Perspectives in Biology and Medicine

THE PHYSICS OF LAPAROSCOPIC SURGERY: A DISSERTATION ON THE CONTRIBUTIONS OF FAMOUS PHYSICISTS TO LAPAROSCOPIC SURGERY LEO A. GORDON* At this time in the development of laparoscopic surgery, it is appropriate to undertake a review of the basic principles of physics which govern its performance. Laparoscopic surgery is dependent on technology that uses principles ofphysics for its implementation. Over the years, significant contributions have been made by famous physicists. Each has elucidated a basic principle of physics which has direct bearing on the conduct of laparoscopic surgeries. For most of us, those principles of physics were learned many years ago either in college or in medical school. Most of us have forgotten them. And rightfully so. Why, after studying so hard, should one ever be forced to read, never mind comprehend, such statements as: As the thermal energy of the lattice is proportional to the temperature when sufficiendy high above absolute zero, a point is reached where the mean free path is proportional to the temperature and hence where, in accordance with Sommerfeld 's formula, the conductivity is inversely proportional to the absolute temperature . [1] Yet, despite its complexity, an understanding of physics is essential to the discipline of laparoscopic surgery. We, as endoscopic surgeons, must understand these principles as we seek to effectively perform operations, design new instruments and technology, and contribute to this growing field. A new generation of endoscopic leaders is emerging, but they truly stand on the shoulders of the giants ofphysics. And if those giants ofphysics looked up to see who was standing on their shoulders, they would notice two things: that they have entrusted their discipline to honorable physicians , and that there is gender equality in laparoscopic surgery today. *8635 West Third Street, Suite 865 W, Los Angeles, CA 90048.© 1997 by The University of Chicago. All rights reserved. 0031-5982/97/4003-1019101.00 492 Leo A. Gordon ¦ The Physics of Laparoscopic Surgery These men of science never realized that one day their principles would be used to remove gall-bladders and appendices or to repair hernias. They never dreamed that they would have a hand in removing common duct stones, resecting colon lesions, or creating trocar controversies. But such is science! Ten basic principles and laws of physics form the technological basis of laparoscopic surgery today. 1.Heisenberg's Principle ofIndeterminacy While still in his twenties, Werner Karl Heisenberg, one of the great nuclear physicists of the day, completed important work in quantum theory and atomic structure. In 1932 he was awarded the Nobel Prize for physics. Heisenberg defined methods of detection and observation, contributing greatly to the tools of the nuclear physicist. Using the scintillation method, the cloud chamber, and the Geiger counter, Heisenberg formulated his Principle of Indeterminacy. After formulating this principle, the German Roentgenologic Society requested that he apply his principles to the study of operating room delays. He studied delays using his principle, which he later refined to the Principle of Operating Room Support Indeterminacy. This formulation gives a physical and mathematical explanation for the delays in operating theaters, particularly during high gamma ray dispersal during the performance of intra-operative cholangiography. Heisenberg's Principle of Indeterminacy states: The location of the radiology technician at the time of cholangiography is indeterminate. 2.Thomson 's Principle ofNegatively Charged Particles Sir Joseph John Thomson received the Nobel Prize in Physics in 1906, mainly for his discovery of the electron. He worked with magnetic deflection of cathode rays in different gases. He formulated his principle of negatively charged particles using a cathode tube in a belljar and applied his principle during an outbreak ofblank films in the early phases ofthe introduction ofintra-operative cholangiography. Mystified by the number ofunexposed films, he formulated his "on-off" theory of roentgenologic devices . His Principle of Negatively Charged Particles gave a formulaic explanation for the frustration many surgeons experience during cholangiography for laparoscopic cholecystectomy. Thomson's Principle of Negatively Charged Particles states: The passage of an x-ray through an empty cassette generates no data. Perspectives in Biology and Medicine, 40, 4 ¦ Summer 1997 | 493 3.Schrödinger's Theory of Wave Mechanics Erwin Schrödinger made great contributions in the fields of color theory...