25 February 2012

raise your hand if u ever assist a 12 hour operation!

it all started since early morning.
i was assigned to assist a planned procedure, where my surgeon plan to explore the pancreas of Mr. S, who had alleged MVA (motor vehicle accident) last month.
this is a pancreas. yes i know it doesn't actually smile like that. ehe~

8 am
After the GA (general anesthesia) doctor had review the patient and satisfied, the patient was brought to the OT (operation theater) room.

as a houseman, it is my job to fill up the white board with patient's name, type of surgery, diagnosis, surgeon in charge, GA doctors, scrub, circulating and GA nurses, and the MA (medical attendant) in charge.

then i must prepare patient's antibiotic and insert catheter

then only i scrub in and assist the surgeons
p.s. did you know how to differentiate ranks in OT?
as people didn't wear any name tags and wear mask, we wear different color of cap.
specialist: pink
nurse:  blue
doctor: green
sister: yellow 
student: white

8.45 am
operation started.
layers of abdomen were cut
did you know how many layers we had to cut? this is a common viva questions in surgical posting!
here's the answer :
1. Skin
2. Fascia (Camper's fascia, Scarpa's fascia)
3. Muscles (Rectus abdominis, External oblique muscle, Internal oblique muscle, Transverse abdominal muscle)
4. Fascia transversalis
5. Peritoneum

so we had breached the peritoneum shortly but there were adhesion everywhere!!
the mesenteries were glued to each other that no organs were visible.

click to get a better view of mesentery

after 4 hours, we had drained out all of the pus, but still we couldn't find the pancreas.
my surgeon decided to rest for a while so all of us went to the pantry to eat (except for the GA doctors lah. they were responsible to keep the patient sedated)

then the operation continue....
bloods were spurting..
tie, cut, tie cut...
and me was retracting the whole time with a deaver
this is a deaver. we use it to retract to get a better view of the inside of the abdomen

my leg hurts so bad, nurses had changed shifts, but we were still operating!
there was even times where i almost dozed off. hihi.
thankfully my surgeon didn't realize that.
it must be so damn tiring for him, right?

six hours had gone by when the surgeon said he can't repair the damage and decided to took out the spleen and half of the pancreas!
but it was so hard.
the spleen was stuck to the stomach, and also to the intestines.
i was amazed how my surgeon can be patience with those adhesion!
i lost count of how many pints of blood the GA doctors had tranfused.
at last we managed to took out the spleen and half of the pancreas

reminder: don't ever enter an operation without memorizing the anatomy!!!!!

the operation finish at 8pm.
but i still got jobs to do.
i must label the specimens, type up the procedure and findings in the computer, and filling up forms.
the operation had made me dizzy.
i never ever assist an op more than 3 hours.
phew, i can't even walk after standing up for more than 12 hours.
what a tiring day!!!!
but it is a great experience!

p.s. rasa macam hero pun ade. hihi

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