Tahoe docs teach intricate orthopedic surgery techniques


By Jessie Marchesseau

ROUND HILL — Seven doctors, nurses and assistants, two monitors, multiple trays of surgical tools and two large adjustable spotlights fill the cadaver lab Dec. 3 at Tahoe Orthopedic & Sports Medicine in Round Hill.

The things that resemble raw turkeys on metal stands — those were the cadavers. They were not full bodies, just shoulders. There were two of them set up at separate surgical stations; one for each of the two doctors participating in the Lake Tahoe Sports Medicine Fellowship.

Dr. Brian Duggan, left, prepares to operate on a shoulder as Dr. Kyle Swanson observes. Photos/Jessie Marchesseau

Dr. Brian Duggan, left, prepares to operate on a shoulder as Dr. Kyle Swanson observes. Photos/Jessie Marchesseau

The doctors, known as fellows, will take part in four of these cadaver surgeries during their year in the program. Sometimes they use knees, other times hips, this day it is shoulders.

“It’s a way to give the fellows the most realistic way to practice a surgical technique and to learn new ones,” said Dr. Keith Swanson, program director for the Lake Tahoe Sports Medicine Fellowship and one of its founders. “You can try things, new things that you wouldn’t try on someone if you haven’t done it before.”

This was exactly why Dr. Brian Duggan, one of the fellows, was so excited about Friday’s cadaver lab. He was looking forward to performing suprascapular nerve decompression on a shoulder. It is a relatively rare surgery that he has only encountered once.

“This is something that most surgeons have never done,” he said. “It’s one of the most complicated surgeries.”

Duggan, originally from Detroit, did his residency in Maryland before moving to Lake Tahoe in July for the fellowship program. He says his goal is to have a general orthopedic practice specializing in sports-related injuries.

The fellows are not medical students. They are fully trained orthopedic surgeons when they arrive. They choose to participate in the fellowship as a way to acquire more in-depth training specifically in the field of sports medicine.

Duggan applied for the fellowship because he says he knew it would give him the opportunity to see a variety of cases, get a wealth of hands-on experience and work with experts in the field of sports medicine. He has already seen an improvement in his surgical skills since starting the fellowship four months ago.

“Because of the complexity of orthopedics, the more training you can get in your specialty, the better,” Swanson said.

When it comes to additional training in the field of sports medicine, doctors’ options are relatively limited. The Lake Tahoe Sports Medicine Fellowship is one of 95 across the country and the only one in Nevada. What’s even more unique about the program is that it is not located in a big city or associated with a large metropolitan hospital or medical school.

“The only reason we can do a sports medicine fellowship in a small town like this is because of the high volume of sports injuries here,” Swanson said.

Swanson and six other local doctors make up the fellowship faculty. Drs. Steve Bannar, Jeffrey Cummings, Roger Rogalski, Kyle Swanson, Robert Rupp, and Daniel Robertson all donate time to the program. However, the fellowship benefits these doctors almost as much as it does the fellows, giving the seasoned surgeons an opportunity to work with doctors who have just finished training in the latest techniques and assist them with research projects.

“If you want to really get good at something, you need to become a teacher at it,” Swanson said. “I think they teach me almost as much as I teach them.”

Swanson credits the program with keeping the orthopedic care here on the South Shore some of the best available.

This was evident as Duggan and Kyle Swanson performed the rare decompression surgery. It is an arthroscopic procedure, meaning the doctors use a tiny camera to do the surgery rather than cutting the flesh open, and one that is currently a hot topic among the medical community.

Water dripped from the shoulder as Duggan maneuvered the long metal tool equipped with the camera through tissue to the suprascapular nerve. The doctors intently watched the monitor in front of them, pointing out the rotator cuff and different types of tissue they were passing through.

On the other side of the room, fellow Dr. Cecelia Pascual Garrida watched a different monitor as she performed an arthroscopic rotator cuff surgery on her shoulder with Robertson assisting.

“I think the bottom line of all this for the public is because of this program, it keeps the orthopedic care very high in this community,” Keith Swanson said. “It’s the very highest care available.”

(Click on photos to enlarge.)


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