The first ever known surgery over Skype with Dr. David Nott

Skype was developed in 2003 to help people stay together, no matter where in the world they happen to be. Since launch, we’ve discovered many weird, wonderful and original ways that people use video calling. From pet sitting to interior design. From working out to personal stylist advice—people really do use Skype in the most creative ways.

Recently, we came across the The David Nott Foundation, a UK-based charity which gives surgeons and medical professionals the skills they need to provide relief and assistance in conflict and natural disaster zones around the world.

Dr. David Nott
Dr. David Nott. Photo by Francesco Guidicini

Founded by Dr. David Nott and his wife Elly, The David Nott Foundation’s main focus is to improve the standards and practice of humanitarian surgery in conflict and catastrophe areas around the world. Both are passionate about helping those less fortunate than themselves and their efforts in treating victims in areas of catastrophe goes from strength to strength. We caught up with Dr. Nott, “the Indiana Jones of Surgery”, and found out how Skype features in their mission to help surgeons develop their skills for warzones—and how he and his wife started volunteering their time:

“I started in Sarajevo in 1993. I watched a film called The Killing Fields with my Dad and I had a fascination about different places and helping people. The film was about a friendship between a journalist and a local interpreter in Cambodia during the civil war but essentially about people helping each other. And then something sparked in my head, that I’d like to do something like that myself. When I became a consultant, the first thing I did was to volunteer my services to Médecins Sans Frontières in Sarajevo. I should have only stayed for a couple of weeks but I ended up staying for three months.”

Dr. Nott tells us how technology and Skype came into the picture:

“In 2007, I believe I was the first person ever to receive details of how to perform surgery via text messages in the Congo. This was when a friend of mine texted me the procedure of how to take off somebody’s shoulder and arm. This was in the Congo, in the middle of a jungle, without any help or anything!”

And then after surgery by text message, came the first ever known surgery performed over a Skype video call.

“Surgeons in Aleppo sent me a picture of a man whose jaw had been blown off by a fragment in a bomb blast. They asked me what they thought they could do. I took the pictures around to several of my colleagues to get their opinions on what they thought was the right thing to do to fix it. The doctors in Aleppo had never done this sort of operation; they’d never mobilized a myocutaneous flap (which is a muscle and tissue flap that rotates into the neck). They’d never mobilized a muscle before either, so that’s where Skype came in. They had a phone attached to a selfie stick so I could view everything. The operation started at about 8 in the morning and went on until 4 in the afternoon. It was very complicated but it worked 100%. Using Skype was fantastic because it allowed me to see what they were doing in real time. I was telling them which bit to cut, which bit not to cut—I directed them all the way through, from the moment they picked up the knife to the moment they put in the stitches.”

What about the technical challenges of using Skype in a war zone?

“The WiFi kept going down actually, it wasn’t constant. And obviously there were shells falling, as well as bombs being dropped around the area. And that obviously has an effect on the WiFi signal. Every so often, I’d be in a very precarious moment telling them to cut this bit—and then all of a sudden I’d lose the picture. I had to tell them, if I did lose the picture, they should stop operating until I could see what they were doing again. Even though Skype went off-and-on so many times in an hour, it gave me enough information to see what they were doing. It was 100% successful, an 8-hour operation using Skype. This man couldn’t speak at that time but about a week later, they took all his tubes out and finally he was able to say thank you very much to us. He was so delighted he was crying.”

Dr. Nott continues to tell us about how Skype helps train surgeons:

“When you’re training surgeons, they’re junior, so they don’t always know how to do the procedure. I’m always standing at the opposite side of the operating table and guiding them through things until they can do it themselves. That’s what I was doing here. But even though I wasn’t physically there, I was electronically there via Skype.”

Doctor David Nott, the first ever known surgery over Skype

Is communication as fluid on Skype as it is face-to-face?

“The main problem is sometimes the language barrier. You need to speak very slowly and clearly for them to really understand what they’re doing because if you spoke quickly and it was a bit muffled, then they might do the wrong thing.”

Given the dangerous climate in places like Aleppo, is it easy to keep in touch with patients and surgeons after the operation itself?

“That hospital where we did the operation was attacked recently. I don’t know where the patients are. They’ve been dotted around Aleppo somewhere or they’ve been sent home, but that hospital now is completely destroyed. There’s only one other hospital available so some of the surgeons have gone there. There are patients now lying on floors in wards all over the place.”

How about the surgeons?

“I’m not sure really, I haven’t been able to keep in touch with them so I’m a bit anxious for them. It’s terrible, it’s so dangerous. Doctors, nurses and hospitals are being targeted because the rebels are using healthcare as a weapon. If you take out a hospital, there’s no care or support for the thousands of people who are there so it just makes the situation significantly worse.”

As the conflict and tensions in Syria continue, Dr. Nott tells us he and his wife intend to pursue their efforts in helping wherever they can.

“It was an amazing thing that we did and I was delighted that Skype was there so we were able to operate together. It’s an amazing piece of technological wizardry.”

On October 31, 2016 Dr. Nott received a Special Recognition award at the Pride of Britain Awards in London, an award honoring his work as a war surgeon having operated under fire in the world’s most dangerous places, risking his life to save others in countries such as Afghanistan, the DRC and Syria. For the past 23 years, Dr. Nott has taken several months’ unpaid leave from his NHS job in London to work as a volunteer for aid agencies including Médecins Sans Frontières, the Red Cross and Syria Relief.

We love hearing stories like The David Nott Foundation and to think that our technology helps in this way is incredibly humbling. We’re always on the lookout for original uses of Skype. If you’d like to share your story, just tag us @Skype on social media and we might feature you.

To use all our latest features, make sure you have the latest Skype app on all your devices. And to keep up-to-date with all our news, follow us on FacebookTwitter and Instagram.