Two Surgeries I Didn't Know Were Surgeries

This week was a pretty short one for me, as I was only at the hospital on Monday and Tuesday. I was out of town for the rest of the week, so I wasn’t able to do as much as in previous weeks. I spent most of my time in the OR during those two days, but I did reach my goal of having at least 6 participants do timed anastomoses.

On the other hand, I watched some surgeries that I didn’t even know existed before Tuesday. The first case was on a person whose costal cartilage was protruding on the right side of his sternum. This excess cartilage was causing his chest to have an abnormal ridge to the left of his midline, since his left ribs were normal. To correct the problem, the surgeon, Dr. Greenfeld, had to cut through the patient’s chest until his costal cartilage was exposed. He pointed out to the rest of us in the room that the cartilage from separate ribs was overlapping and building up, only making the problem worse. Dr. Greenfeld pulled the cartilage out of the kid’s chest from about 4 different ribs and kept the pieces to the side. This left a gap in the patient’s chest, which the surgeon closed with some of the pieces of cartilage, so the cartilage would heal without the prominent ridge. The patient was in his late teens, so his ribs and his cartilage were very mature, making it much harder to pull the cartilage out. Another effect of the age is the amount of pain that the patient would have during the healing process of a few months. Any excision of the actual ribs would be more effective in removing the ridge, but would be more painful during recovery, so Dr. Greenfeld only took cartilage. Before completely closing the wound, the surgeon placed a drain in the kid’s chest to address any internal bleeding.

Another surgery (that some people may react more sensitively to) that I watched was on a baby that had just been born 2 hours earlier. The baby was tiny, and weighed less than 2 kilograms! His limbs had about the same girth as my thumb. In order to explain why he was in the operating room so early, here’s some background:

While in the womb, a human’s intestines are developed outside the fetus’s body, and when the fetus is big enough, the bowels fold into the abdominal cavity, following a specific pattern. In some cases, including this one, the bowels do not enter the abdominal cavity, and the baby is born with its bowels outside its body (not a pretty sight), although the ends are still connected to the stomach and the abdominal wall. However, this baby was too small to fit the bowels back in immediately, as most babies with this condition are. So the surgeon, Dr. Cox, placed the bowels in a special bag, in which the opening enters directly into the baby’s abdomen. Every day, the bag will be taped, and the bowels will slowly enter the baby’s abdominal cavity, until the opening can be closed surgically.