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Gina Nelson MD, Obstetrics and Gynecology

Gina Nelson MD, Obstetrics and Gynecology
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Structure Sunday: The Structure of Laparoscopy

March 15, 2015 in women's health, surgery, Consumer Awareness

In the " olden days" all surgery was done through open incisions, meaning an incision large enough to see and get at whatever you were operating on. During my Ob/Gyn specialty residency training in the years 1990-1994, our profession made a big transition to laparoscopy. Instead of large 14 cm incisions for a hysterectomy for example, we made a 1-2 cm incision tucked discreetly under the belly button and two others out to either side of the same size. We would use instruments on sticks in the side ports to do the surgery. Most recently we have a adopted the use of the multi-armed Da Vinci Robot for laparoscopy which confers numerous advantages to surgeon and patient alike.

One a warm evening in 1992 in a synagogue in Boulder Colorado, I had the pleasure of meeting an elderly Russian man and his family. His wife was a cardiologist and his adult children a variety of scientific professionals. They were recent refugees to the States. Despite their education and experience, they could only find work at McDonalds.

 The old gentleman himself had been Chief of Surgery in a large Russian hospital. Since his children spoke English, I decided to chat with him though a translator about what surgery we were doing at the University Hospital. I described the new laparoscopic technique, from the small incisions, to the use of CO2 gas to elevate the abdominal wall, and the positioning of the patient with her head down, to get the bowel out of the way of the pelvic organs. I described the long straight tools which we inserted in the two side ports, one cautery, and one grasper, and how we could switch out for a scissors which rotated at the end. There we sat at a festive dinner table after services, with good food, and these amazing people, discussing the latest advances in surgery. I had to suppress my eyes from getting misty when I contemplated all they had been through. I thought he would be so proud and pleased. 

He listened thoughtfully but his face was very grave. I feared he had not understood me. He seemed restless. I finally had to ask his daughter what was the matter, and she measured her words in a thick Russian accent. He did not believe me. He said it was impossible. He thought I was mocking him. Despite my best efforts, he gathered up his family and left. 

I wish I could have a chance to show him all that I have presented for you in the latest section of my website: Laparoscopic and Robotic Surgery. Click HERE to see it. 

Tags: history of surgery, laparoscopy
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