Monday, April 6, 2015

What Medical School Looks Like X

Sometimes medical school looks like a computer game. Tonight the surgery students played Operation* with a da Vinci robot. One of my colleagues was so dexterous that I told her I would let her take out my prostate with the machine (!).

It consists of a console (bottom) complete with 3D/HD viewer, articulated hand controls, and a number of foot pedals. The system controls a separate robot that looks like a surgical octopus, with multiple arms for holding the camera and various grabbing, clipping, and burning tools. The surgeon and techs have to clean and prep the patient with “ports” to insert the instruments through small incisions in the skin first, but then the surgeon literally sits in a corner and operates from there.

The student also got to try three different computer training simulations: one picking up jacks and putting them in little cups; another taking rings off pegs, transferring them between instruments, and placing them on another peg; and an “endometriosis” simulation that required us to position two tools and a camera with our hands while working the camera and two different cautery tools with our feet. These were challenging but fun, since the only stakes were bragging rights. In reality, surgeons have to score at least 75% on 18 of these simulations before they can get robotic operating privileges at this hospital. I scored about 83%, 68%, and 90%. Another student had three passing grades, and we joked that he was well on his way to getting his privileges. (Funnily enough, he’s going to be an orthopedist. But bone surgeons are more often associated with hammers and saws than the delicate kind of operations for which robotic surgeries are often used, like removing a prostate or a uterus.)

The instructor asked that we post no photos publicly, so this one is from the official Da Vinci website. If you are at all curious, click on the link to see a couple short videos demonstrating the system. There's even one showing a surgeon from Japan folding an origami crane the size of a penny!

The <em>da Vinci</em> System surgeon console
* The game Operation was invented in 1964 by a University of Illinois design student, who in a cruel twist of fate found himself uninsured and in needed of dental surgery last year. I think the doc's edition must be an original one, as there's no "brain freeze" ice cream cone in his head. The set was complete with the Doctor and Specialist cards and their corny--and money-grubbing--rhymes.

"Water on the Knee"
Pump the water--fill the pail. Take your money, so you can set sail. $1000.

Patient has overloaded "Bread Basket." Remove a slice, the fee is nice. $1000.

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