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Surgeon Uses Video Games to Sharpen Laparoscopic Skills

February 05, 2014

Meet the surgeon who established the world's first video game warm up suite for surgeons. James "Butch" Rosser, MD, has found through his research that surgeons who play video games are more efficient and make fewer mistakes in minimally invasive surgery.

The cover to Super Monkey Ball

Super Monkey Ball is a vintage video game that is still putting players' fine motor skills, visual acuity, and agility to the test. Players navigate a monkey within a ball through mazes and around obstacles to make it to the finish line. Go too fast, and the monkey flies past the finish line right off the course. Go too slow, and it might not have enough momentum to make it up a hill. 

Disaster usually follows.

The game, which was released in 2001, is played on a Nintendo GameCube and requires precise movements and keen reflexes. And it's more than amusing entertainment— it's a legitimate tool being used by surgeons to prepare for the OR. So is Nintendo's Wii Golf. 

James "Butch" Rosser, MD, FACS, is a surgeon at Florida Hospital Celebration Health who specializes in minimally invasive laparoscopic surgery. Rosser, 59, has worked on studies that have found that surgeons who warm up by playing video games, are more efficient and make fewer mistakes.

The genesis of Rosser's studies come from a deep love of pop culture.  Inspired by TV shows such as Star Trek and Ben Casey, and from a strong passion for comic books, Rosser has been motivated to use these pop culture icons for the greater good.

In the 1970s, when Pong became a massive hit, Rosser grew fascinated by the technology that allowed him to play table tennis on a television screen, while engaging in the activity in a physical manner. What Rosser didn't know was that he was starting to develop skills that he would use later in his career.

James "Butch" Rosser, MD, FACS

Once the early 90s came along, and laparoscopic surgery started to make its way into the mainstream, Rosser started to make some connections between the surgical technology and the games he had been enjoying. Rosser wondered if the games may have something to do with his skill at the surgery.

"I never knew why I was good at this type of surgery," said Rosser. "People would say 'Oh my god, we've seen a lot of people do this. You're a natural.' So in the back of my mind I thought, 'Is it true? Am I better at this because of my video game capability?'"   

6-Minute Warm Ups
When Rosser went to work at Yale University, he decided to test out his hunch. Working in Yale's invasive program in laparoscopy, he started training programs to see if video games could make a surgeon more efficient in minimally invasive surgery.

"We found out that if you warm up for a minimum of six minutes with certain video games… you were more efficient and had fewer errors," says Rosser. "With the Institute of Medicine report in 1998, it showed us that almost 100,000 people in country die from medical errors, and 57% of those errors came from surgery. Armed with that, I was able to convince the leadership here at Celebration Health Hospital to establish the first world's first video game warm up suite for surgeons."

The study showed that participants who played video games in excess of three hours a week [PDF] had 37% fewer errors and finished their procedures 27% faster than their counterparts who did not play video games.

Met By Skepticism
It wasn't all sunshine for Rosser's research. When he introduced his video game hypothesis, it was met with strong skepticism.

"Most of these people that are my colleagues aren't as sensitive about pop culture. In fact, they've left pop culture behind in their youth…""So when I suggested that Super Monkey Ball could be part of a training program, they were just taken aback," Rosser says.

"You've never lived until you've gotten hate mail from both the New York Times and the LA Times at the same time, and it wasn't just my colleagues, it was the general public who villainized video games. But, as the data keeps coming out, and the research that I'm doing keeps coming out, I've been blessed to see people slowly get it."

Conducting studies isn't the only way Rosser is spreading his message. Rosser has written a book on the subject, and hosts the Top Gun Laparoscopic Skills and Suturing Program, [video] which allows surgeons to hone their surgery skills to make them more effective in minimally invasive procedures.

Rosser says that if someone took a picture of him playing video games, and during a laparoscopic procedure, they'd have an identical silhouette. Both require him to look at a screen, utilizing joystick-like levers, and both put a serious expression on Rosser's face.

He may look serious, but the surgeon radiates joy. Along with his love for comic books, video games, and Star Trek, Rosser is also an aviation fan, another avocation that demands a high level of visual and spatial acuity.

Telemedicine an 'Integral Part of Healthcare Delivery'
Rosser says he hopes that his studies and research on video games can bring along a new age in healthcare, and in telemedicine. The goal would be that the use of technology will help patients become more interactive with their care.

"You see a child who uses a computer and these consoles and they are very sophisticated as far as navigating the digital trees to get to stuff, and it's just going to be a natural thing for them to be able to navigate and to be able to assist in their own healthcare," he said.

"So as far as I'm concerned, we cannot rest until telemedicine is an integral part of healthcare delivery DNA and familiarization with these pop culture icons like video games and their consoles and their navigation techniques is going to pave the way for that to happen."


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