February 12, 2014

Surgery update #1

So I started my GI surgery rotation on Monday at UPMC Presby/Montefiore. My very first day I was lucky enough to scrub in on a NINE HOUR surgery and watch a complete gastrectomy (removal of stomach) for a guy that has gastric cancer running in his family. He doesn't have it, but opted for a prophylactic surgery, as he has a genetic mutation predisposing him to it. So that was cool, but very very long. My back and feet were miserable! I did get to meet my attending and a few residents and med students, so that was nice.

Yesterday I arrived at 5:30AM for rounds with the GI surgery team. Then I scrubbed in on a TEN HOUR whipple procedure (pancreaticoduodenectomy)! This surgery involves taking out part of the stomach, duodenum (part of small intestines), and pancreas, and complete removal of the gallbladder and common bile duct. Then they reattach all of this stuff and I won't get into the details of that…But the reason for the surgery was because this woman had a duodenal adenoma that had to be removed. It was a cool surgery and I got to help out…and by help out, I mean pass instruments to the surgeons.

Today was an easy day. Rounds at 5:30AM, then 2 hour loop ileostomy performed laparoscopically. This procedure involves taking the ileum (part of the small intestines) and looping it out of the abdomen. Then a small incision is cut into the ileum so that stool/etc can be drained at this point instead of passing into the colon. The reason the woman had this done was because she has perianal cancer, which is not very common. After surgery I spent some time researching different surgeries and going through the patient list. Then the surgery team met for lunch (junior resident, intern, med students, PA and myself), which was nice. I really like the team I'm working with so far. Afterwards I made my way down to the outpatient clinic for a few hours. Then I got to go home 3 hours early! First time in a couple days that I've really been able to see the sun!

So far surgery is both fun and boring and tiring and interesting. But I think as I get used to it and become more familiar with the procedures and with my team then I'll like it more. We'll see! Back to the hospital at 5AM tomorrow. Hopefully I'll get to scrub in on a cool surgery!

OR time = 21hrs

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