My character has to perform surgery on herself and by herself.

She has all the surgery tools and a screen to watch what she is doing.

She is in a clean stable environment and there is no risk of infection.

She has to perform surgery near her spine, where she's inserting a microchip connecting to the nerve connected to the brain. The technology is futuristic so this is possible.

What I'm specifically asking if she could actually do the surgery?

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    Moving your hands in your back is quite difficult so performing a surgery in your spine will be even more... Does it requires anaesthesia? If it does it's quite probable she won't be able to do it... she may fall asleep. Also, you must think how much complicate is the procces? Just inject a a microcrip may be really easy, but that isn't the same as connecting each nerve from the spine to the chip. – Ender Look Nov 27 at 2:09
  • What level is the rest of the technology? Does she have something that allows her the impossible reach to get to the section near her spinal column? How is she at the sight of blood? What about her blood? (It makes a difference to some.) Does she have sufficient blood for transfusion to reduce risk of dying on the table? Why is she doing it on herself instead of guiding someone (which would be significantly easier and lower-risk in this case)? – Sora Tamashii Nov 27 at 2:10
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    I have serious doubts that anyone, even a skilled surgeon, could perform surgery on their own spine. – JBH Nov 27 at 3:56
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    Depending on size of microchip - could it simply be injected like a pet microchip? those are size of large grain of rice. Injecting something is far more achievable and believable than self-surgery – Chromane Nov 27 at 6:09
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    @Suthek -- I don't know what the OP's expertise is, but I'm guessing surgery isn't it. If the chip does all the work, then the question should be closed. If the technology is so advanced that the chip can integrate itself within the body, then "surgery" is not required and the question should be deleted as being senseless. Spinal tap isn't something you do on yourself either. Spinal tap isn't (really) a surgical procedure per se (it's an anesthesia thing, usually) so that's moot as far as the question goes. – elemtilas Nov 28 at 14:56
up vote 42 down vote accepted

No.

Just no.

Not at all possible. Even with video. (One caveat only applies.) Even with futuristic technology. You're still dealing with the totally unfuturistic human body. And that's something the other autosurgery answers fail to deal with.

Human arms and hands aren't designed to work behind our backs all that well. Especially when away from direct visualisation. She will need not only finger dexterity to do this job but also main strength and range of motion that will be severely curtailed for hours.

Other answers have focused on abdominal / ventral autosurgeries. Yes, those are possible, and are relatively simple procedures: you can see what you're doing and are not putting strain on your arms and your hands are working in their natural anatomic position. A c-section takes something like 20 minutes. An appendectomy can take as little 5 minutes.

None of them address the specific needs of spine surgery. The kind of surgery your character will have to do will require several hours of preparation and actual work -- if she were an actual surgeon working in an actual hospital setting. I know you've accepted one of those answers, but the reality is that your scenario simply is not going to happen.

enter image description here

This is a typical spinal surgery set-up.

In order to access the nerves to connect the chip, your character will need to make an incision. Incisions bleed, so she will need to achieve hemostasis. She will need to carefully dissect through two or three inches of subcutaneous tissue: muscles, connective tissue. You know, stuff that she's going to need in order to move her body around after the procedure!

enter image description here

This is what it looks like when dissected down to the connective tissue on the spine itself.

Once she gets down to bone, she'll still be a good inch to inch and a half away from the spinal cord itself. She will need a powered drill with several different kinds of specialised bits; she will need (quite literally!) a hammer and some chisels; she will need rongeurs. She's got to basically dig a hole through the bone in order to access the spinal cord.

enter image description here

Dem bones!

Once she gets through the bone, she's going to be confronted by the dura mater, which is the layer of tissue that protects the spinal cord and contains her cerebrospinal fluid. This is the same layer of tissue and fluid that surrounds & bathes the brain. She's going to have to be very careful when dissecting bone off the dura. It's very easy to tear!

enter image description here

The dura.

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View of the spinal cord itself.

Once she makes the incision through the dura, she'll at last be down to the spinal cord. Yay! That is the nerve that connects to her brain. Everything she's done so far is basically preparation for seating the implant. The "chip". At this point, she will have to know where in that mass of neurons is the appropriate nerve for the "chip" to be connected to. Easy-peasy!

