Rethinking Healthcare

Citrus surgery? Doctors refine their craft on clementines

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While there are high-tech surgical simulators on the market, perhaps a simple, cheap clementine can teach doctors the skills crucial to laparoscopic surgery.

You know what’s a great tool for practicing minimally invasive surgery? Citrus fruit, according to Pamela Andreatta of the University of Michigan Medical School. NPR reports.

Laparoscopic surgery is performed with a camera and surgical instruments inserted through tiny incisions in the body. The traditional model of learning by watching then doing is putting young doctors in operating rooms before they've mastered basic skills, Andreatta says.

And while there are surgical simulators on the market – including high-tech digital systems offering a virtual reality – she believes the skills crucial to laparoscopic surgery might be better taught with something simple… something like a clementine.

The pelvic anatomy, for example, consists of a mix of substantial and delicate tissue. So does a clementine: sturdy outer peel, fragile pith, and a white spongy layer under the skin.

  1. So she set up an opaque box with holes on the top where you can insert a camera, scissors, and a grasper.
  2. Over 40 doctors and doctors-to-be had to dissect the fruit – take off the peel in as few pieces as possible, remove the pith, separate the segments, and then put everything back together and suture the peel closed.

They had 2 hours to do this. The minimally invasive surgery specialists scored the highest, by far. Residents and nonsurgical faculty scored significantly lower. Medical students, with little or no surgical experience, fared the worst. (Check out the difference at NPR.)

"You can find clementines or setsumas or tangerine variations all over the world," Andreatta says. "You can go out and pick them off a tree, and it costs very little or nothing… and yet it's very advanced training."

The clementine is one of several dozen low-cost simulations Andreatta has developed for teaching minimally invasive surgery. Another uses colorful foam shapes purchased from a craft store.

Her hope is that the training boxes, clementines, and foam pieces can be placed in offices and hospital rooms for doctors to practice on during a free moment. They’ve even been taken to Ghana.

[From NPR]

Image by Muffet via Flickr Orange slice. Haha, couldn’t help it.

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Janet Fang

Contributing Editor

Janet Fang has written for Nature, Discover and the Point Reyes Light. She is currently a lab technician at Lamont-Doherty Earth Observatory. She holds degrees from the University of California, Berkeley and Columbia University. She is based in New York. Follow her on Twitter. Disclosure