Agraphia Medical Tragicomedy

19Dec/050

Zac’s First Surgery

Raise your hand if you've performed a pelvic exam today. Scrubbed in on surgery? Ok, now raise your hand if you've felt someone's aorta pulsing in between your fingers in someone's peritoneal cavity. No? How about cut a suture?

How about CLAMP, STAPLE, AND SEVER SOMEONE'S SMALL BOWEL? Read on, dear readers.

I went in to see surgery today with my dad, who was assisting another doctor here in town with an ovarian tumor debulking. The woman's tumor had metastasized all over her abdominal cavity, so the first order of business was to cut off her greater omentum, which is a loose apron of fatty tissue that hangs from your stomach. Her omentum was chock full of fibrous, nasty tumor. Unfortunately, the omentum also carries the blood supply to the stomach, so cutting it away involved meticulously clamping every single tiny artery, cutting them, and then tying them off. The surgery took the greater part of 3 1/2 hours.

Anyhow, the attending was really awesome about letting me be around. First off, he had me do a pelvic on the woman so I could feel the cancer through the vaginal wall, and then as he was performing the surgery, talked me through basically everything he was doing- all the anatomy, the techniques, everything. By far and away the coolest part was when he used a tool that allows you to staple two 4" lines next to each other while simultaneously cutting down the middle. Essentially, you put a loop of small intestine in it, zip the tool along, and you are left with two severed, perfectly closed ends of intestine.

The tool is pretty easy to use though... so once he had gotten it into place he let me grab the handle and zip it through the bowel. Maybe I exaggerated before about how much I actually did (probably best, since it was surgery on a live person, and I am, in fact, just a 1st year medical student). But, my hands didn't shake at all.

It was pretty much amazing- and at the same time, it got really boring at points. Once he had sutured the 12th small vessel leading from the stomach (and was still only halfway to cutting off the omentum) I was ready for something new. There's only so many vessels you can watch ligated and still be interested. 'Course, watching the small bowel part was amazing, and I wasn't the one doing the work... that could be a big part of it. They have to do some really nifty tricks to get the small intestine hooked back up to the large intestine after a resection.

Surgery may still be in the cards for me- seeing all the anatomy I had just learned in such vibrant color was incredible... I really enjoyed it. Of course, it'd be more fun if I were the one holding the scalpel :-) Some day, perhaps.

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