Conference Coverage

Teaching opportunities of live surgery broadcasts debated

View on the News

Potential for distraction is an issue.
Dr. Peter Angelos

Dr. Peter Angelos

Although I do not agree with the suggestion that surgical meetings such as AATS and STS should reverse their ban on live surgery broadcasts, Dr. Bavaria’s suggestion certainly brings attention to an important question about how to maintain the safety of patients in the operating room, while still allowing for optimal teaching opportunities. Most surgeons have accepted that in a live surgical broadcast, the surgeon’s primary attention on the well-being of the patient in the operating room is potentially distracted by the audience viewing the procedure from afar. Although I cannot cite evidence that patient safety is actually compromised from such live broadcasts, self-reflection certainly suggests that there is a potential risk for the surgeon to have competing concerns during surgery, potentially at the expense of safety. In a similar context, I wonder where are the data that previously recorded videos of surgical procedures have less educational value than live operations. I am concerned that the fascination with live broadcasts has much to do with the sense that a complication might occur and that this fascination has little to do with educational value. Although I disagree with Dr. Bavaria’s conclusions on live broadcasting of operations, I commend his refocusing of attention on the educational value for students of viewing surgery in real time. Simulations are good teaching tools, but firsthand observation remains essential.

Peter Angelos, MD, FACS, is the Linda Kohler Anderson Professor of Surgery and Surgical Ethics, chief of endocrine surgery, and associate director of the MacLean Center for Clinical Medical Ethics at the University of Chicago. Dr. Angelos has no disclosures.


 

REPORTING FROM AATS


He pointed to a 2011 study that examined 250 cardiac procedures that were broadcast live to 32 scientific meetings. Researchers found that “there is no evidence for an excess perioperative risk for patients operated under the conditions of live broadcasting” (Eur J Cardiothorac Surg. 2011;40[2]:367-71).

A member of the audience at the AATS session pointed out that the study may be misleading because only top surgeons may be willing to perform procedures live on television. Dr. Bavaria responded by noting that the outcomes of surgeries performed on live video were not worse.

Skeptics have also expressed concern about the potential for sensationalism in live broadcasts and the drive for participants to make a splash: “the demands of ‘the performance,’ including questions and discussion with the audience, may divert the surgeon’s attention and produce an inferior outcome,” wrote three physicians in 2011 (J Surg Educ. 2011 Jan-Feb; 68[1]:58-61).

The trio also expressed worry about safety risks posed by extra equipment and extra people in the operating room during a live broadcast. However, Dr. Bavaria said the crowded conditions of an operation observed in person – instead of via video – could be worse: “You don’t have a sterile environment, you have people hanging around all over. A moderated live session could be better for the surgeon and the patient, rather than having a bunch of people in the room.”

Dr. Bavaria was also asked why surgeries couldn’t be recorded for airing later instead of being broadcast live, as this approach “takes you out of the nexus of having two masters, the patient and the audience.” In response, Dr. Bavaria said editing takes extra time in order to capture the nuances of the live procedure.

Dr. Bavaria reports no relevant disclosures.

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