Technology puts surgeons on the cutting edge

Vermont Business Magazine, Jun 01, 2002 by Kutny, Elizabeth

For orthopedic surgeon, Dr Elizabeth McLarney, technological advances in the past decade have taken the rural out of Vermont Trip introduction of the Internet allow; her inexpensive and easy communication with, other surgeons outside the walls of Brattleboro Memorial Hospital where she works McLarney can access specialists and cutting edge procedures without leaving her desk.

Certified by the American Academy of Orthopedic Surgeons, she explained that a benefit to the organization is the various websites that it offers its members.

"There are all sorts of discussion groups, places where you can go in and say 'I have a patient with this.' And you are not violating the patient's confidentiality because you are not releasing any specific details about the patient. You can talk about their clinical problem and get feedback from other people who are dealing with the same thing," McLarney said.

Capitalizing on the technology available began for McLarney during her time in the Navy, when she was stationed in Japan and provided health care to the entire Pacific Fleet.

"I would have corpsmen, who were basically high school graduates, calling me saying, 'I have this guy and he fractured something.' They would be talking about a bone that was located in the wrist, but they were actually talking about the foot," she said. "You are trying to make a decision on whether this person needs to be medivaced at the cost of $50-70.000 off a ship. So what I did was to get digital cameras for all the ships and have them take pictures because they all had e-mail. Then they would e-mail me the pictures and I could make a much more intelligent decision."

McLarney brought the idea with her to the Brattleboro, Now when a consult is needed on a patient, she takes a digital photograph of the xrays and uses e-mail to get faster responses.

"I had a patient who I wanted a second opinion on, so what we did was we took her X-rays and used a digital camera to take pictures of them. Then sent them with her consent as a jpg file to an expert at a major academic center, where all they do is knees," McLarney said. "And then I picked up the phone and called. He was able to pull up on his computer her x-rays and we could have a discussion about what was the best treatment for her."

She emphasized the freedom of communicating and researching that the Internet allows.

Now, literature searches can be done within seconds on the Internet, when before there was the task of searching through library materials and requesting articles or books to be ordered, which could take weeks. Technology advances do not stop with the Internet. Textbooks are another learning tool that have become extremely interactive.

"A lot of our textbooks now have CD-ROM's in them and you can actually watch the person, who has published the book, do the surgery," she said. "So if you want to review something you just pop it in and click on it." McLarney said the technology available also allows viewers to either slow down or speed up the procedures while watching on their computer.

In regards to actual procedures becoming more technologically advanced, McLarney said that the field of orthopedics is really there. Arthroscopic and laparoscopic procedures on the bones and - joints are now less invasive, and utilizing the scopes eliminates damage to the other body structures. Procedures, including a tear in the rotator cuff, a group of muscles in the shoulder, have been reinvented with the help of technology.

"We used to just slash open the entire shoulder, from the clavicle or collarbone, and come halfway down the arm, to just cut all the muscles in there and open to the rotator cuff, she said. By using trechnology of the arthroscope, surgeons are able to get to the injured area without causing damage. to the surrounding tissues. McLarney said an advantage of arthroscopic surgery is that everything is done through tiny little incisions making the recovery easier for patients, but this also has its disadvantages.

"Sometimes it is tough because patients look and see two little holes and they say 'oh great, I am doing terrific.' But you still did all the surgery inside, so it needs to be progressed at a certain level. The hardest part now is trying to keep patients back - back from doing too much," she said.

Staying current and continuing medical education is important for surgeons who are trying to offer the patients the best care they can give, said McLarney. On average she attends five to six courses a year. And with the advances of the Internet some courses are being taught online, eliminating the hassle of traveling across the country in McLarney's case, the technology advanced procedures that exist now were being used while she was in medical school and doing her residency. This has benefitted her in not only being knowledgeable of procedures, but also in the speed at which she can complete a procedure.

"During my five years of residency I did a lot of arthroscopic stuff, so I was very use to it, but some of the older orthopedic surgeons, some of them don't do anything arthroscopic. It takes me less time to do a lot of the arthroscopic procedures than it takes other people who didn't kind of grow up in their residency doing it," said McLarney. With surgeries taking less time, patients are not under anesthesia for as long, a definite benefit, McLarney said.