I was surprised. The senior faculty performing laparoscopy was trying to fit the end of the fiberoptic cable to the gas insufflation inlet on the operating laparoscope. Laparoscopy, like many other procedures is quite mechanical. The steps are fixed, and not difficult to remember. After some time, it becomes a subconscious activity, like breathing and walking. I had seen some residents trying to achieve the impossible - what I just described, or connecting the end of the gas insufflation tube to the receptacle for the fiberoptic cable. But to see the same being done by senior faculty? The error was corrected after a few attempts, without anyone drawing the gynecologist’s attention to it. I thought about it, and understood. The said consultant was under pressure and was allowing it to distract him from the work at hand. Perhaps such a thing would not happen with more experience.
Then I thought about the residents who committed the same mistake at times. It was not as if they did not understand what should be connected where. It was probably because of tension.
“It does not fit there” I have to say. “It goes to the other receptacle.” Then they correct themselves, but without a word or even an apologetic smile.
I have also seen some of them putting the telescope in place of the trocar in the cannula and putting their eye to the eyepiece before connecting the fiber optic cable and switching on the light. When they do not see anything inside, they look outside the telescope to find the cause of the failure to see anything.
“You cannot see anything inside the peritoneal cavity until you switch on the light” I advise them. They do it without a word or even an apologetic smile.
I always wondered why they would not show any response to my advice and just correct themselves. Now I know. It is the tension of having to perform the operation, expecting either unknown complications, or criticism for errors. Laparoscopy is a stress test for sorts for them.
