A Japanese surgical expert is invited to perform a laparoscopic liver resection on a very ill patient at India’s prestigious All India Institute of Medical Sciences (AIIMS). About 100 surgeons observe. During the operation, the patient starts to bleed. Reports say members of the audience encouraged the surgeons to switch to an open operation after bleeding could not be controlled laparoscopically. The surgeons do not convert to an open procedure for several hours, and continue to attempt the procedure laparoscopically–as the audience who enrolled in this course expected.

The patient dies.

Was he a good candidate for the minimally invasive surgery? Did he or his family know the procedure was going to be televised to a conference? Did they know a Japanese surgeon would be doing the operation? Was that surgeon properly credentialed to operate in India?

The events have created a maelstrom of opinion, and a rapid flurry of activity to ban or at least curtail live demonstrations such as this. Are the demonstrations for the greater good, allowing a large number of surgeons to learn advanced techniques in one setting? Do they bridge gaps between institutions, and even countries, that might not occur naturally? Or do they pressure performing teams to take risks they would not otherwise?

What do you think?

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