How Do Surgeons Learn to Operate?

Have you ever wondered how a surgeon learns the skills required to operate on someone? Would it be on a real patient for instance? It's an intriguing thought. An event took place at the Dana Centre, on Wednesday 20 February, attempting to answer just that: How Do Surgeons Learn to Operate? 

I happened to come across this event whilst randomly browsing the web for new ideas and, after initially rousing my interest, I noticed it was only a day or two away from taking place. 'Probably fully booked by now' I thought, but I phoned the venue on the off-chance and discovered that, not only was space still available, but it was completely free to attend! The kind lady I spoke to reserved me a place and sent me an email confirmation.

I got a little lost trying to get there and arrived with only minutes to spare before the event started. The Dana Centre is part of the Science Museum, but in a separate building located just behind it, and is a venue that specialises in adults-only events themed around the big issues in science. This was my first ever visit there (hence getting a little lost!) and I was looking forward to what I hoped would be an illuminating evening.

When I arrived I was directed, from the main reception, down a small flight of stairs, to a lower level area where the event was to take place. I was immediately informed that photographs and video footage would be taken and asked if I had any objections to that, which of course I didn't (although perhaps I should have, not being the most photogenic individual!). The room where the talk/demonstrations were to take place was a long rectangular space. In the middle of the room was a 'stage' area, basically a platform raised a foot or so above the ground. An operating table was set up on the platform, with a latex rubber 'patient' lying across it, covered with a sheet. In a cutaway section in the top of the sheet, inserted into the 'patient', were keyhole surgical instruments. On either side of this stage area were rows of seats, facing inwards. Mounted high at each end of the room was a video screen and a large TV monitor was situated a few feet in front of the operating table.

The event was presented by four different people and the initial introduction was made by Jeff Bezemer, a senior research fellow at the Institute of Education. The evening was quite interactive and Jeff began by requesting the audience participate in a poll. We were asked, in the event of having to undergo surgery, who we would prefer to carry out the operation: a qualified consultant; a trainee surgeon, supervised by the consultant; or no preference, i.e. either one. We used handheld electronic keypads to register our votes.

Predictably, the highest percentage voted for the consultant. We were told we'd be asked this same question again at the end of the talk. Jeff then brought two other people onto the stage, Omar Faiz, consultant surgeon at St Marks Hospital and Alexandra Cope, specialist surgical registrar in the Oxford Deanery. Both of them dressed in full surgical gowns, they basically re-enacted an operation on the colon that was actually performed by a trainee, under the supervision of a consultant. Some original video footage of that operation, from the inside of the patient's abdomen, was used to enhance the re-enactment and we could hear the actual verbal interaction between the consultant and the trainee. This also explained the presence of the TV monitor. In a real operation environment it would be showing the surgeons what was happening inside the patient in close-up detail, via a tiny camera. We in the audience were able to see the real video footage via the aforementioned mounted screens, which was paused at frequent intervals so that Omar and Alexandra could explain exactly what was happening at each stage, giving us an insight into the decisions for carrying out each incision/action on the patient. Their commentary was analysed by the fourth presenter, Roger Kneebone, professor of surgical education at Imperial College London.

After the re-enactment finished, the audience were invited to pitch questions to all the presenters. At the end of this we were once again asked to vote on our preference of surgeon and, as one might have expected, overall opinion had changed, with the highest percentage coming out in favour of either consultant or trainee, i.e. no preference. The audience were obviously impressed at the high level of assistance and guidance given to the trainee and reassured that every single step was carefully monitored.

We were then invited to go and talk to the presenters informally and discuss any issues involving surgical procedure. We also had the opportunity to have a go ourselves: a couple of mock-ups had been created for anyone interested to get a feel of what it's like to carry out keyhole surgery. One was a fake body-cavity, complete with internal organs(!) ...

... and the other was a plastic torso inserted with the same keyhole surgical instruments as the stage 'patient' and a smaller TV monitor, displaying the cavity inside (which contained mini pasta shells that could be picked up using the 'pincers' at the end of the tools!). 

Although the venue had a bar, not a drop touched my lips (he's lying I hear you say!), but plenty of others had a tipple and I had an interesting chat with one or two attendees and the guy who had set up the dummy 'patient', before finally deciding to head off. Must remember to keep an eye on this venue. Very interesting, informative and educational event. And offered free to the public. Well done Dana Centre!