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Live! From the OR

In Hospital Webcasts, Only the Surgeon Gets in Closer

By January W. Payne
Washington Post Staff Writer
Tuesday, August 3, 2004; Page HE01

It wasn't easy for Victor Ganderson, 61, to agree to GERD surgery in June. For four years he had stalled, researching treatment options and talking to his doctors. But it wasn't until the Columbia man watched -- live, via his home computer -- the operation being performed that he decided to go ahead.

Ganderson learned about the "webcast" through his job as a database manager at the University of Maryland Medical Center (UMMC). The surgery was broadcast live on the Internet, from what was billed as the Baltimore hospital's "Operating Room of the Future."

Hospitals nationwide are now recording surgical procedures for broadcast on the Web for patients, physicians and the just plain curious. (MDirectAccess)

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Ganderson said he wasn't squeamish about watching surgeon Adrian Park point out a region of pulsating pink tissue inside the patient's stomach.

"This thing that's beating right here is -- we're just under the diaphragm, underneath of the patient's heart," says Park, head of general surgery at UMMC, in a video of the procedure. Despite the sometimes-graphic scenes, Ganderson called his doctor afterward and was referred to Park for surgery to correct his GERD, or gastroesophageal reflux disease, a condition in which the stomach contents leak back, sometimes painfully, into the esophagus.

"After watching it and seeing how benign the minimally invasive surgery was, I was convinced to go ahead and have it done," said Ganderson. Four years earlier, he had decided against traditional GERD surgery because the procedure was more complex and recovery time was longer (a month, compared with about half that time for the less-invasive version).

UMMC is among the hospitals nationwide now recording surgical procedures for broadcast on the Web for patients, physicians and the just plain curious. The operations are either broadcast live or aired later.

UMMC's broadcasts began soon after the June 2003 opening of the hospital's new operating facilities, which include state-of-the-art equipment such as touch-screen monitors that hang from the ceiling on movable booms, permitting doctors to view patients' lab results and diagnostic films during surgery. Four rooms have "telemedicine capability" -- live audio and video feeds -- and two permit voice-activated adjustments to patient beds, lights, monitors and camera views, individually programmed for each surgeon.

So far, UMMC has aired two surgeries -- the GERD procedure and a minimally invasive repair of a mitral valve, a tissue flap that regulates blood flow through the heart. (The GERD procedure is accessible at www.or-live.com/umm/1202/, the mitral valve surgery at www.or-live.com/umm/1151/.) The hospital plans two more webcasts in the early fall: one of an orthopedic spinal surgery and another of a sympathectomy, in which a surgeon destroys or removes part of a nerve that causes excessive sweating in the arm.

Live broadcasts allow viewers not only to watch but to e-mail in questions, some of which are answered by an operating room narrator while surgery continues.

James Gammie, a cardiac surgeon at UMMC, said one patient traveled from Florida for mitral valve repair surgery after her husband found UMMC's Web page describing its minimally invasive surgical technique.

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