Training resident doctors is a part of my job. Their training includes operative techniques. Laparoscopy is one of the operations they have to learn. It is my observation that no matter how strong and healthy the resident doctor may be, he/she finds inserting the trocar and cannula through the abdominal wall during their early days of training. They huff and puff and still the instrument does not enter the peritoneal cavity. Perhaps they are afraid. Perhaps there is some other reason. I usually try the following technique when everything short of my taking over fails.
"Stop all efforts" I say. "Leave the instruments aside. Take two long breaths and keep the air inside for some time before breathing it out."
They do it as told, because the other option is I take over and insert the laparoscope.
"No insert the trocar and cannula while your red blood cells and muscles are still highly oxygenated. It must work. It always works."
They try and it does work. They are happy that they have managed to get the trocar and cannula inside.
"Sir, what made you advise this two-breath technique?" my inquisitive Assistant Professor asked me once.
"Well, it is not described in any book, and I am not sure the scientific explanation of blood and muscle oxygenation I give is the real explanation of its success. I have not done any study to prove it statistically that it is really effective."
"But what gave you the idea?" he asked.
"I saw a movie once. The hero is an American cop, who is kidnapped and recruited by a Korean martial arts teacher to destroy some villains. He trains the cop. One of the things in the training is deep breathing for oxygenation. The teacher believes it improves strength and performance. The hero excels in martial arts possibly because of the oxygenation, or more likely because that is in the script. But I liked the idea. I use it as a joke, and to give the poor resident one last chance to succeed. Perhaps the ultimatum works. Perhaps his/her faith in me works. May be one day I will write a scientific paper on it, and some journal might print it too!"
This happened a long time ago. I still use the trick, but have not got around the writing the paper. Perhaps I have to take long breaths so as to be able to get started.