Once the implant is in place, she's off the hook, right!?

Hell no!

She's still got to extricate herself from the situation. She has to close each and every layer that she just butchered in order to get down to the spinal cord. She will need to very carefully sew her own dura mater closed using extremely thin sutures and long specially designed needle holders.

Once that's done, she's gong to need to take all those bone chunks, mix them up with some blood and allograft bone chips in order to make a kind of bony bandage over the hole she made.

enter image description here

Stitches and glue.

enter image description here

Bone chips!!

And then she'll have to secure the implant itself to her spine so it won't move around and come loose. She does NOT want to create a CSF leak where the "chip" attaches to her spinal cord! This will involve another drill which she'll use to shape a pocket in her spinal column so that the "chip" will have a secure home. And then a much smaller drill and a bunch of fiddly little screws to secure the implant to the bone.

enter image description here

Screws!

Then she'll have to close up the layers of muscle and tendons, subcutaneous layers and skin. If she's lucky, she'll end up with a nice little scar.

Basically, all you're asking your character to do is be not only an orthopedic surgeon (for the bone work) but also a neurosurgeon (for the nerve work and implantation) but to do all this whilst wide awake and alert! Sorry, but a little 0.5% novocaine is not going to get her through this.

Spine surgery is brutal. It requires great physical strength to do the dissections and to get through the bone. She can not do these things on herself.

You're also asking your character to be a surgical technologist. They're the ones that sort through all the thousands of surgical instruments, all the sizers, the drill bits, the fiddly little strings of suture to make all the surgeon's magic even possible.

enter image description here

A Surgical Tech rocks the setup!

And you want your girl to all this all by herself?

Super Woman couldn't do this all by herself!

McGyver couldn't do this all by himself!

Synopsis: there is no way in hell a single person can perform spinal surgery without help. She will most likely die on the table. You do not understand how close those drills and chisels are to the aorta and vena cava. A little slip will send something sharp right into a major vessel, and then she'll bleed out. If she doesn't kill herself outright, she will faint. Like I said, spine surgery is brutality. It is physically brutal and barbaric. She won't be able to put up with the hours of agonising pain that this will cause. I'm all for acupuncture, but I don't think that's going to help much. Since she can't be asleep to perform surgery, that leaves local anasthetics. There are serious side effects (including death) if she uses too much of that.


So, what's the one caveat that will allow her to accomplish all this?

Basically: magic. She can sit herself up against Handvavium LLC's super-advanced robot and push the start button. Let the robot do all the work and she can watch it go from the screen. That's all there is to it!

But actual autosurgery? No. Not possible.

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    Thank you for posting the only sensible answer to this question! – JBH Nov 27 at 23:04
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    Thanks, @JBH! It was a fun answer to write. Even with futuristic technology, barring some kind of robot that does all the hard work, the premise just doesn't make sense. Too many difficulties. Too much potential for terminal errors. – elemtilas Nov 28 at 1:39
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    I feel like most of these images are better off as links with some sort of warning... – Brian H. Nov 28 at 10:14
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    Point understood. However, the question regards surgery. "Warning" is rather assumed by query type in my opinion. – elemtilas Nov 28 at 10:17
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    Good answer, but I think the "futuristic" setting can explain all of these difficulties away. Given the direction that surgical technology is progressing (specifically miniaturization and laparoscopy) it is not difficult to imagine that a futuristic spinal surgery would only require an insertion of a needle somewhere around the surgery site and then the rest being carried out through some sort of computer interface (maybe VR since this is the future). – SamYonnou Nov 28 at 15:50

Yes, this is possible.

Here are some real life examples:

Woman carries out caesarean on herself - and she and baby live

A pregnant woman in Mexico is reported to have given birth to a healthy baby boy after performing a caesarean section on herself with a kitchen knife...The unidentified 40-year-old [other sources give her name as Ines Ramirez Perez], who lives in a rural area without electricity, running water or sanitation, and whose home was an eight-hour drive from the nearest hospital, performed the operation when she found she could not deliver the baby naturally.

