Ask Skeptical Scalpel-Learning Surgical Skills


Medical student Sara ‏@Stichflamme asks, “What exercises such as suturing and other skills can I do to prepare for a career in surgery?

Skeptical Scalpel

I have always felt that more important than technical skills are knowing both whom to operate on and when. I’m reminded of a blog I wrote in November of 2011 called “I could teach a monkey to operate”. I pointed out that this cliché has been around for a long time, but so far, there are no reports of a monkey successfully operating.

At one time, applicants to surgical residencies had to pass dexterity tests such as carving something from a block of soap or making a model airplane. I know of no program that still requires such activities.

By the time you finish training, many operations may be robot-assisted. Surgical robots purportedly eliminate tremors and facilitate precise dissection. Devices such as the Ligasure have revolutionized both open and laparoscopic surgery and reduced the need for tedious knot-tying. Staplers for organs and skin have almost eliminated sewing. We even have looped and barbed sutures that don’t require knot tying skills to secure.

I posted a version of this on Sermo yesterday. All of the commenters felt that skills such as knot tying will be necessary for the foreseeable future. However, I can think of many common minimally invasive procedures that can be done without tying a single knot.

The consensus was that a budding surgeon should learn to tie knots and sew. A study showed that surgeons who played video games performed better at laparoscopic skills than those who didn’t play video games. This is hardly proven but you would be surprised at how many people believe it.

Bottom line: Practice knot tying on the bedpost until you can do it quickly and smoothly with your eyes closed. I suggest using string or even clothesline at first so you can see how the knots are formed. Regarding video games, I defer to “docpark” on Sermo who said, “I would have to add that not all video games help. 1st person shooters not as good as a 3rd person games, and classic games are best. I recommend Defender, Asteroids, or it’s iOS update Meteor Blitz.” I trust you will know what that means.

Good luck.

OnSurg thanks Skeptical Scalpel for permission to re-post his blogSkeptical Scalpel tweets at @Skepticscalpel


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