OSHKOSH, WIS. -- The family is glued to the television, and they're not watching the "Cosby" show.
Thanks to a $10,000 video system installed in each of the two operating rooms at the Doctors SurgiCenter here, family members can watch delicate eye surgery live and in color while a nurse gives a play-by-play of the unfolding scene on the monitors.
The surgeries are predominantly intraocular implants in which a tiny plastic lens is inserted into the eye after a cataract -- a clouded lens -- is removed. But other surgeries, including knee and foot surgeries, are viewable as well.
Observers are given both a bird's-eye view and a surgeon's-eye view of the operation. While the patient is being prepped, the view on the television monitor is of the operating room seen from above. When the surgeon begins to use an operating microscope, a built-in camera provides the family member with the same view as the surgeon's.
So popular has been the 18-month-old program that some patients request a video copy of the surgery so they can play it back later and watch it themselves or show it to other relatives and friends. A copy is graciously provided, if requested, for the cost of a videotape.
The venture is the latest in medical education and marketing efforts, in an ever-increasing competitive medical marketplace. The profit-making, free-standing outpatient surgical facility is in direct competition with the 200-plus-bed Mercy Medical Center in this Fox River Valley city of 50,000.
Outpatient surgical centers in Florida and on the West Coast also are allowing family members to view certain operations.
Sherry Lynch, a registered nurse and clinical director of the Oshkosh center, said one advantage of the video program is that family members know exactly what is going on. "They know the patient is O.K. Instead of sitting in a room where it is wait, wait, wait, drinking coffee and chewing fingernails, they know when they see the stitching, he will be out of surgery soon."
As a selling tool, videotapes of surgeries are taken around to area nursing homes, senior citizen centers and health fairs, where they are explained by a nurse and technician.
On a recent fall day, Bernice Holke had settled into the viewing room to watch cataract surgery on her aunt, Marie Zimmer, 83, the first of six consecutive implant surgeries on tap that afternoon.
Sitting in a soft chair in the darkened room, she gazed intently at the television a few feet in front of her as surgeon Stephen Dudley deftly made an incision into her aunt's eyeball.
"Well, isn't that interesting," she said as Dudley used a diamond-tipped scalpel to cut an incision just above the iris, the colored part of the eye.
"Here it goes," she said as the operation proceeded quickly. "Isn't that beautiful."
The operation, from opening incision to last suture, took 19 minutes. During that time, nurse Linda Curtis described the action. When the cataract was removed, she produced a real but somewhat dried-out cataract in a small plastic bag for Holke to look at -- and touch if she wanted.
When the suturing began, Curtis produced specimens of the thinner-than-hair suture material for Holke to marvel at.
While there are 29 surgeons who use the center from time to time, only Dudley currently allows his patients' family members to view the surgery. "They don't like the feeling of other people watching over their shoulders," Dudley said of the other surgeons. Also there is some concern that a mistake or problem would be there for all to see -- and preserved on videotape that could be used as evidence in a lawsuit.
Dudley sees that as an advantage, however. If a problem arises, he can tell the family member watching what steps he is taking to solve the problem. That way, he said, there is less chance of an adverse reaction from the family. He has never been sued. --