She took three small glasses of hard liquor and, using a kitchen knife, sliced her abdomen in three attempts ... and delivered a male infant who breathed immediately and cried...Before losing consciousness the woman told one of her children to call a local nurse for help. After the nurse stitched the wound with a sewing needle and cotton thread, the mother and baby were transferred and treated...at the nearest hospital."

Doctor rescued from Antarctica in 1999 dies at 57

Dr. Jerri Nielsen...treated herself for breast cancer while stationed at the South Pole in 1999...Nielsen caught the nation's attention in 1999, when she found a lump in her breast as a 47-year-old physician stationed at the Amundsen-Scott South Pole Research Station. After finding the lump in June, she diagnosed herself with breast cancer and began treating herself using chemotherapy agents that the U.S. Air Force parachuted to the station the next month.

It was later revealed...that Nielsen -- an emergency room doctor from Cleveland, Ohio -- performed a biopsy on herself with the help of non-medical crew, who practiced using needles on a raw chicken.

In your character's case, the surgery is something from the future so hopefully the tools are too. She'd be unlikely to be able to reach her spine properly but even today we have robots that do surgery and can be controlled by computer. So she could do that.

Imagine robotic surgery, for example (and this is modern day; in the OP's world, the tools would be higher tech).

And imagine an operating version of this:

enter image description here

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    Do you have an example of anyone performing surgery on their own spine? It's comparatively easy when you don't have to reach behind you, use two mirrors, and operate with your hands upside down and backward. – JBH Nov 27 at 3:57
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    No, but I do have this (and this is modern day; in the OP's world, the tools would be higher tech): med.nyu.edu/robotic-surgery/physicians/what-robotic-surgery – Cyn Nov 27 at 3:58
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    The person would still be performing the surgery. I edited my answer to show a picture. The robotic arm is just a tool, like a scalpel. But instead of controlling it with your arm and fingers, you control it with a computer (using your arm and fingers). – Cyn Nov 27 at 4:08
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    @JBH I think you're incorrectly conflating "robotics" with "automation". The robotics means that the arms holding the tools aren't physically your arms. Without automation, you're still controlling them directly. It's easy to imagine a haptic suit of some kind, maybe with a VR helmet, that allows the arms but doesn't have the automation. Indeed, I could see those happening in our world quite easily -- robots are much easier to sterilize than humans, their arms never shake from exhaustion, and they can have all the tools in their hands much quicker than us mere humans. – Nic Hartley Nov 27 at 18:05
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    @JBH I wasn't talking about OP's idea, I was talking about the answer I commented on. – Nic Hartley Nov 27 at 22:54

Is it possible to perform surgery on yourself?

Leonid Rogozov, when based on a Russian Antarctic base as doctor, was forced to perform appendix operation on himself.

On the morning of 29 April 1961, Rogozov experienced general weakness, nausea, and moderate fever, and later pain in the lower right portion of the abdomen. None of the possible conservative treatment measures helped. By 30 April signs of localised peritonitis became apparent, and his condition worsened considerably by the evening. Mirny, the nearest Soviet research station, was more than 1,600 km (1,000 mi) from Novolazarevskaya. Antarctic research stations of other countries did not have an aircraft. Severe blizzard conditions prevented aircraft landing in any case. Rogozov had no option but to perform the operation on himself.

The operation started at 02:00 local time on 1 May with the help of a driver and meteorologist, who were providing instruments and holding a mirror to observe areas not directly visible, while Rogozov was in a semi-reclining position, half-turned to his left side. A solution of 0.5% novocaine was used for local anaesthesia of the abdominal wall. Rogozov made a 10–12 cm incision of the abdominal wall, and while opening the peritoneum he accidentally injured the cecum and had to suture it. Then he proceeded to expose the appendix. According to his report, the appendix was found to have a dark stain at its base, and Rogozov estimated it would have burst within a day. The appendix was resected and antibiotics were applied directly into the peritoneal cavity. General weakness and nausea developed about 30–40 minutes after the start of the operation so that short pauses for rest were repeatedly needed after that. By about 04:00 the operation was complete.

After the operation gradual improvement occurred in the signs of peritonitis and in the general condition of Rogozov. Body temperature returned to normal after five days, and the stitches were removed seven days after the operation. He resumed his regular duties in about two weeks.

