Live From the OR

Live From the OR
Jon Einarsson, MD, and Wolfgang Fitz, MD, in the minimally invasive surgical suite at BWFH.

Telesurgery is revolutionizing how surgeons around the world learn and adopt best practices in surgical care, and Brigham and Women’s Faulkner Hospital (BWFH) is at the leading edge of the movement.

BWFH has built seamlessly interconnected, smart operating rooms (ORs) with telesurgery in mind, using advanced “plug-and-play” devices that adapt as the surgery progresses and are ready to livestream at a moment’s notice. The system’s flexibility helps surgeons achieve the closest view of finer techniques needed to repair delicate organs, and creates a safer OR experience.

“It wasn’t long ago that the effort required to produce and televise a high-definition image took an entire film crew and enough equipment to fill the whole operating room,” says Pardon Kenney, MD, chief of surgery at BWFH. “Thinking of the capabilities we have now—this technology will only get smaller.”

A commanding performance

 For BWFH surgeons who showcase their work, telesurgery is not about entertainment or using the best gadgets available.

“The livestream’s purpose is to teach a perfectly-orchestrated procedure,” says Wolfgang Fitz, MD, an associate orthopedic surgeon, who noted that surgical broadcasts are often the highlight of professional conferences for surgeons. “It is part of our mission to educate our colleagues around the world, and to show what we are doing at the Faulkner to make procedures safer for the patient and simpler for the surgeon.”

A single conference can generate an audience of several thousand physicians, who observe the live operation and ask questions of the surgeons in real time.

“We are used to talking and fielding questions in the OR from our residents and staff throughout a procedure,” says Jon Einarsson, MD, chief of the Division of Minimally Invasive Gynecologic Surgery. “From our perspective, this is no different.”

Einarsson and Fitz each performed live surgical procedures last year, and their successes are helping to elevate BWFH’s profile as a premier community-based hospital.

“These surgeons are world leaders in their respective specialties,” says Kenney. “They represent the very best of our hospital, and I’m confident that their considerable skill and experience comes through to the audience.”

For experienced surgeons, the live broadcast is all in a day’s work.

“We are still 100% focused on the patient, who receives the same care they would get as in any surgery,” says Fitz. “The duration is the same, and with this new system, we avoid the distraction and risks of having camera crews in the operating room with us.”

There is one notable difference—patients who volunteer to participate as subjects get to keep a taped copy of the telesurgery. From Einarsson and Fitz’s experiences, every patient who has been involved so far has taken them up on the offer.

Coming attractions

BWFH will continue investing in practices that propel surgical education forward, such as telesurgery. As with virtually every other facet of modern life, keeping up with the pace of innovation is always a challenge.

“The technology is changing so rapidly that it can be outmoded in as little as six months,” says Kenney. “That’s why we outfitted our operating suites with a modular system that we can update as we go.”

Already sensing where telesurgery is heading, the surgeons predict that 3D and 4K (four times the resolution) cameras are the next step in visualizing surgical practice. Down the road, they also hope to develop the observatory into a dedicated teaching center where surgeons at every career stage can hone and adapt their skills.

“We are getting ready for the next phases of the 21st century,” says Kenney. “We are investing in our future.”