Surgery through the eyes of a teenager - Day 2

The first day in the operating room may have been very interesting but the second day was a truly amazing experience for everybody, I believe. At 8 AM sharp, the entire medical staff gathered for the daily visit paid to all the patients. Here they analyzed the progress each of the patients made, which of them should undergo an operation and which of them should be discharged. After that, I attended the shift report, where the day's schedule was settled as well. I found out that Dr. Halpern was supposed to do a hybrid surgical intervention, combining a femoral artery bypass downwards, from the upper part of the thigh towards the upper quarter of the leg, with two stent insertions into the same artery but upwards. Dr. Halpern was responsible together with another colleague surgeon, for performing the bypass manoeuvre. After that, two other surgeons using the help of the two, would insert the two stents under live X-ray scanning on the patient, so that the surgeons would not be blindfolded when introducing the stents.

The patient's femoral artery, common iliac artery and also external iliac artery, had several atherosclerotic narrowings. Therefore, because of their position on basically the same long blood vessel, a radical decision was taken. Instead of undergoing multiple operations, all the problems were solved in only one big intervention. It basically implied the harvesting of the great saphenous vein and attaching it to the femoral artery by anastomosis (suturing in place) with the reversed portion of the saphenous vein previously harvested. Here, the surgeons realized that the saphenous vein that they had already connected, was too long. Therefore, they had to cut it into half and then remove another extra 2 cm, followed by sewing the two pieces together. This wasn't a major complication, but it cost the whole crew a precious quarter of an hour.

Then, under live X-ray scanning, the two 8 cm stents were introduced: first came the one that should have fit into the common iliac artery and only after that, the one for the external iliac artery. This went exactly as planned. The live X-ray scanning was the only moment that I couldn't attend due to the fact that the stock of lead coat aprons had been exhausted and obviously I could not take the risk of exposing myself to X-rays.

The final step was suturing the whole length and depth of the wound back into place. This was again done with some difficulties in the end because a 5 cm portion of the 50 cm long and 15 cm deep wound started bleeding from inside out, and all the suturing in the area had to be undone in order to stop the bleeding. In the end it turned out to be a complete success.

Although painfully tired, with a backache and a neck pain from sitting upright close to the surgeons, I felt extraordinarily, due to what I saw in those more than 8 hours of intense surgical intervention, an intervention done only once before that in Bucharest, also by Dr. Halpern.

If fascinated as I was when seeing the whole thing taking place in front of my eyes, then catch up with tomorrow's post! :-)