So, it seems that is should be possible, with adequate preparation, to perform self surgery.

Is it possible to perform surgery by yourself on your spine?

But in the above case the abdomen is accessible with the hands with no big hurdles. Accessing the back region is going to be more cumbersome, especially considering the unnatural posture of the hands and the elbow when operating on oneself's back, if the operation has to be executed by hands.

If instead your character has the necessary tools for performing tele-surgery (basically remotely controlled robotic arms and hands), it should be feasible.

robotic surgery

The visor needs to be adapted to a laying position and of course the subject cannot undergo total anesthesia, but only local anesthesia shall be applied. Moreover, considering that the back will be cut open to access the spine, movement of the arms shall be prevented and the tools shall be operated only by finger movement.

  • Same question I gave to Cyn: do you have an example of anyone operating on their own back? Two mirrors, hands upside down, elbows bent in the wrong direction. I'm highly dubious. – JBH Nov 27 at 3:58
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    it sounds like they need more than one doctor in Antarctica. – theRiley Nov 27 at 4:07
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    @JBH, as I stated, accessing your back with only hands is going to be cumbersome at least. That's why I suggested remotely controlled operation, where remotely means "use a visor and some controllers to operate the arms working on your back". – L.Dutch Nov 27 at 4:29
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    @theRiley The wintering crew at Antarctic bases is small (10-14). Adding another doctor for the very few cases you need it is not worth it. (Also, if you are going to have a duplicate doctor "just in case", you really need a duplicate diesel mechanic too - the diesel generator which produces the base's electricity and heating is pretty damn important.) – Martin Bonner Nov 27 at 11:35
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    The original case report is very much worth a read, BTW. His use of the first and third person to describe the doctor and the patient, and his commendation of his assistants' "stamina and presence of mind", are a masterpiece of dry humor. – Sneftel Nov 27 at 13:52

All in all, it's pretty unrealistic. Then again, if it's SciFi, why not.

Even the documented real cases where people have (allegedly) done surgery on themselves are for the most part somewhere in between "fucking heroic" and "unbelieveable".

I am not going to say it's all lies, but as someone who performed that kind of intervention (on others, in proper conditions) for a living 15 years ago, the idea of e.g. operating your own appendix seems like something that's, well let's just say not very likely to succeed unless you are some kind of superhuman (or credible, for that matter).

Taking Rogozov as an example. With nothing but local anaesthetic, your belly will be hard as rock as soon as you cut in, let alone touch the peritoneum (with muscle relaxant on the other hand side, good luck operating or breathing). Speaking of which... the sensation of touching, or cutting through your peritoneum (which is not under local anaesthetic) is a sensation worth having. Imagine being on a football field, and one of those meatbags taking a 20-meter charge, then kicking you in the crown jewels, as hard as he can. That's approximately the feeling of cutting in your peritoneum. Staying conscious and actually doing something that requires delicate manual work for an entire 20 minutes after that? Well, kudos on being a real tough guy, Mr. Rogozov. But I'm more inclined to believe this is a case of Korsakoff, no offense intended.
Also it's worth to note that local anaesthetics are ineffective in acidic environment such as... oh wait, an inflammated appendix. Then there's that thing about accidentially cutting open the caecum and suturing it. And yes, not only living to tell, but going to work again after only two weeks. I've seen 22 year olds spending a week struggling for their lives with peritonitis in the ICU after having one of those incidents. And that was in the early 2000s, consuming a 5-digit sum of care and antibiotics. This the kind of incident that, no matter how big your balls are, gives you cold sweat when you're an experienced surgeon. Let alone someone in 1960 who graduated a year earlier and is doing the operation on himself lying on his back. I mean, sure, when you're desperate and have few choices you probably try everything, but seriously... that's so fucking awesome superhuman that its factual accurracy is hard to believe.

But even if we assume the accounts are totally true and accurate -- the fact that one person did it and survived does not mean it is "doable" (in a sense that you can do it and expect to live). That's like saying Mrs. Vulović survived a fall from 10,000 meters (when in reality, she didn't fall at all), so it's doable to fall without parachute from 10,000 meters. Well, go ahead and try, no worries, you will always arrive on the ground.

