Tuesday, September 23, 2014

Laparoscopy

On this weekend, I had the opportunity to attend a workshop on Basic and Advanced Laparoscopy. We were taught everything about Laparoscopy from the very beginning - how to hold the instruments, what the instruments are, how to suture stuff inside the abdomen, working the instrument with what you see on the camera in front of you, hand-eye co-ordination, where and how to put the ports in....all the stuff that you want to know before you just plunge into Laparoscopic surgeries.
Thing is, I've always watched Laparoscopies. Easiest surgery to watch actually. It is an Air-conditioned OR (yeah, I guess I've started using a lot of American terminologies now. If I plan on doing my residency there, makes sense to use their words instead of ours), you can sit on a comfy stool to watch and you have as good a view of the organs as the operating Surgeon. It's pretty damn amazing. After all, it is tiring to watch a 5 hour surgery standing tiptoed, in a crowd, straining your neck from here to there to get a better view.
So back to the workshop. We started with the Endo Trainer. Its a plastic box with holes for the ports. They keep stuff like plates of peanuts, sugar cubes, Polo pills, match sticks and plastic gloves in it. The instruments go in through the holes. You can get really good training in picking those peanuts up, moving them from one plate to the other. The sugar cubes are a little tougher. You have to stack them on one another. The 2-D image in front of you doesn't help a lot in that. The match sticks and Polo pills are the worst. You have to pick a pill and then loop it into the match stick that's stuck down on the rubber padding. Not as easy as it looks! We also got to learn and practice intracorporeal suturing on the same. I, apparently did not have great instruments. But, wow, was that tough!
The key to good Laparoscopy is to stop working with your hands in your head. This is just my thought. I'm just a beginner. But, from what I saw and did, I realised this. When you learn a new language, for example, you always tend to think in the language you know well. And then, you translate that thought into your new language. It's only when you start thinking in that new language that you actually learn. That's the same principle with Laparoscopy too. You can't keep thinking of how you'd separate tissue or suture an incision with your bare hands and then use those methods with that instrument. You have to allow that instrument to be your hand. The needle-holder is not going to be this 20 inch long instrument that you directly hold and just plunge inside. It's going to have a long handle, a different grip and, most importantly, a really small area to move in. Unless and until you can think in terms of moving the needle holder and picture it as a part of your working hand, you can never get good with Laparoscopy. That needs patience, practice and perseverance.
I personally had a great time. I realised yet again, how much I LOVE surgery, love being inside an OR. I also learnt that I am good at this. Day to day practice and I could make myself really really proud. I like looking back at things I've done and marvel at them. I like saying stuff like, "Wow!! You go girl!". I can do that in Surgery or any surgical field. It's great to know that the love I'd felt during my Casualty posting was not a one time thing. I know I love this and I get a feeling I can get really good at it too.
I thank my luck that I had this opportunity so early on. Experiences like these help mould the clay of my confused mind into a beautiful pot. There is a long way to go, but I'm taking small steps. And, I get a feeling that the beautiful piece of art is not very far off :-)

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