Intended for healthcare professionals

Rapid response to:

Feature Medicine and the Media

Demystifying surgery live on TV

BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k4910 (Published 22 November 2018) Cite this as: BMJ 2018;363:k4910

Rapid Response:

The risks outweigh the benefits of showing live surgery on TV

We were grateful to Greta McLachlan for highlighting the issues with presenting live surgery to a wider audience, “Demystifying surgery live on TV”[1].

With any treatment modality one must balance the benefits against the risks. The risks of surgery are inherent and live surgery acts to increase these. Patients incur increased risk due to the stressful nature of live surgery, with surgeons’ self-assessing as being significantly more stressed and having poorer performance when performing live surgery[2]. The operation was shown after the watershed which resulted in the operation being performed out with regular working hours. Steps were taken to minimise the impact of this but the evidence showing reduced cognitive performance at night[3] and the increased risks when surgery is performed out of hours[4] cannot be ignored.

The article points out the benefits of live surgery, including those stated by the surgeons involved. We absolutely agree with these but believe that all these benefits can be realised without the use of live surgery. A recorded, step-by-step operation would still enable the general public to witness the operation in full and listen to the surgical commentary and insight throughout. The excellent teamwork on display during the operations and the focus on how the surgical team works would also still be seen. Importantly, the operation could be performed within normal hours. All of this could be realised without the added risks of performing the surgery live. In addition, the programme did not show true live surgery as a 20-minute delay was added to avoid airing a catastrophic complication. If a live recording can be delayed by 20 minutes, then why not record the operation and show it later?

Other surgical societies have banned live surgery[5], with the Royal College of Surgeons remaining unconvinced that the benefits outweigh the risks[6]. We call upon all the Royal Colleges to go one step further and stop allowing this unnecessary risk to patients.

Yours sincerely,
Dr Iain McPherson, Foundation Year 2 Doctor
Mr Mohammed Asif, Consultant Thoracic Surgeon

References:

1 McLachlan G. Demystifying surgery live on TV. British Medical Journal 2018;363:k4910
2 Khan SA, Chang RT, Ahmed K, et al. Live surgical education: a perspective from the surgeons who perform it. BJU International 2014;114:151-158
3 Kaliyaperumal D, Elango Y, Alagesan M, et al. Effects of Sleep Deprivation on the Cognitive Performance of Nurses Working in Shift. Journal of Clinical and Diagnostic Research 2017;11:CC01-CC03
4 Asfour L, Asfour V, McCormack D, et al. In surgeons performing cardiothoracic surgery is sleep deprivation significant in its impact on morbidity or mortality? Interactive Cardiovascular and Thoracic Surgery 2014;19:479-487
5 Sade RM. Broadcast of Surgical Procedures as a Teaching Instrument in Cardiothoracic Surgery. The Annals of Thoracic Surgery 2008;86:357-361
6 Royal College of Surgeons. Position Statement: Broadcasting Live Surgery. https://www.rcseng.ac.uk/library-and-publications/rcs-publications/docs/... (accessed 02 December 2018).

Competing interests: No competing interests

04 December 2018
Iain McPherson
Foundation Year 2 Doctor
Mr Mohammed Asif, Consultant Thoracic Surgeon, Department of Thoracic Surgery, Golden Jubilee National Hospital
Department of Thoracic Surgery, Golden Jubilee National Hospital
Golden Jubilee National Hospital, Agamemnon St, Clydebank, G81 4DY