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"Surgeons broadcast cinema vérité" reports Andrea Tortora, Cincinnati Courier Managing Editor

Live Internet broadcasts of surgeries are beginning to make medicine more accessible to thousands of patients -- and are becoming a potent marketing and educational tool for hospitals and doctors.

"It's more powerful than a phone call or an article," said Dr. Randall Wolf, a cardiothoracic surgeon and director of the Center for Surgical Innovation at the University of Cincinnati.

University Hospital and UC Surgeons Inc. spent more than $140,000 in 2004 with Connecticut-based medical broadcasting company SLP3D to broadcast on the Web four unique, minimally invasive procedures used to treat lung cancer, obesity, liver tumors and the irregular heartbeat called atrial fibrillation.

The trend builds on what for years was simply a teaching tool: Surgeons and other health care professionals watched new procedures from theater-style observation areas high above an operating room.

Today the view is much closer, presented as the surgeon sees it through an endoscope, with close-up shots and a documentary style. Anyone with computer access has a front-row seat -- and the ability to e-mail real-time questions like the one Gary Gibson sent on Nov. 16, during the session Wolf did on atrial fibrillation (AF).

He wrote, "Suffer intermittent AF. In AF now. Last time in AF 18 Mo. Had cardiac ablation in 1992. Had angioplasty 4 times. Amiodarone no longer seems to work."

Gibson, 62, wanted to see if he was a candidate for Wolf's AF treatment, known as the minimaze procedure. He'd heard about the webcast on the radio and was dissatisfied with his current treatment.

"I had no idea that procedure existed," Gibson said recently while working at his Tri-State Sterling heavy truck dealership in Sharonville. Gibson figured he was stuck on medication, which he said wasn't helping.

"When you go into a-fib it feels like you lose half your horsepower," Gibson said. "I was approaching congestive heart failure. I was really headed for trouble."

He received a reply to his e-mail and later met with Wolf. Gibson's surgery was Jan. 3, and he's now back on the golf course, feeling good and strong.

"The webcast was so detailed. It gives you a complete overview," Gibson said. "And now I'm cured."

That's exactly the kind of experience administrators were hoping for when they signed with SLP3D, said Stephanie Savicki, University Hospital spokeswoman.

Each broadcast cost $35,000 to produce, promote and archive, and "they are another tool to communicate with the consumer," Savicki said. The webcasts also help to retain and attract new physicians, who want to work where the latest technology is available, she said.

Hospitals across the country are beginning to use webcasts as a way to educate patients and advertise the expertise of doctors. Ross Joel, executive vice president at SLP3D, said audiences can be in the low thousands, with 60 percent medical professionals and 40 percent potential patients.

"All trends show the Internet is a place where professionals and consumers go for health care information," Joel said. "In a sense it's as much direct-to-professional marketing as it is direct-to-consumer."

For Wolf, the broadcasts are an easy way to get the word out to referring physicians and patients about new procedures available in Cincinnati.

"The idea is to allow patients to see what all the treatment options are," Wolf said. "If it's new, the doctors might not know about it yet."

Wolf's a-fib treatment uses the Isolator device manufactured by West Chester company Atricure to interrupt abnormal circuits in the heart muscle that cause an irregular heartbeat. Wolf and his colleagues devised a way to use the technology without the need to crack a patient's rib cage by instead entering the chest cavity through an incision in the armpit.

Wolf's ingenuity is the kind of thing Department of Surgery Chairman Dr. Jeffrey Matthews wants to see at UC's College of Medicine. He and Wolf decided to create the surgical innovation center after meeting at downtown Cincinnati's Brandstorm agency, part of Northlich, in 2002. At the time, Wolf was working at Ohio State University. After the meeting Wolf and Matthews talked in a parking lot on Fourth Street about how they could work together.

In addition to the webcasts, Wolf and his colleagues are providing telemedicine sessions, where they can help physicians in other parts of the world during a procedure or hold a conference with doctors in another city.

Matthews likes the results.

"Physicians can benefit by receiving patient treatment right at their desk," Matthews said of the webcasts. "And participants can ask questions online during the surgery and can see it in the archives after the event."

What makes the broadcasts so effective is their digital clarity. Those watching see the same image the surgeon does.

"I don't have to push my head out of the way," Wolf said. "They see it as I see it in real time. And with the Internet, you can get care any where in the U.S."

Click to view Dr. Wolf's webcast.

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