“If you fail to plan—you plan to fail”

Alexandra Grob, participant of the “AO Spine Advanced Level Specimen Course—Complex Surgical Techniques: What can you learn from pilots”, describes her experience.

03 December 2019

Martin Stienen (AO Spine Switzerland Neuro Officer), USZ; Sven Hoppe (AO Spine Switzerland Chairperson), Inselspital Bern; Markus Loibl (AO Spine Switzerland Ortho Officer), Schulthess Klinik

I am very glad that I got the opportunity to attend this specimen course. I arrived to a warm welcome at the Institute of Anatomy in Bern from the AO Spine Team. During the first half day, we were briefed for the following practical exercises on the anatomical specimens. Presentations were held by some of the national faculty members and guest speakers on anterior lumbar interbody fusion (ALIF), posterior occipito-cervical stabilization of C0/C2, as well as thoracoscopic corpectomy and pedicle subtraction osteotomy (PSO). The procedures were explained step by step. Moreover, the correct indications were highlighted, and potential challenges & pitfalls were discussed. The faculty then presented the Nodus Medical© system. This is an innovative digital tool, which helps the surgeon plan the procedures, adapt those according to a patients’ individual clinical/anatomical features and support the interdisciplinary teamwork in the OR.

As essential part of this special course, pilots from the Swiss military talked about challenges of their job and about parallels between safety strategies in both aviation and surgery. In several presentations and discussions we learned about strategies to efficiently implement key safety measures, including but not limited to thorough planning, briefing, use of protocols/checklists and - my personal take home message - debriefing. Additionally, we were transferred to the airport Bern Belp in order to participate in a flight simulator training with emergency scenarios. Here, we had to apply the previously learned strategies in a realistic scenario.

For the wet lab part, three participants performed the surgical procedures per anatomical specimen. At each station the experienced faculty members were closely involved and guided us in case of difficulties. The surgical procedures were successfully performed in every case, and both surgical instruments, hardware and imaging (fluoroscopy) was available. Every participant had sufficient hands-on experience.

During the breaks, we were treated well with coffee and food. I particularly want to highlight the amazing dinner at the traditional “Kornhauskeller” in the old town in Bern, which completed the course with pleasant social interactions.

I have just finished medical school and am eager to learn more about how to safely and efficiently perform spine surgery. For me it was a fantastic opportunity to get a deeper insight about how to successfully complete even complex procedures. Most other participants had considerably more experience – many of them have conducted spine surgery for many years already. I had the impression that also for those participants the course provided new insights. For me, it was also a good chance to meet future colleagues.

I would like to thank AO Spine Switzerland sincerely for the opportunity to observe this course.

Alexandra Grob, University of Zurich

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