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.

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.

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.

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!

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.

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!

The dura.

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.

Stitches and glue.

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.

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.

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.

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.

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.