updated 4/18/2008 1:24:32 PM ET 2008-04-18T17:24:32

A Philippine hospital recommended penalties Friday, including possible dismissal, for three doctors and a nurse who conducted a rowdy operation on a patient that was videotaped and posted on YouTube.

The unidentified doctors and nurses from the central Philippine city of Cebu have been condemned by medical associations. Health Secretary Francisco Duque III has ordered an investigation.

The Vicente Sotto Memorial Medical Center in Cebu, where the operation to remove an object from the patient's rectum took place Jan. 3, recommended filing administrative cases against the four personnel, with penalties ranging from reprimands to dismissals for violating a code of conduct and ethical standards.

Medical center spokesman Dr. Emmanuel Gines said the government-run hospital can only recommend penalties to the Health Department and cannot take action on its own.

The nearly 3-minute video of a noisy operating room shows doctors and nurses laughing, giggling and cheering. At one point, a hand appears with a cell phone camera taking a close-up picture of the surgery.

As a doctor gingerly pulls out a 6-inch-long spray canister from the male patient's rectum, someone shouts, "Baby out!" amid loud cheers.

The doctor then removes the canister cap and sprays the contents toward a crowd of nurses and doctors viewing the procedure.

The 39-year-old patient, who remains unidentified, plans next week to file a complaint seeking the revocation of the licenses of those responsible and a civil suit for damages, his lawyer, Guiller Ceniza, said.

A hospital committee that investigated the incident reported that the successful operation may have prompted the cheers, but added they were "excessive and inappropriate and some acts were already in violation of some hospital policies," the hospital said in a statement.

Gines said a fourth doctor and three other nurses were "sternly warned," and a clinical instructor who supervised a group of nursing students from a local school who observed the operation was banned from the hospital.

He said a nursing student suspected of uploading the video to YouTube would be dealt with by the school.

Ceniza said his client was dismayed that the hospital did not impose penalties itself after its investigation.

"We are not satisfied with the proceedings conducted by the hospital," Ceniza said. "All the while we thought that they were conducting an administrative proceeding ... to impose sanctions but what turned out was merely a fact-finding inquiry."

The Cebu Medical Society condemned the incident "in the strongest possible terms." It said the medical staff were insensitive to the patient and violated his rights to privacy. "The actions are indefensible," it said.

The patient received surgery three days after a New Year's drinking spree and a "one-night stand" with a male partner, Ceniza told The Associated Press.

He said his client was too drunk to remember how the body spray canister ended up in his body.

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