BOSTON -- It was a first-of-its-kind operation. The patient was a meteorologist stationed at the South Pole, but the surgeon in charge was thousands of miles away in Boston.
It was a first-of-its-kind operation. The patient was a meteorologist stationed at the South Pole, but the surgeon in charge was thousands of miles away in Boston.
So when a meteorologist stationed there fell and injured his knee earlier this month, doctors had a decision to make.
"It would be four months before they could get him out of there," Massachusetts General Hospital Dr. Bertram Zarins said. "By then, the muscle already is atrophied and stiff, so he would not get full flexion. He would not be able to do sports, so we knew he would have a disability if we left it alone."
Zarins is the team doctor for clubs like the Boston Bruins and New England Patriots. He and colleagues at Mass General decided the best solution was to walk the South Pole station physician -- a general practitioner -- through knee surgery with the help of a video link to the sight.
"I watched the screen that they had and told him where to make the incision, and after he made the incision, I saw what was going on and told him the next step," Zarins said.
The biggest risk was with the anesthesia. Unlike a hospital surgery where trained technicians administer and monitor powerful pain medication, there would be no such person on-site.
"Everything has the potential to go wrong," said Vicki Modest, an anesthesiologist. "Instead of the patient being numb from the waist down, they can get numb from way high in the chest on down. If that happens, their breathing is compromised."
But the operation, which took two hours, was a complete success and the patient, Dar Gibson, has begun physical therapy.
"The stitches are out. He already has 48 degrees of knee flexation. He's walking around and no swelling or pain, so I think everything went very well," Zarins said.
The U.S. Antarctic Program has used two-way voice and video links in the past to assist with medical concerns, but this was the first time telemedicine has been used for surgery there.
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