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Visiting neurosurgeons watch surgeons in the OR from the Shapiro Board Room.
This spring, a group of 30 visiting neurosurgeons from around the world shadowed two BWH surgeons in the operating room. It sounds like a recipe for one crowded OR, but thanks to cutting-edge technology and a group effort from departments across the hospital, everyone had a front-row seat and there was plenty of space for the surgeons to operate.
The two-day event—a master class that taught attendees about a novel endoscopic procedure performed at few hospitals in the country—brought surgeons together to learn first-hand how to perform the procedure and manage complications. But instead of learning via a traditional lecture format, the group used technologies such as video conferencing, live streaming and 3D endoscopy to broadcast three surgical cases from the OR to the boardroom, in real time.
“This truly was a multi-team effort,” said course director Edward R. Laws, Jr., MD, FACS, director of BWH’s Pituitary/Neuroendocrine Unit. “We worked with representatives from BWH Audio Visual, BWH Educational Technologies, Partners Collaborative Media and outside vendors; the end result was an extraordinary collaboration that allowed us to share our knowledge and expertise with others.”
At the beginning of each day, when the OR was being set up, Laws and Harvard Medical School fellow Zachary N. Litvack, MD, MCR, as well as visiting professors who are also experts in the field of pituitary surgery, presented lectures on surgical anatomy and the principles of the techniques that were going to be performed. Then, once the operations started, Laws and Litvack described what was taking place as the attendees watched from a series of monitors set up in the Shapiro Board Room. Each participant’s seat at the table was equipped with a microphone, allowing them to converse with the surgeons throughout the procedures. At the conclusion of each case, Laws and Litvack followed up with additional lectures on surgical technique and perioperative management, as well as how to avoid complications.
“Whether you’re still in training or a practicing surgeon learning a new procedure, it’s important to have somebody there to walk you through the operation step-by-step,” Litvack said. “The technology we used in this course fills a lot of voids in surgical training and serves multiple purposes. By simulcasting from the OR, you demonstrate all of the nuances of an operation—not just the technical motor skills, but how the patients are taken care of from the moment they’re brought into the OR.”
What’s more, Litvack notes, not everybody has the advantage of watching and learning from someone who is as renowned in the field as Laws.
“Short of being in the operating room with someone like Dr. Laws, this is as close as you can get to replicating the experience of being a fellow, which is typically a one-on-one experience,’” Litvack said. “But, this is for an audience of 30 people instead of one.”
Both Laws and Litvack say that after the success of the first class, they are optimistic that the same technologies will be used at BWH in the future, in other areas of medicine, as well.
“I hope this is a prototype for what other surgeons in other disciplines might be able to do when they’re at the leading edge,” Litvack said. “This is more than just a showcase of technology. It’s a whole mindset of how to teach young physicians, or practicing physicians who are trying to learn something new, and it’s an incredibly powerful mode of teaching and learning.”