As for the question's details:

clean stable environment and there is no risk of infection surgery near her spine [...] inserting a microchip connecting to the nerve connected to the brain

So basically, cut through the skin and open the liquid-filled spinal canal which rules out "no risk of infection". Then insert a foreign body that connects to a single nerve connected to the brain. Well, far down in the cauda that would probably even be doable (if this still counts as "connected to the brain", which is technically not the case, being the lower motoneuron) but further up the spine where you find the real "connected to brain" neurons, good luck cutting open the bundle and fiddling with it without accidentially pulling an axon or two (or ten) and provoking a jerk with devastating results.
All that over a monitor via remote manipulators (unless you are a Chinese acrobat of sorts?). Uh. Well sure, while at it, why not transplant your head onto a different body.

Unless you consider some very, very tough SciFi voodoo (AI assisted half-robotic remote manipulators with, I don't know... force fields, super awesome nanobots, engineered bacteria that keep the skin barrier but refuse to grow in spinal fluid, bacta-tanks that magically cure everything, whatever?) I don't think this can be done, realistically. Not with any chance of success anyway.

  • Thanks for injecting a bit of humour into the answer! – elemtilas Nov 28 at 2:08
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    Well, I guess that blows away my idea of cutting in from the front instead of the back. Unless "all the surgery tools" includes some sort of ventilator. – MarkHu Nov 28 at 4:39
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    @MarkHu -- Oh, she can certainly do spine surgery from the front! All she has to do is hold her own intestines out of the way for hours on end while she digs around in there. Or she can also pretend to be a thoracic surgeon and collapse her own lung while she digs around up above. – elemtilas Nov 28 at 10:08

It sounds like the most difficult part would be actually reaching around to to insert the microchip if it's behind her own back. With a local anaesthetic, she'd be able to make the incision and insert the chip. Obviously I can't speak to the extent of the futuristic technology, or how involved the surgery is, but a simple insertion certainly wouldn't be too hard.

You might be interested in reading about a Russian doctor called Leonid Rogozov. He was the lone physician on an Antarctic expedition when he developed appendicitis. With no other options he gave himself a local anaesthetic and performed a self-appendectomy.
In his case he did have assistance in the form of a driver and meteorologist, but he made a full recovery and resumed his duties about a week later.

Another related topic would be biohackers or grinders, which is a term for people who experiment with cybernetic implants upon themselves. An example would be inserting small silicon-coated magnets under the fingertips, which can give the person a primitive electromagnetic sense as the magnet twitches and pushes against the nerve endings in the presence of an electrical field.

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    Aaaand finally, same question I asked Cyn and L.Dutch. Do you have an example of anyone operating on their own back? Two mirrors, hands upside down, elbows bent in the wrong direction.... I find it very hard to believe. – JBH Nov 27 at 3:59
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    What mirrors? The question says "screen." – Cyn Nov 27 at 4:40
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    Off the top of my head, I don't know of anyone performing an operation on their own back. From the question I would assume she has a camera and a screen in front of her so she can watch what she's doing. Depending on where the chip has to go - middle of the back would be difficult, but back of the neck may be simpler. – Chromane Nov 27 at 6:05
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    Considering that she needs to connect the chip to the "nerve that connects to the brain" (the spinal cord), I don't think just shoving a chip into a random spot on her back will accomplish anything. The surgery to do what the OP is asking is extremely involved. If it were just a matter of injecting a remote chip, then she could do that into the subcutaneous fat on her abdomen somewhere and call it a day! – elemtilas Nov 28 at 2:03

So if the technology is futuristic then why should she perform surgery herself. Let the future create a smart surgical pod that is capable of doing any kind of surgery. Just select a surgery and proceed and the computer is smart enough to finish the surgery with perfection.

I remember the surgery scene from the film Prometheus.

Using current technology I agree with the answers saying that this is not possible.

My suggestion would be to have the chips specially made and equipped with nano-technology for this purpose though. All she has to do is make a cut near her spine and slide the chip in. It will automatically activate once inside and extend nano-fibres to penetrate the spine and connect itself.

This makes the required surgery much simpler and safer to the point that it becomes a lot more believable.

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