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NY Daily News reports: Up close and surgical - a click of the mouse opens operating room doors

By STEVE DITLEA
Wednesday, September 28th, 2005

When Manhattanite Jennifer Robbins was told she needed a heart-valve replacement, she didn't know much about the toughest yet most permanent surgery for her condition: the Ross procedure. So she hurried over to an operating room at Beth Israel Medical Center to see the operation performed by her surgeon, Dr. Paul Stelzer. Reassured, she went ahead with the surgery a month later in the same OR.

Robbins' initial visit wasn't an actual one. Getting a prospective patient, let alone anyone not directly involved in surgery, into a New York City hospital operating room would require permission from the patient under the knife, doctors and hospital administrators.

Instead, Robbins' presence was virtual, via a one-hour video of the operation originally performed live on the Web in October 2004, archived and available 2-4/7 at OR-live.com. It's one of 205 recently shot videos of surgical procedures at the site, accessible for free.

UNPRECEDENTED ACCESS

For fans of "ER" on broadcast television and OR reality shows on the Discovery and Learning Channel cable networks, seeing what goes on within the sterile zone may not seem so novel. Yet the three-year-old OR-live site offers unprecedented access to some of the nation's top operating rooms for patients and families faced with crucial medical decisions.

"It put my mind at ease to see how comfortable Dr. Stelzer looked during the operation," Robbins recalled a few weeks after her own successful surgery. Also reassuring for Robbins, a technical designer in the garment industry, was the skilled suturing in the video: "I appreciated the stitching and the cutting," she said.

At age 40, Robbins was an ideal candidate for replacement of her own failing heart valve with one from the other side of her heart, which was in turn replaced with a valve from a human cadaver. The Ross procedure, which puts the patient on a heart-lung machine for much longer than a simpler mechanical or pig valve replacement, results in a repair that can last a lifetime (instead of 10 to 20 years for more common replacements - and without their need for anti-coagulant drugs).

AN INEXPENSIVE SHOOT

Only a few cardiac surgeons in New York or elsewhere offer the procedure. "It's my Mercedes-Benz option for isolated aortic valve disease in younger adult patients," explained Stelzer, who has been performing the difficult operation since 1987. To promote his expertise among referring doctors and potential patients around the world, Beth Israel's marketing department paid the $35,000 cost of producing, Webcasting and archiving the video by OR-live's parent company, slp3D Inc. of West Hartford, Conn.

Shooting surgery live is expensive, involving three cameras in the operating room and one covering the Webcast host, usually a medical colleague, plus four technicians handling multimedia concerns. In some cases, the tab for a video is picked up by makers of the device or by ug manufacturers. To date, some of OR-live's archived videos have been accessed by more than 25,000 visitors.

A replay of "Unique Aortic Valve Replacement for Younger Patients" (despite its dull title) proved compelling viewing. This was Stelzer's 375th Ross procedure. (Jennifer Robbins' was No. 382.) On screen, the 58-year-old surgeon exuded the calm of an airline pilot in the eye of a hurricane. With a stilled heart beneath his hands, he pointed out wonders of anatomy and tricks of the trade (a replacement valve is healthy if it holds water squirted into it).

Amid the painstaking work of reconstructing a human heart, he even found time for some humor; asked if there was any danger of dying during the operation, he responded, "Me, or the patient?" He turned dead serious when discussing the vital math of surgical experience with this procedure: "I lost three out of my first 30 patients, three more out of the next 200, and I haven't lost anybody since 1998," he said.

A little too much information? Apparently not, judging from the 4-to-1 ratio of non-professionals to health professionals accessing OR-live's Webcasts and archived videos. Peter Gailey, slp3D executive vice president for business development, noted that the site's original audience was supposed to be mostly doctors. "The big 'A-ha' for us was how well embraced this has been by the patient population," he says.

DEMYSTIFYING THE PROCESS

From cardiovascular surgery to urology, endocrinology to radiology, OR-live is evolving into an online video encyclopedia of 21st-century medical procedures, accessible to anyone with a Net connection and a mouse.

"This demystifies the operating room," said Eve-Marie Lacroix, chief of the public service division for the U.S. National Library of Medicine (part of the National Institutes of Health), which has added OR-live videos and live Webcasts to the resources on its popular patient-oriented site, MedlinePlus.gov. "It's not just patients before their surgery. Patients who've had surgery can finally understand what they had."

As for Robbins, recovering from her operation and without new episodes of "ER" to watch on TV, she began browsing OR-live again. "Now I'm interested in seeing other procedures that people I know have had," she said.

© 2005 Daily News, L.P.



Medical Information
The information provided on this site is presented for educational purposes. It is intended to support, not replace, the relationship that exists between a patient/site visitor and his/her existing physician.

This website is owned and operated by OR-Live, Inc. OR-Live, Inc. is not a health care provider and does not provide medical diagnosis or treatment. OR-Live, Inc. only provides visitors to the site with referrals to medical facilities and health care providers that may be able to assist them in their medical needs. OR-Live, Inc. has not conducted an independent investigation or performed other due diligence functions with regard to the health care providers or medical facilities to which the referrals are made.

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