Why is surgery always performed standing up?

[Messerschmitts]

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This is kind of an esoteric question. Why is it that even 9 hour liver transplants must be performed standing up? Is it really so impossible to design an operating table and set of sterilisable stools that would allow the surgeon to sit? I don't think increasing surgeon comfort would lead to any adverse patient outcomes. The usual argument I hear is that you'd have to lean forward towards the patient due to the angle of the knees. However, they have those ergonomic half-kneeling chairs.

http://en.wikipedia.org/wiki/Kneeling_chair

I'm just saying, is all 😛 I don't see why you can't sterilise a couple of those stools (maybe put some wheels under them for increased mobility), and make those 7 hour whipples fly by. Yes, yes, I'm so lazy, I know. But I suspect this "no-sitting" policy is kind of a macho tradition thing. But you guys tell me.

 

[anon-y-mouse]

This is kind of an esoteric question. Why is it that even 9 hour liver transplants must be performed standing up? Is it really so impossible to design an operating table and set of sterilisable stools that would allow the surgeon to sit? I don't think increasing surgeon comfort would lead to any adverse patient outcomes. The usual argument I hear is that you'd have to lean forward towards the patient due to the angle of the knees. However, they have those ergonomic half-kneeling chairs.

http://en.wikipedia.org/wiki/Kneeling_chair

I'm just saying, is all 😛 I don't see why you can't sterilise a couple of those stools (maybe put some wheels under them for increased mobility), and make those 7 hour whipples fly by. Yes, yes, I'm so lazy, I know. But I suspect this "no-sitting" policy is kind of a macho tradition thing. But you guys tell me.

Doesn't your hospital have any daVinci robots? I always fight to get the robotic cases just so I don't have to scrub in. EVERYTHING can be done robotically! The surgeon is sitting comfortably like 10 feet away.

 

[Messerschmitts]

Doesn't your hospital have any daVinci robots? I always fight to get the robotic cases just so I don't have to scrub in. EVERYTHING can be done robotically! The surgeon is sitting comfortably like 10 feet away.

Ha ha, same reason why I like going in on laprascopic cases. I get to sit in the corner and watch the screen! :-D So lazy!! (Don't tell my resident) We don't have enough robots to go around, also. After long open cases my legs always feel like they're going to fall off.

 

[PeepshowJohnny]

Dude, I hate standing too (Grade infinity flat feet) and I often had this fantasy while scrubbed into some marathon cases.

I LOVED hand plastic cases partially because they'd pull up a few stools, flop the dudes hand onto the table and we'd all be able to sit around and do the case.

 

[njbmd]

Surgery isn't always performed standing up. I do more than a few procedure sitting. I hate sitting but I perform some of my cases seated on a stool or chair (vascular surgery).

 

[trudub]

Some surgical subspecialties perform a majority of their cases sitting. Definitely not all cases are performed standing.

 

[78222]

All the AV Fistulas I've scrubbed on were sitdown cases. I loved it!

 

[Long Dong]

Because they like to stand around and talk about how alpha they are. The longer they can stand without a bathroom brake and the longer they can stay up without sleep the more alpha they think they are.😉

 

[Winged Scapula]

I once considered Hand Surgery because of the ability to sit during a case (well not really, but it *was* a perk). And just this past Friday, I inserted a brachytherapy catheter while sitting because the bed wouldn't move and the patient was to uncomfortable to lie on her side.

Frankly, however, you need to stand for a lot of cases. Its awfully hard to see in a deep hole while sitting unless you were sitting about 6 feet in the air above the patient.

 

[HarvardBlackman]

-Ease of movement
-Field of view will be relatively unobstructed
-View position/angle is ideal for most surgeries

However, there are some cases where surgeries should be performed while sitting, kneeling, or in any other position.

 

[MonkeyNuts!]

Because if you nailed the patient to a low ceiling, and tried to do the surgery upwards while sitting down, you would get a crick in your neck.

 

[psych22]

This is kind of an esoteric question. Why is it that even 9 hour liver transplants must be performed standing up? Is it really so impossible to design an operating table and set of sterilisable stools that would allow the surgeon to sit? I don't think increasing surgeon comfort would lead to any adverse patient outcomes. The usual argument I hear is that you'd have to lean forward towards the patient due to the angle of the knees. However, they have those ergonomic half-kneeling chairs.

http://en.wikipedia.org/wiki/Kneeling_chair

I'm just saying, is all 😛 I don't see why you can't sterilise a couple of those stools (maybe put some wheels under them for increased mobility), and make those 7 hour whipples fly by. Yes, yes, I'm so lazy, I know. But I suspect this "no-sitting" policy is kind of a macho tradition thing. But you guys tell me.

the field of medicine has much room for improvement. coming from an engineering background and having worked at the us patent office, i can tell you that there is a trend of increasing biotech innovations. the semi-conductor and EE innovation days seem to have peaked already and now we're starting the biotech surge.

messer, as for your idea, to see what's out there you can do a patent search at: http://www.google.com/patents

you'll find that there were alot of chairs developed in the 80's and most of the new inventions are regarding to remote minimally invasive surgeries. i didn't do a comprehensive search tho.

http://www.google.com/patents?id=tGc-AAAAEBAJ&printsec=abstract&zoom=4&dq=surgeon's+chair

btw, one of the patents mentioned something about the possibility of an air embolism occuring while performing surgery while in the seated position. did that mean, while the patient was in the seated position?

