SURGICAL PROCEDURES DURING THE COVID-19 PANDEMIC: REMAINING SHARP

In unpredictable times, it is essential to continue to be in touch with fellow doctors in order to continue learning, growing, and developing professionally.

“As I educate my residents (as well as) fellows and work with my colleagues, most of us acknowledge both the significance of maintaining surgical skills through periods of inactivity as well as exactly how difficult this might be when the surgical volume runs out, which is a distinct possibility” an MD doctor emphasized, and also gave some pearls of wisdom that can help alleviate this circumstance.

A clinical assistant professor, related being a doctor as well as maintaining skills to being a member of a football team. Most of the players are off the field the majority of the time.
He explained that coaches utilize certain methods for those players outside the field to keep them prepared and also all set to perform when called upon.
Surgeons can prepare themselves for action by producing mental representations of themselves “in the video game” via mindful and direct observation. They likewise can play the “anticipation game” by picturing what they would do when faced with the current situation, he clarified.
Additionally, the doctor encouraged that surgeons have hands-on tasks that they can work on while sidelined; these tasks are directly associated with the expected surgeries.
“These actions make it possible for surgeons to maintain a direct connection with what is happening in the operating room, and can be practiced for optimum results” he said.

Philosophies to live by
“Surgical skills start in your head and not in your hands, as you imagine and visualize and organize the surgery in your head” he claimed. He mentioned that one way for surgeons to fine-tune their abilities is by watching videos of routine cases, such as a cataract treatment.
He recommended starting from the beginning without fast-forwarding the recording, even when absolutely nothing impressive is taking place.
“Feel that agony of stasis,” he claimed. “See actively, make note, draw diagrams, picture hand positioning throughout the procedure and also place incisions; pause, re-watch, and rewind to get an absolutely good idea of what you would have to do if confronted with that surgery. Focus on basics such as hand as well as phaco positions and also second instrument position. Be critical of yourself as well as seek the ‘why’ behind every activity or inactiveness that may occur as well as attempt to comprehend every subtlety of the procedure.”
Significantly, he also suggested trying to design a minimum of 1 workable change that can be implemented during the next surgery in the operating room.

After understanding an easy case, surgeons can advance to a more difficult surgical treatment, such as a case of a dropped nucleus, in which things do not necessarily continue as expected. The same steps detailed formerly can be applied on these cases, as well.

“Concentrate on the problems but [move] ahead and forward in time in the video clip to figure out just how it occurred, what happened and how it progressed, beginning with the start, as well as just how it was taken care of,” he claimed. “Discover the cause before the root cause and picture all the actions from the initial event, which led to the surgery, all the preparations for the surgical procedure to the complication and then beyond.”

Most significantly, the surgeon can identify productive tasks to work on to prevent this in the future in the operating room.
“Pick up from others by standing on the shoulders of giants, who have faced and performed these complicated surgeries” he stated.
This can be tackled by reading the constant stream of surgical techniques that have been described in the literature.

“The act of reading a summary before watching an accompanying video is useful. The Journal of Cataract & Refractive Surgery may be a good place to begin,” he noted.
Following reading, now is the time to watch the videos, to understand visually and mentally what was said verbally in the descriptions. This can promote the understanding of new techniques as well as exactly how to manage challenging cases.

The American Society of Cataract and Refractive Surgery clinical education and learning website and also YouTube videos, are all good sources.
“Be critical as well as [apply] those same watching skills, which were enumerated earlier. Stop the video clip briefly at important points and ask ‘What would I do next?'” he recommended.
He also explained that doctors can share the info they gained with associates and also the community and go over best practices, challenges, complications, and resources.
“We have opportunities to use teleconferencing options to build bonds as well as practice [distance] socializing, and so still staying in touch and discussing without the need for physical contact” he said.
Ultimately, he recommended working with technological skills making use of a microscope or surgical supplies.

“Devices as well as implants are often available from reps, and model eyes can be made specifically for numerous medical techniques and also can be recycled, thus almost exactly producing the operating room in your clinic and actual situations” he said.
The current atmosphere will certainly change, and eye doctors should be prepared for it.
“The situation will certainly end and also we will be called off the bench,” he stated, pointing out that the decreased surgical volume and also delayed care can translate into some cases that might present enhanced complexity.
“Stay risk-free, remain rational, remain healthy and balanced, and also stay sharp, maintain and upgrade your skills and remain active even in periods of inactivity” he ended. “These directives apply with and without a pandemic, as they can be practiced anytime, whenever there’s a lull.”