Surgery as sport

luc-lemmens 
Luc Lemmens (Turkey)
Surgery should be more than a profession, more like a sport we look forward to perform. 
In most of the cases surgery should be fun and not tiring. Therefor we need standardizing, standardizing and standardizing!
Cases different from the standard should be brought back to the standard asap. Once that done, everything comes to normal and peace again.
 
Surgery should be performed in a comfortable position for the surgeon. Try to avoid extreme position to work. Keep the shoulders in a normal position. Working with elevated shoulders causes pain and is very tiring.
 
Adapt the position of the patient to the comfort of the surgeon: place the patient in a Trendelenburg position, reverse Trendelenburg position and side if needed. Therefore fix the patient well with good shoulder fixation or foot rests. 
 
Don’t try to do all high abdominal operations in between the legs of the patient. Nearly all high abdominal operations can be performed from the right hand side of the patient. By tilting the patient to the right the shoulders of the surgeon come in a normal position. I only perform a cholecystectomy in between the legs of the patient. The left hand side of the patient is for a right hemicolectomy, appendectomy and gynecologic procedures. 
 
By working this way, we only need 1 assistant and, if you are rich enough, a scrub nurse.
 
Maybe robotic surgery is the most ergonomic (you can drink coffee…) but then you need at least one other surgeon at the table, i.e., for the stapling. 

I don’t see the need of the robot in digestive surgery, maybe in the future when we work from a distance…..

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