Live surgery telecast

School of Medicine ophthalmologist demonstrates live surgery via satellite

David Chacko, MD (left), chair, department of ophthalmology, University of Nebraska, Lincoln; and Michael E. Rausen, MD (right), assistant professor of ophthalmology, LLUMC, welcome Howard V. Gimbel, MD, MPH, FRCSC, professor of ophthalmology, as the new department chair.

The Loma Linda University School of Medicine department of ophthalmology telecast a live surgery broadcast to the American Society of Cataract and Refractive Surgeons meeting in San Diego on Monday, April 30.

Six cataract surgeries performed by Howard V. Gimbel, MD, MPH, FRCSC, chair and professor in the department of ophthalmology, were broadcast via satellite to a group of 1,100 physicians for continuing medical education credit. Robert Osher, MD, an ophthalmologist from the Cincinnati Eye Institute and the University of Cincinnati, was the moderator for the session, making comments to the audience and relaying questions from the audience to Dr. Gimbel.

During the broadcast, Dr. Gimbel demonstrated some of the latest developments to aid in removing cataracts, including new silicone-tipped irrigation aspiration cannulas. He also demonstrated newly developed one-piece foldable intraocular lenses that can be introduced into the eye through very small incisions and have minimal edge reflection and glare.

Dr. Gimbel utilized the latest design of Zeiss operating microscopes for the broadcast. The built-in microscope cameras gave excellent quality images for the television monitors in the operating room, as well as for the surgeons and others viewing the surgery live via satellite transmission.

For the broadcast, Dr. Gimbel selected a variety of cataract surgery cases, including more challenging surgeries with very dense cataracts and very small pupils.

"With these cases we were able to demonstrate techniques that I've developed for breaking up the cataract, and techniques with special dyes used to highlight the capsule so that a precise opening can be made in the capsule to remove the cataract and insert the lens," Dr. Gimbel says.

In addition to demonstrating small, self-sealing incisions in the eye that do not require sutures, Dr. Gimbel and his team demonstrated surgery using no needles for anesthesia. Instead, they used anesthesia drops and an anesthetic gel on the surface of the eye. This makes it unnecessary for the patient to wear an eye patch following surgery.

The nearly two-hour session was sponsored by Alcon, a Texas-based company that manufactures instruments used to remove cataracts, and devices and prosthetics used in surgery, such as the intraocular lens.

"This type of educational venture is very effective," Dr. Gimbel says. "Surgeons have commented to me about live surgery broadcasts--that it's just like being in the operating room with me, looking through the microscope of not only the camera on the microscope, but also the other cameras in the room, to show close-up side views of the eye and views of hand positions holding the instruments."

Dr. Gimbel has participated in this type of broadcast more than 20 times from his practice in Calgary, Alberta, Canada, but this is the first time for such a broadcast from the Loma Linda Outpatient Surgery Center.

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