The Best Workout You Never Knew Existed…

I didn’t either…until I became an OB/GYN intern and did my GYN Onc rotation.

What is this secret work out and are sign ups more competitive than Soulcycle?


Unfortunately, there is no fancy name for this workout: Uterine Manipulation During Robotic Surgery.

What is uterine manipulation during robotic surgery?

I’m so glad you asked!

Basically, robotic surgery is a fancy form of laparoscopic (“minimally invasive”) surgery that uses 5 ports (more than the usual 3 ports in “straight stick” laparoscopy) to operate. One main advantage of the robot is that you get “360 degrees of freedom,” meaning that the arms of the robot have a wrist, which conventional laparoscopy does not. However, after doing some of the robotic training modules and feel like my wrist could no move as I wanted it to, I beg to differ with the da Vinci robot company.

I like to call this instrument

I like to call this instrument “The Swan,” because that’s exactly what it looks like when the use it to push down the bladder in a hysterectomy. It looks like a swan stroking its feathers. I want them to rename that step “The Swan Move.”

Left: Console Where You Sit To Control the Robot  Middle: The Robot Right: Screen To Watch Everything On

Left: Console Where You Sit To Control the Robot
Middle: The Robot
Right: Screen To Watch Everything On

The other fantastic thing about the robot is the “undraping.” To maintain sterility, the robot is draped with a gown before you dock it at the patient. Every time, I’m like “here’s the Wizard of Oz moment! Let’s meet that wizard!”

You get where I'm coming from, right?

You get where I’m coming from, right?

Fortunately, I have never said any of these things out loud in the OR.

Anyways, back to manipulating.

In GYN surgery, you have to put a device into the uterus to help move it around during surgery so the surgeons can see what they need to see. If you’re curious, my favorite manipulator is the V-care. I have no idea why they named it that either (joking).

Usually, manipulating is the interns job or some lucky person who hopefully ate his or her Wheaties. They always tell you that “you just don’t know – the uterine manipulator is the most important person in the surgery!” We know this is like telling us “there are no small parts” when you get the token Angel in the Christmas pageant and not Mary of the Angel of the Lord.

The reason this is such a fantastic work out is two fold.

First, the primary job on the uterine manipulator is to, at all times, be “pushing in as hard as you can!” This then becomes the world’s longest and most intense isometric exercise. These surgeries can go on for hours. You think pulsing for that last 10 counts is hard? Try three hours. And, just when you sort of stare off into space and realize that you arm may be sort of numb, the surgeon asks you “you’re pushing in as hard as you can, right?! Can you push in any harder?”

Second, to both manipulate and maintain surgical sterility around the robot, you have to also have a Cirque du Soleil-eqsue like contortionist ability. Don’t touch anything, keep you arm up and over one of the robot arms, and push in as hard as your can. Or else.

Apparently, people aren’t as attracted to OB/GYN as other fields with better lifestyles. So, I have an idea.

At the beginning of the year, I’m going to instagram all of the interns dominant arms. At the end of his or her (usually her — this is OB/GYN) gyn onc rotation, I will take an “after” instagram showing the fruits of their uterine manipulating efforts.

And, if they fail, I will go all Tony Perkis in Heavyweights on them.

That’s the real reason I do all of these work out classes. To keep up in the OR.

Actually, no, the reason I really do them is to carry more seltzer home from the grocery store. Every time I leave Fairway or Whole Foods and don’t feel completely weighed down by seltzer, I think “one more 12 pack — you could’ve had that.”

Speaking of the grocery store, I have a confession to make.

I bought non-organic apples. They just looked better.

When I die of someone weird progressive neurological disease, remind me of this choice since every time you read “what foods to buy organic,” apples are at the top.

Ok, I’m bored of this post. You probably are, too.

One final thought: Pregnancy isn’t fair. People who are dying to be pregnant can’t. Those who don’t want to be are. Those people who are really sick with horrible medical problems can sometimes get pregnant but then it makes the disease worse (well, depending on what it is).  And then you have the partnerless who, in the age of assisted reproductive technologies, have a whole new paradigm of parenthood to consider – donor egg/donor sperm/single parenthood. And, then you also can’t eat unpasteurized cheese or sushi for 40+ weeks.

So, yeah, hats off to pregnant women.

It is far past my bedtime.

Night night.

Until next time.

Daily Coffee Tally: 1.5 (WHO AM I?!)

3 thoughts on “The Best Workout You Never Knew Existed…

  1. When holding a patient’s leg during a bazillion hour burn care (so many staples, sometimes), I’m convinced it’s a better workout than class could offer me. Certainly want a Camelback under those isolation gowns…

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