Live broadcast of surgeries

Surgeries broadcast live with the aim of promoting knowledge sharing between peers are a growing phenomenon. The Angus Ambulatory Ophthalmic Surgery Center at Maisonneuve-Rosemont Hospital (HMR) wants to become an international reference in this field.

Tuesday, the D^r Flavio Rezende performed a series of retinal surgeries, of varying levels of complexity, which were transmitted live in an observation room in downtown Montreal.

The event took place the day before the annual conference of the American Society of Retina Specialists, which is being held this week at the Palais des congrès de Montréal. This gave international retinologists the opportunity to attend the broadcast.

“There are different levels of complexity, depending on each case that we have chosen for this day, to try to have a global approach to the different current surgical techniques,” explains Dr.^r Flavio Rezende.

It took about four years to organize the first day of live broadcast. “It took a long time to build the technology to broadcast. There are a lot of technical aspects, installing cameras and having a good network so that there is no [délais] between the surgery that’s happening and what people are seeing,” says Dr.^r Rezende.

A retinal operation is the most micro of surgeries in the human body. “Normally, when we operate, we see images of the retina through the cornea. It’s like a transparent layer that allows us to see through it. There are patients whose cornea is opaque because they have had trauma or something. So, we would not be able to do the surgery if we did not have the camera in our eye,” explains Dr.^r Rezende.

HMR’s expertise is to perform this type of surgery with a small tube equipped with a camera. “It means an optical fiber in the eye that works like a camera to allow us to see in another way,” he explains.

Ask questions in real time

One of the aspects that was appreciated by the doctors on site was being able to ask questions throughout the session and have a discussion with D^r Rezende after the operation.

“I find it really useful, because it allows you to understand the thoughts of the surgeon who performs the procedure,” comments Dr.^r Fares Antaki, vitreoretinal surgeon who will start at the CHUM in September.

“We can ask specific questions and, when we go to practice our own intervention, we can try to reproduce some of the things learned during the session,” he continues. As we attend the intervention live, we can ask all the questions that come to mind at this precise moment, at this precise stage. »

The D^re Bruna Gil Ferreira, a retinal surgeon who trained at the University of Montreal and now practices in Brazil, was also delighted with the experience. She talks about the usefulness of having tips from real life.

“Sometimes, when we go to a conference or take a course, we are only taught the classic and simple cases, but life does not happen like that,” emphasizes the D^re Gil Ferreira. There, we get advice on what’s really happening in the field, on what to do, and these little tips, for example on how to hold the cannula or adjust his lighting, and we can see live what he’s doing and how it’s going. »

The D^re Cynthia Qian, retinal surgeon and colleague of D^r Rezende, points out that when students or doctors attend lectures, the surgery presented is often neat. “Sometimes, five-hour interventions are summarized in two minutes. So it doesn’t really reflect what’s happening live,” she says.

In addition, broadcasting to another room allows more people to witness the intervention. “The operating room is very small. […] It can’t accommodate a lot of people,” argues D^re Qian. During the first surgery of the D^r Rezende, there was only him, the nurse and a fellow.

“Broadcasting the procedure live allows a whole room of people to participate and learn as it happens, because you can’t have all these people crammed into the operating room,” she explains.

Furthermore, the D^r Flavio Rezende is concerned about seeing certain surgery videos on social media, which sometimes spread bad information. “There are a lot of videos that are put on the internet in one way or another, with very little control over quality,” he laments. So, the objective is to build something in Quebec through the University of Montreal and the Maisonneau-Rosemont Hospital, to build something of good quality at the surgical level, of high level, of high complexity. »

For the future, he wants to do live-streamed surgeries fairly frequently to bring international exposure.

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