Solo surgery

To do any complicated surgery safely you need a surgeon and an anaesthesiologist. Most of the rest of the people there are to assist, or in case there's a complication. You could do it solo, it just would be riskier.

Veterinarians perform surgeries like that all the time, with just 1 or 2 assistants. I imagine people doctors do also, just not in the major medical centers. Do you think that a physician practicing in the wilds of an Amazon jungle is going to refuse to do a procedure because he doesn't have 12 trained assistants and a full surgical suite?

Is it advisable in human medicine? In a best case scenario, no. Can it be done? Of course.

I recall what I read as a true story about 12-14 years ago, in regard to the problems of email spam (that with the onslaught of spam this man might have missed the email that saved his life - the only reason we get such little spam now is because ISPs run very effective filters). There was some guy sailing some long trip (maybe around the world) solo and his only communications was email through satellite. He had an arm that developed gangrene (and was in the middle of the ocean and couldn't possibly get a rescue). He emailed back about it, and a surgeon was found who gave him instructions on how to cut off the arm, and he succeeded.

Thus (presuming this is really a true story) it's possible for even an untrained person to do surgery with coaching by a surgeon. Not sure if that includes a cortical implant.

I recall a story about two heart surgeons who operated on a man on an aircraft in flight. Unfortunately, signal-to-noise on the internet is such that I'd need to know an exact phrase from the news story to find it.

There was also the recent story of a surgeon in the Antartic who had to take out his own appendix.

And the guy who had to cut off his own arm when he got it trapped under a rock in the mountains.

crunchyblanket said:

Is it theoretically possible for a skilled surgeon to perform surgery without assistance, or with a single assistant? I know there's a multitude of legal and ethical reasons why this isn't done, but could it theoretically happen?

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I've done it on many ocassions. If something can be done under local, you don't need an anaesthesiologist. If you have a properly sized retractor, you don't need an assitant. The more complicated the surgery the higher the risk of doing it solo, but if someone is septic and there's nobody to help, sometimes you have to go it alone.

crunchyblanket said:

If it could, are there any types of surgery/any specific operations that would not be possible to perform solo? For example, brain surgery - is it too much of a stretch to suggest that a two-person team could implant a cortical chip?

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Perfectly feasible; that's not going to be much different than a burr hole for intracranial pressure monitor placement which are often done at the bedside. (or at least were done that way when I was a resident) Again, that's actually amenable to be done with local.

mirandashell said:

There was also the recent story of a surgeon in the Antartic who had to take out his own appendix.
...

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What, another hapless surgeon?! Dr Rogozov (USSR) removed his own appendix in the Antarctic in 1961.

I had surgery performed on me twice by a single person with no assistant. This is because in both cases I was awake and the only anesthetic needed was Novocaine. Once was for wisdom teeth and the other for ingrown toenails. The time I had a cut in my hand stitched up there was an assistant there but she didn't do much of anything and the doctor could have done without her.

Izhitsa said:

What, another hapless surgeon?! Dr Rogozov (USSR) removed his own appendix in the Antarctic in 1961.

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nah, I am sure it was more recent than that.

lbender said:

Veterinarians perform surgeries like that all the time, with just 1 or 2 assistants. .

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This was certainly the case when I worked in the feild. Usually it would be the vet and a nurse. Now, veterinary nurses don't even have to be qualified here*, so it can essentially be a vet and a civillian.

The main job of the nurse was to monitor the heart rate and blood pressure.

Some operations physically needed more people - like castrations. You would ahve the vet, and also an assistant who was holding the rope to keep the back legs pulled away, and another assistant who was sitting on the neck, just in case the animal snapped out of anestetic (which is pretty common in horses) and tried to get up.

I would assume that it's possible in human surgery too. Especially with uncomplicated procedures.


*Here, in order to get on a veterinary nursing course, you must already be employed as a veterinary nurse, or have a surgery who will sponsor you. Most of the nurses I worked with weren't qualified, and very few of them had a desire to do so. That said, the on the job training is second to none, especially in large animal practice where the nurse is often expected to be a handler, groom, farmer and wrestler all at once.

mirandashell said:

There was also the recent story of a surgeon in the Antartic who had to take out his own appendix.

And the guy who had to cut off his own arm when he got it trapped under a rock in the mountains.

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Wasn't there an astronaught recently who removed a lump from her breast while in space?

Sorry, got that wrong, polar station again, not an astronaut - Dr Jerri Neilsen - she had to operate on herself. http://en.wikipedia.org/wiki/Jerri_Nielsen

There's a whole wikipedia article about this, which I would recommend reading, but not while you're eating lunch: http://en.wikipedia.org/wiki/Self_surgery