Having Fun in the Operating Theatre

Comments 2 ; Posted 10 years ago by Andreas Obermair

As a surgeon, I suspect many people perceive the operating theatre to be among the most frightening and intimidating places they could visit in a lifetime, but in actual fact, it's quite the opposite.

What may surprise many patients is that as opposed to the formal, rigid nature of conversations, which take place in the office or boardroom, the environment in the operating theatre is vastly different. In theatre, we enjoy a rather relaxed and informal atmosphere, where all members of our team behave as good friends who laugh, converse and continually support each other.

My patients can rest assured that no matter how nervous or stressed they may feel going into theatre, while in our care, their surgery will be carried out under a positive, convivial and relaxed atmosphere.

This is another one of the greatest pleasures of being a surgeon - working with a tight cohort of familiar, experienced and passionate colleagues who make this working environment possible.

Take the flight deck for an example. Non-familiarity between pilot, co-pilot and crew has few serious implications. A Qantas pilot once told me he could easily fly with someone he doesn't know or like.

Each member of the flight crew has an exact copy of the handbook in front of them. Pilot and co-pilot work through their checklist. If there's a variation from the norm, there will be another script available elsewhere in the checklist.

By contrast, non-familiarity within surgical teams can bear a myriad of challenges. In an operating theatre, very little is scripted. Surgeons need to be quick problem solvers. There are a multitude of decisions to be made during a single (even “easy”) surgical case.

I love the team I work with, and I love the work we do in the operating theatre, yet there's no way all possible scenarios can be scripted and taught. In the dynamic setting of theatre, familiar team members adapt much quicker to change. We need to find solutions to problems, small or large, as we go.

While some members of my regular surgical team weren't necessarily the most experienced when we first began working together many years ago, they shared my excitement and passion for what we do. The longer we've worked together, the more efficient we have become.

The familiarity of my team has lead to seamless communication during surgery, confidence in each other's actions, consistency and predictability of actions, and the ability for my team to behave as one connected entity. To enjoy ourselves. It’s simply a pleasure to work with them.

A typical surgical team consists of five key roles:

• Surgeon
• Surgical Assistant
• Anaesthetist
• Scrub Nurse
• Scout Nurse

While patients may focus their attention to the surgeon, the other roles are critical, too.

For example, nursing staff need to know the technical aspects of all equipment and surgical instruments. If one instrument is faulty or not the best option to solve a problem, it is her job to find a better replacement very quickly 

Because unexpected events during an operation can be awkward, time consuming and sometimes challenging, it means my team needs to be as responsive, agile and as confident in one another as possible.

For example, our team recently had to adjust our approach to a surgical procedure that was originally planned as a simple hysterectomy, but we unexpectedly found the patient to have peritoneal spread beyond what was expected.

Under such circumstances, managing serious deviations with a team that is confident and experienced with one another is highly desirable. As a surgeon I can only achieve great results with a great team.

It means surgical processes flow without the need for discussion. I'm handed the necessary surgical instruments without needing to request them. I stretch my hand, and they are given to me. No words exchanged.

This is very important to me, because my biggest priority is concentrating on the anatomy and the procedure without distraction. (Sometimes people say they paid me a visit in theatre but I was oblivious to them.)

• I don’t need to discuss the adjustment of the operating table, the beanbag I use, the arms-by-the-side positioning with the anaesthetist. S/he simply knows.
• I don’t need to request certain surgical back-up instruments to be on standby, because they will be there every single time I operate in that theatre.
• And I don’t need to explain what direction the assistant needs to pull in, and at what time, and how strong. I don't need to say what to avoid because my surgical assistants know what I need.

Undertaking both simple and complex procedures with my team is a truly rewarding challenge. I am aware that as a surgeon, it is my job not only to make sure I lead a successful operation, but to assemble a team of highly qualified, well trained and passionate co-workers.

Surgery does not need to be a frightening experience; you will always be in the very best hands.