Posts Tagged ‘Beth Israel Medical Center’

surgery-2-300x200What can surgeons do for six minutes that enhances performance, reduces errors, and improves patient outcomes?

Play video games.

As unlikely as it sounds, specialists in laparoscopic surgery are finding that they can improve their results in less time than it takes to boil water, simply by picking up a controller and getting their game on. I can hear the protests already. Video games are a scourge, a blight. They’re incubators of violence, and responsible for the downfall of modern society. They can’t possibly offer anything positive.

Actually, they can. Laparoscopic surgery is minimally invasive and very small-scale: surgeons insert a tiny video camera and set of miniature surgical instruments into a patient and use video game-style controllers—like joysticks and d-pads—to manipulate these tools from outside the body. This requires precise hand-eye coordination, keen depth perception, and a high level of manual dexterity—the exact skills needed to excel at video gaming, and which games are uniquely suited to develop. According to Dr. James C. Rosser, a laparoscopic surgeon at Florida’s Celebration Health hospital,

I use the same hand-eye coordination to play video games as I use for surgery… I could come in, sit down, and put this [the surgical tool controller] in my hand and not find it foreign to look on that screen and do something with my hands.”

Dr. RosserDr. Rosser proved this in 2002, while practicing at Beth Israel Medical Center. He had 33 surgeons participate in a three-month study that involved, among other activities, playing a series of video games before simulating laparoscopic surgery. About half of the participants had a history of game play, though all of them played throughout the study. Researchers compared the results between participants, as well as against non-gaming colleagues. Across the board, they found that surgeons who played video games were faster and more accurate than those who didn’t—dramatically so: at the low end of the skill spectrum, gaming docs made a third fewer errors and were a quarter faster than their non-playing counterparts. Among participants, the most skilled surgeon gamers were nearly half again as accurate and more than a third faster than those at the bottom of the heap. Further, after controlling for extent of training and number of cases completed, the best predictors of surgical success were video game skill and amount of past gaming experience. Said surgeon and participant Asaf Yalif,

We were surprised and actually awed by the fact that your video game skill, meaning how well you play, as well as the number of hours you have spent on video games were very highly correlating — meaning if you do this well you will be less error-prone, you will be faster and you will perform better at laparoscopic surgery.”

Dr. Rosser recently conducted a follow-up at Celebration Health hospital with 300 laparoscopic surgeons, half playing a video game just prior to scrubbing in. The results? A six-minute video game warm-up resulted in more effective performance and better patient outcomes.

Another study at the University of Rome, Italy, published this past February in the journal PLOS ONE, provides further evidence of gaming’s impact on laparoscopy. Researchers gathered 42 post graduate students in general, vascular and endoscopic surgery, and split them into two groups. Both groups received standard training, but one group also trained on the Nintendo Wii. After four weeks, the Wii group showed significant performance improvement in several areas, including economy of instrument movements and efficient cautery. The authors’ conclusions? The Wii could be a valuable tool for laparoscopic training, and an effective, inexpensive, and entertaining means of enhancing standard surgical education.

Surgeons can’t operate on live patients every day. It’s a numbers game: there just aren’t enough people who need surgery to go around. Other means of honing surgical skills—such as simulators—are therefore critical. The catch is that typical medical simulators run into the hundreds of thousands of dollars—an expense that can be hard for many hospitals to swallow. A game console—like the Wii, Xbox, or Playstation—costs a fraction of that, and provides a viable and effective way to keep surgeons sharp.

Consider this: According to both the Institute of Medicine and the Safe Patient Project, medical errors in the United States run up between 17 and 29 billion dollars in hospital expenses, and result in around 100,000 deaths each year. If video games can reduce even a fraction of these, then perhaps it’s time to get our surgeons playing.

You can find Dr. Rosser’s JAMA Surgery article here.

The New York Times has a piece about Dr. Rosser here.

And you can learn more about Dr. Rosser’s recent work here.

For information about the study at the University of Rome, check the link to PLOS ONE

… and the write-up in Science Daily.