Out of Touch

Learning objectives

After listening and discussing, participants should be able to:

1. Describe “tissue sense” and how tactile feedback informs surgical judgment.
2. Compare what is gained and lost moving from open to laparoscopic to robotic surgery.
3. Discuss how trainees can build judgment when they rarely operate open.

Discussion questions

1. Dr. Gordon chose surgery to touch and cradle pathology in his hands. What drew you to your field, and has technology changed it?
2. How would you explain “tissue sense” to a first-year student? Can it be taught on a simulator or through a console?
3. What does a patient gain from minimally invasive and robotic surgery? What might they lose that they never see?
4. The essay describes surgery behind a glass partition. Where else in medicine has technology put distance between clinician and patient?
5. If the next generation of surgeons rarely operates open, what should residency programs do about it?

Quick activity

List three pieces of information you get from touch during an exam or operation. For each, name what replaces it when you can't touch, and what that replacement misses.

How to run it

Play the episode together (10 minutes) or assign it beforehand. Start with the first question to let people react to the humor, then move to the harder ones. Remind the group that the episode is satire and some of its “facts” are invented; spotting which ones is a good exercise in itself.

Background reading

• What is laparoscopic surgery?
• How does robotic surgery work?