 

[makushin]

This reminds me of that Sienfeld episode where George buys the security guard a chair.

 

[psych22]

This reminds me of that Sienfeld episode where George buys the security guard a chair.

haahaaaa!!

 

[Orthodoc40]

Surgery isn't always performed standing up. I do more than a few procedure sitting.

And so, OP - the moral of the story is - Wiki is not an authority on... ANYthing!

 

[Depakote]

Robotic surgeons? What in the hell is that anyways?

They're amazing, here's one at a birthday party for one of the attendings...

 

[scotties123]

They're amazing, here's one at a birthday party for one of the attendings...

and here is one fitted for heavy duty ortho surgeries

 

[smq123]

Robotic surgeons? What in the hell is that anyways?

In Mexico we just insist doctors and sudents to buy those leg stockings to not feel the pain of standing up for 12 hours nonstop. Drats, I need to buy a pair.. but they cost 70 dollars, ouch! >_<'

Don't listen to the other guys who responded.

They're not robotic surgeons - it's robotic surgery. The laparascopic tools are attached to long arms that are connected to a surgical robot. The surgeon sits at a separate "desk," and controls the arms. (on the left in the picture below.) It is laparoscopic surgery, but with more instruments, and the surgeon can do more delicate work. It's usually called the "da Vinci system."

The robot is usually used for very delicate cases - prostatectomy, or re-anastomosis of the Fallopian tubes after a bilateral tubal ligation. The advantage is that it is a robot - so it never trembles, or shakes, or gets tired. If you look inside that desk, it is like a 3-D picture - some things look "close up," and others look "far away."

The problem is that you don't have a sense of feel, so you don't know how hard you are really pulling or tugging.....so it is easy to rip a vein or damage a nerve by tugging too hard.

 

[MaryLennox]

it also seems that standing is better than sitting in case of an unexpected twist (i.e. you hit an unseen blood vessel and blood starts shooting!) its much easier to jump into action to stop it if you are standing. Imagine if youre sitting on a stool, concentrating so hard that you dont notice you've wrapped your ankle behind the leg of it . . . then blood shoots into the air, you jump up, trip over the chair, fall onto the patient or the floor . . . sterile.

in all seriousness though, i wanna be a hand surgeon. screw standing.

 

[braluk]

I wonder if you can design leg and hip braces that hold up most of your weight and allow to pseudosit while standing.

 

[Depakote]

I wonder if you can design leg and hip braces that hold up most of your weight and allow to pseudosit while standing.

robot pants.

 

[smq123]

I wonder if you can design leg and hip braces that hold up most of your weight and allow to pseudosit while standing.

Why bother? Just get your legs amputated. It might be a little challenging to get to codes and traumas, but (on the bright side) - you'll be able to stand in the OR for hours, and your legs won't hurt!

😉

 

[goldenwest]

This thread delivers. 👍

 

[OwnageMobile]

I wonder if you can design leg and hip braces that hold up most of your weight and allow to pseudosit while standing.

There was an invention of this sort on the news a few years ago. It was a brace system within a pair of jeans. A slight difference of this gadget was that it didn't brace at near-standing height, more at a sitting posture.

I always find myself worrying about this pain of standing. I thought a climbing harness-like device would be cool--like your braces but from the ceiling.

 

[Habeed]

Honda has a walking/squatting assist device that just might help with this...

Yeah, I know.

It might make you the butt of many, many jokes..

Here is the original article I linked the images from.

http://blog.wired.com/cars/2008/11/honda-announces.html

 

[Forthegood]

Ok, so far we have covered standing, pseudostanding, assisted standing, sitting, and kneeling. I guess I should bring up crouching and flying to round out the list a bit.

That's a great idea. After scrubbing, the nurse assists you into a harness that suspends you in the air. No need for height adjustments on operating tables, the surgeon will just fly right in and save the day. We can patent that, and also be the first people to put a big "S" on the chest of sterile gowns for additive effect!

Where would we be without SDN?

 

[Hematopoet]

Why stop at the pants? For ultimate comfort:

The guns can alternatively be replaced with something more useful...