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Here's a portion of a transcript from OR-Live. The procedure was a "Video Assisted Thoracoscopic Lung Resection". This was a pediatric case on an infant (forgot what age).
Does this statement not speak volumes about the realities of the intangible benefits of what an anesthesiologist really provides?? It's easy to overlook this (or study it), because of an obvious lack of metrics for such a thing. But, I personally think it speaks volumes.
Here it is: (bear with the font issues resultant of copying from one program to another etc.)
STEVEN ROTHENBERG, MD: I have. Iíve trialed some of them, but my feeling is we donít use suture assist
devices in open surgery; why would we use them in thoracoscopic surgery? I think itís extremely important that if
youíre going to do these proceduresÖyou shouldnít do a thoracoscopic lobectomy if you canít suture
thoracoscopically. I think thatís a clear test of the skill level that you have, so if you canít suture, if you canít
throw down a suture, then you shouldnít be doing this. Having said that, I think most people can develop the
skills to do this. Itís a little bit hard because the heartís beating right there and thereís not a lot of space, but itís
a dry field and it doesnít take that many sutures. I use the reverse C technique of laying down square knots.
PDS, because of its memory, is a little tough to suture with, but again, I think itís the best choice in these cases.
If I could just get the anesthesiologist to stop the heart, it wouldnít take so much time, but they get funny when I
ask them to do that. I would like to thank Dr. Clark ñ heís our anesthesiologist ñ for doing an excellent job. One
of the keys to the success of this surgery is having complete understanding and ultimate trust in your
anesthesiologist. I donít worry about what theyíre doing. I know that if the babyís not doing well, they will tell me
and I can make adjustments for that, but otherwise, Iím not concerned about the babyís condition and thatís a
huge relief. So if youíre going to do these procedures, you need to have that kind of relationship and
understanding with your anesthesiologist and they need to have trust in you to know that if you run into a
problem, you can get out of it. So itís a very important relationship, as much as I hate to admit it. I have a little
burr on the end of my needle and thatís whyÖyou can see the pulmonary artery just beating away right up there.
Does this statement not speak volumes about the realities of the intangible benefits of what an anesthesiologist really provides?? It's easy to overlook this (or study it), because of an obvious lack of metrics for such a thing. But, I personally think it speaks volumes.
Here it is: (bear with the font issues resultant of copying from one program to another etc.)
STEVEN ROTHENBERG, MD: I have. Iíve trialed some of them, but my feeling is we donít use suture assist
devices in open surgery; why would we use them in thoracoscopic surgery? I think itís extremely important that if
youíre going to do these proceduresÖyou shouldnít do a thoracoscopic lobectomy if you canít suture
thoracoscopically. I think thatís a clear test of the skill level that you have, so if you canít suture, if you canít
throw down a suture, then you shouldnít be doing this. Having said that, I think most people can develop the
skills to do this. Itís a little bit hard because the heartís beating right there and thereís not a lot of space, but itís
a dry field and it doesnít take that many sutures. I use the reverse C technique of laying down square knots.
PDS, because of its memory, is a little tough to suture with, but again, I think itís the best choice in these cases.
If I could just get the anesthesiologist to stop the heart, it wouldnít take so much time, but they get funny when I
ask them to do that. I would like to thank Dr. Clark ñ heís our anesthesiologist ñ for doing an excellent job. One
of the keys to the success of this surgery is having complete understanding and ultimate trust in your
anesthesiologist. I donít worry about what theyíre doing. I know that if the babyís not doing well, they will tell me
and I can make adjustments for that, but otherwise, Iím not concerned about the babyís condition and thatís a
huge relief. So if youíre going to do these procedures, you need to have that kind of relationship and
understanding with your anesthesiologist and they need to have trust in you to know that if you run into a
problem, you can get out of it. So itís a very important relationship, as much as I hate to admit it. I have a little
burr on the end of my needle and thatís whyÖyou can see the pulmonary artery just beating away right up there.
