Urology Centers of Alabama

Telesurgery: Educating Surgeons and Patients From Afar

This past April… Thursday the 18thto be specific… I performed an artificial urinary sphincter surgery to treat the urinary incontinence of a man who had undergone prostate removal as a treatment for Prostate Cancer. Now, it is not unusual for me to perform this kind of surgery. In fact, for the last decade I have consistently been one of the highest volume urinary incontinence surgeons in the world; very few urologic surgeons do more of these surgeries than I do. Also, I was observed by surgeons during this surgery, and that also is not unusual for me as I routinely train surgeons how to place artificial sphincters, male slings, and penile implants. What WAS unusual about this particular surgery was that I was observed by over 5,000 surgeons from 86 countries around the world! How is that possible…? That is the subject of this blog: telesurgery.

On that day, the artificial sphincter case was shown on the internet; so, surgeons (and patients!) could watch the procedure on their computers or smart phones. In addition, the observers could ask me questions by typing the question into their device and it then showed up on my phone. I received over 30 questions live questions during that surgical presentation. My nurse read the questions to me, and she typed my answer back to the surgeon/patient. Some of the questions were very basic, good questions, and some were very detailed, specific questions about my technique or about a patient of their own. Telesurgery, which is the beaming/transmission of a surgical procedure to an audience via cable or, in this case the internet, makes surgeon and patient education a whole new ball game. In the past, I could teach 2 or maybe 3 surgeons at a time by bringing them into my operating room and have them observe. Or, I could show a surgical video to a patient in the clinic to let them know what is involved in a surgery they may be considering. Now, the doc or the patient can log on, watch the real procedure, and ask questions if they wish. They can be in the comfort of their home or office… they can ask questions without the fear of sounding foolish or uninformed to the other observers. AND, I can reach thousands of people not just a few. Telesurgery also improves the care of the patient on the table: if I put 10 or 12 surgeons in my operating room to observe, that might increase the risk of infection, but a camera sitting in the room with one extra person to film/video is no concern at all. Telesurgery improves the care of patients I may never see: hopefully, the surgeon viewers will better understand the procedure and how to best perform it, and so their patients will benefit. There will be surgeons who observe and decide  “Hmmm, I better leave these surgeries to a surgeon with a ton of experience; I am sending my patients to Dr Christine.” and these patients will benefit by getting treatment from an expert.

Telesurgery improves how I teach and the education of who I teach. Today, the classroom is limited only by the number of students who log on… it’s amazing.  What else could telesurgery do? I have had surgeons who will have questions or difficult situations during a surgery and they will call me and email or text me actual pictures or even short video from the ongoing surgery; this lets us solve the problem together by phone, but at least I can see what they see.

Telesurgery is something in which I have a huge interest (in case you could not pick up on my enthusiasm). I am always interested in ways to better educate surgeons and patients. Using the power of the internet, high quality video, and our amazing home computers and smart cellphones, and combining this with my surgical experience and desire to teach, is a natural fit in my eyes. I am very blessed to practice at a time when these advancements are available, and I want to use them to pass on what other surgeon educators have given to me. Coming soon to your computer/cellphone…. telesugery!!