy became known as a global icon in minimally invasive surgery under his direction. He has authored over fifty peer reviewed articles and a similar number of abstracts. He has contributed numerous chapters to major surgical textbooks on a wide range of topics, including his chapter on intracorporeal suturing in upcoming new edition of Fischer's Mastery of Surgery textbook. Dr. Rosser is currently writing "The Art of Laparoscopic Suturing: The Top Gun Experience" due to be released this fall. He is a contributing editor of Surgical Laparoscopy and Endoscopy, Archives of Surgery and Surgical Endoscopy, and the Journal of the Society of Laparoscopic Surgery. He has also been the chief investigator on several large research efforts and grants and has mentored over forty fellows and research assistants.

Dr. Rosser has also been a key participant in numerous important medical society meetings. He has been a moderator at the Fourth World Endoscopic Congress, and chairperson for several post-graduate courses for the American College of Surgeons, Society of American Gastrointestinal Endoscopic Surgeons (SAGES), and Society of Laparoscopic Surgeons. A sample include being moderator for "Laparoscopic Inguinal Hernia" at SAGES in 1993; "How to Teach a Technical Skill" and "Credentialing and Mentoring" at the 81st Annual American College of Surgeons Congress in 1995; "Emerging Issues in Minimally Invasive Surgery," "Advanced Laparoscopic Surgical Procedures in a Unique Outpatient Setting: The Recovery Hotel," "Mini-Laparoscopy under Local Anesthesia for General Surgeons" and "Knowledge Transfer Techniques for the Next Millennium" at the American College of Surgeons 25th Annual Spring Meeting in 1997; the Minimally Invasive Section of the American College of Surgeons Post-Graduate Courses in 1995 and 1997; and the Top Gun Laparoscopic Skills Program at the American College of Surgeons over the last ten years.

Rosser has always been a pioneer in assimilating technology into education. He was the first to author full featured, fully interactive computer based instruction in the CD-ROM format and has ten CD-ROM electronic book titles over the years. Six of them were released under the "Yale University Laparoscopic Series" label and have been internationally recognized. His efforts have not only been directed toward surgeons, but he has also broken new ground in the area of computer assisted patient information delivery and establishment of informed consent. All of these efforts have attracted critical acclaim in both the New England Journal of Medicine and The Lancet.

The idea of mobile training and technology assimilation for better healthcare delivery continues to be a primary objective in many of Dr. Rosser's ventures. Inspired by his work as the technical coordinator for the Yale/NASA Commercial Space Center at Yale under the direction of Dr. Ronald Merrell, he aggressively began to utilize telemedicine as a way to eliminate disparity of care. He believes that with telemedicine there can be the establishment of a new paradigm in healthcare delivery where "people don't come to healthcare but healthcare comes to the people" and we can change our healthcare delivery policy from a defensive (after the fact) strategy to an offensive (preemptive and preventative) one. He developed a mobile telemedicine unit and was the lead investigator of "Operation House call", a proof of concept project to develop mobile telemedicine applications, and "Operation Distant Angel", a project designed to bring pediatric healthcare expertise to distant locations using telemedicine. Taking this concept to a global level, Dr. Rosser also spearheaded "Operation Rainforest", a mission using telemedicine to improve delivery of healthcare to rural areas of Ecuador via mobile operating rooms and "Operation Messiah", a telementoring mission to Santo Domingo, Dominican Republic. In addition, he and a team of other physicians with the Yale/NASA Commercial Space Center oversaw health delivery on two Mt. Everest expeditions where cutting edge medical technology for the international space station was tested. He has also utilized his technological expertise to beam education seminars to over 50,000 visitors at the Texas State fair with Operation Cowboy. This project was meant to test the feasibility of mass public healthcare education with distant learning techniques. Over one week, this project spread his high tech healthcare message with great effectiveness. On two occasions Rosser has addressed special sessions held by the World Bank investigating the impact of the information age on healthcare delivery. His global presence in the arena continues with his recent appointment as an independent project administrator for TATRC. His public interest focus also reaches domestically. Dr. Rosser believes strongly that mentoring can positively impact the lives of young people and by using point to point or Internet video communications cyber mentoring can be used to overcome the obstacles to wider deployment of mentoring programs. His Cyber Mentoring Program has taken him across the nation, permitting him to influence students, many of whom may not have otherwise had the opportunity of exposure to medicine as a career possibility.

Dr. Rosser's efforts earned him awards and citations from organizations worldwide. He has been bestowed the honor of receiving the key to city from five municipalities, governors and state legislatures. He has garnered three Smithsonian Awards for technical achievement in medicine. He has been honored with the National Role Model Award, the University of Mississippi Pioneering Work in Surgery Award, the Charles Drew Health Award presented by Martin Luther King III and the Southern Christian Leadership Conference and the National Medical Association's Living Legend in Medicine Award. His clinical expertise and extensive work in cutting edge medical training and research were recognized when he was featured in New York Magazine's "The Best Doctors in New York" Hall of Fame 2002. In 2004, he was inducted into the University of Mississippi Hall of Fame for his contributions to the medical profession and public service. As a result of his extensive research and teaching efforts, Dr. Rosser has been awarded the Johnson & Johnson Special Leadership Recognition Award for Contributions in Laparoscopic Surgery, and the Ethicon Endoscopy Special Recognition in Surgical Education Award, along with the USSC/TYCO award for surgical education. Dr. Rosser's research and clinical activities have been the subject of several documentaries featured on the Learning Channel, the CBS Morning Show, CNN, the Today Show, the Discovery Channel, the Discovery Health channel, and special programming produced by many media outlets around the world. He television work has earned him a Telecommunications Academy Award for programs produced that promote the greater good and well being of the public.

Currently, Dr. Rosser is the Chief of Minimally Invasive Surgery at Beth Israel Medical Center in New York, Professor of Surgery at Albert Einstein School of Medicine, as well as Director of Beth Israel's Advanced Medical Technology Institute (AMTI). AMTI is an education and research arm within the department of surgery with a goal of providing Beth Israel with the necessary infrastructure and support for their residents and surgeons to execute the safe maturation and deployment of minimally invasive procedures. AMTI has four core competencies: Clinical Procedural Development in Minimally Invasive Surgical Techniques; Cyber-based Education and Distance Learning; Research and Development; and Telemedicine . AMTI is a unique platform that has been designed to support the hospitals of Continuum Health Partners in New York, New York as well as other hospitals around the world.

Even though Dr. Rosser has great experience with all minimally invasive procedures, his major clinical focus at this time is surgery of the foregut. The most notable being laparoscopic weight loss surgery. Dr. Rosser is a nutritionally challenged individual himself, having become a weight loss surgery survivor five years ago. He has shed over 172 pounds. He is a living testimony to the life giving power of this procedure. Rosser has a unique and profound insight into the entire surgical weight loss process beyond just the operating room. He truly has a view from an eagle's nest. He relates to his patients as a peer and confidant, while at the same time, giving them the benefits of his surgical talents.