WILTIMS #464-6: BFFs and robots

Saturday: I was a patient's BFF! And she said it during morning rounds with the chief!!! Let's go back to Friday for a second.

(Friday:) There was a patient I was following because I had been in her surgery earlier in the week. She was having a real hard time with her recovery, in part due to not being able to get up out of bed. We wanted her to walk and sit in a chair, but the combination of pain, dizziness, nervousness, and her somewhat intimidating size made it so that no one felt comfortable helping her, for fear that she might fall (a BIG no-no in hospitals).Well after two days of nursing and physical therapy not getting her out of bed (heaven forbid the doctors actually try), I decided to make it happen. I grabbed a couple of med students and we slowly, patiently, helped the patient out of bed to a nearby chair.

It was a pain for everyone involved and took a good 10 minutes (10 minutes!? My god! No one has that kind of time!), but we managed to get her to the chair. And she was so grateful she cried. It's ridiculous to me that it was this much of an ordeal to accomplish this little task.

The next morning for our smaller weekend morning rounds, the chief resident, an intern (1st year resident) and myself walk into her room and the patient says hi to everyone, but specifically smiles at me and says, "Hello, Christopher."

At this point the two doctors stop and look over to me quizzically. "You know his name?" the intern asks.

The robot.

"Oh yes. Christopher was the man yesterday. He and some friends helped me to the chair when no one else could. Christopher said he would get it done, and he did."

"So, you guys are BFFs now?" the intern facetiously asks. "I'm starting to feel jealous."

"Yep. We're BFFs."

I am eight shades of red at this point, but feeling pretty darn good. I might make a mediocre surgeon, but I take good care of my patients.

SaturdayIL: Normally, retracting or manipulating a body part is pretty simple, but a soapy scrotum is very hard to hold in a specific orientation.

The video game control console.

Monday: Yesterday I got to see my first robotically assisted cases. The first was simple and the second was a disaster, but not because of the robot. The robot is really cool and creepy looking (see on the right). The robot essentially allows you do a laparoscopic surgery, but in 3D, with super-human precision, and using tools with intuitive wrists. There are also four arms on this model, so you can retract things for yourself or have a second person control those from a second console. When the other console isn't in use, the med student gets to watch the surgery in 3D too!

The doctor using all this technology tried to justify it's use by saying that traditional laparoscopy has reached a limit as to what it can be used for. This robot-tech is better, but we haven't figured out the best uses for it yet (outcomes for robotic procedures vs. current laparoscopic surgeries are identical (but far more expensive)). I'm not convinced, but if cost weren't an issue, I could see the appeal of robot help.

MondayIL: Holding pressure on a perforated splenic artery during a robotic-assisted surgery is fairly complicated.

TuesdayIL: Bariatric surgery patients often develop acid reflux after the procedure because their newly shrunken stomachs simply can't hold that much acid anymore and it backs up into the esophagus.