The Royal London Hospital and the Barts and The London School of Medicine and Dentistry presented the first live-streamed surgical procedure in the UK. The operation was an extended right hemicolectomy with resection of a metastatic liver lesion.

Here is what I thought about the event.

The case started about 30 minutes late, which is similar to what would have happened in any operating room in the United States with a case scheduled for 2 o’clock in the afternoon.

I noticed some curious things. Many of the staff, including the anesthesiologist, weren’t wearing masks in the operating room. There is no Joint Commission in the UK.

When the surgeon changed his glove, he opened the inner portion of the package with his bare hand, and the scrub nurse then touched the same area with her gloved hand.

The surgeon did not know what the patient’s preoperative hemoglobin level was and had to ask the anesthesiologist.

The colon procedure was done in under an hour which was impressive considering the patient was somewhat obese, but I thought the surgeon hurried a bit. He could have been more careful. For example, he applied staplers without seeming to double check their position.

I previously listed many reasons why I felt live broadcast surgery was a bad idea.

Among them was the problem of distractions and there were many during the case.

• The surgeon talked about how many people in different countries were watching.
• He said that a number of text messages were coming up on his Google Glass screen.
• At 21 minutes into the case, he stopped for a 5 minute interview with a TV crew.
• He chatted with a colleague who came into the room for a few seconds.
• He said hello to a medical student from Australia who had spent some time with him.
• He asked questions of the audience and answered them himself.
• Several times, he asked his technical crew how things were going.

Several other issues detracted from the educational value of the operation.

• The glare from the operating room lights was constant and markedly impaired visibility.
• Most of the time the Glass camera was aimed too high and too far to the right so much of the operative field was not in view. The surgeon pointed out anatomic structures that the audience could not see.
• He moved his head frequently causing the picture to jiggle.
• A stationary television camera with the ability to zoom in would’ve been much more effective.
• The sound quality was poor and often unintelligible.
• The liver portion of the case was not shown because the Glass’s battery had to be recharged after 70 minutes.

What this demonstration showed me is that Google Glass has a long way to go before it is useful for education.

“Skeptical Scalpel” is a surgeon blogs at his self-titled site, Skeptical Scalpel.