AATS Mini Theater: “Barriers to Surgical Development”

Video Categories: Best Practices, Patient Selection, AATS
2 YouTube Views - Published July 30, 2020
Featured Speaker: Dr. Isaac George, Dr. Armin Kiankhooy




Video Overview

A discussion on physician adoption of surgical ablation during their “Fireside Chat” segment, Drs. Kiankhooy and George remedy some career-spanning struggles facing the Maze Surgeon.


Video Transcript

For the hearing impaired members of the AFibSurgeons.org community, we have provided a written transcript below: 

Armin Kiankhooy: What’s the biggest barrier to a new surgeon? How have you been addressing that with your fellows? How do you speak to them about overcoming those barriers? 

Isaac George: I think there’s a fear surrounding ablation. I think when you grow up doing it and when you are – it’s in your culture and its part of your practice routine, it’s very straightforward and it’s very easy. I can see how asking someone to go start doing a new thing that they’re just starting to master let’s say after they just graduated from training or doing things that could potentially get them into trouble at an outside institution with no help or no guidance in terms of getting into bleeding complications postoperatively, or not using the right management, or not having staffing to be able to manage these in an outpatient setting. Those are all feared and those are all real fears. Really the key is to be able to address all of those things one at a time. 

I think the way that’s been most effective when I’ve spoken to other people is to talk to other surgeons. See what they do and take it step by step. You can start small; you don’t have to do everything all at once. I think you mentioned this before; you can start by clipping the appendage. You can then do a basic left-sided lesion set or a right-sided lesion set.  

Become comfortable with the technology, the techniques. Then move on. Eventually, what you’ll find is that translates to clinical outcomes. Then once patients come to you and they feel better, that becomes a real reason to advance the practice.  

Armin Kiankhooy: Yeah, for sure. I think what’s interesting is if you look at the new data coming out of Utah with Dr. Dowdy’s great bet of Intermountain Health. They talk about how he did a study where they looked at the post-T-site surveys of all the residents, cardiothoracic residents. They said on average, they do five ablations. On a scale of zero to five, they feel about three, comfortable. I think that really speaks a lot to the potential we have for our training programs to continue to bring our residents up to speed on how to do an ablation, and for them to feel safe, and to feel comfortable.  

I totally agree. I think it’s a lot asking for a surgeon who’s only done five of any procedure to go out and practice and start doing it safely and comfortably. I think we have room in our training programs as well as like you say, getting out puckering folks, making sure that once they are out, they feel comfortable, that they’ve set up the right infrastructure to support them.