Surgery has both intellectual skills (cognitive) and manual skills (technical). Cognitive surgical skills are those include making accurate diagnoses, knowing- who is/ isn’t a good candidate for surgery, and having a depth of understanding of surgical anatomy. Technical skills can be simply summarized as getting your hands to do what you want them to. There is a huge cognitive aspect to surgery, but in skull base and cerebrovascular surgery in particular there is also a very significant technical component.
Economy of motion – minimizing unnecessary maneuvers that might expose critical structures to unnecessary risk – adroitness, and manual sensitivity are all components to being a good “technical” surgeon.
These manual skills can only be achieved by repetition (practice). Think of it as similar to playing the piano. No amount of listening alone will enable you to play Chopin- you have to practice. This is why volume and experience are so important to achieving good outcomes in skull base and cerebrovascular surgery.
I believe that what what further separates an excellent surgeon from an average one is the willingness to bring the same focus and attention to detail in improving one’s own surgical technique that others might devote to time in the laboratory. Reviewing video is perhaps only one part of continuously improving one’s surgical techniques, but it is a very significant one.
