Hey Guys! So this last week, I’ve spent a lot of time in the operating room, but I’ve also been learning a lot outside the OR. Since I’m conducting research on sutures, Dr. Vegunta and his PAs have been giving me a crash course on how to actually use them.

            First, I learned how to tie knots with sutures, which can become particularly frustrating, but after a while, tying knots almost becomes second nature. And it’s very necessary that knot-tying is easy for a surgeon. For example, Dr. Vegunta and his colleague, Dr. Greenfeld, had to tie sutures in the thoracic cavity while the lungs were expanding and contracting, while the heart was beating, and while there was water and blood coating their gloves. They had been working on the same patient for about 6 hours. Speaking of working in undesirable conditions, Dr. Vegunta had to return to the OR in the middle of the night to perform on a patient who needed immediate attention, and then he came back in the morning as he does every day. Surgeons can have very tiresome jobs, to say the least.

            Anyways, after learning how to tie knots, I started learning how to suture with needles. To close an incision, you need forceps, a needle holder, and, of course, a suture with a needle at the end. Here are some pictures of the needle holder and the suture’s needle:

As you can see, there are notches on the handle, so the user can click the needle holder into place, and it will hold the suture’s needle until the user pulls it back open. The suture I used in this picture was not barbed, as I was practicing knots as well, and barbed sutures do not require knows. However, my research is focused on laparoscopic techniques, so suturing will be fairly different when performing anastomoses in the laparoscopic simulators. For instance, the tools are much longer, since they are designed to be inserted into the abdomen, and you must look at a screen to see what you are working on. Here’s what the simulator and its tools look like:

If you've got any questions, feel free to leave them in the comments!

Hi Followers!

As a preface, Cardon Children’s Medical Center is split into two different buildings: an office building and a hospital. The office building is where the clinics and the doctors’ offices are located, and the hospital building, as you can guess, is where the operation rooms and the patients being treated are. Once I received my observer’s badge, I was able to start going to the hospital with Dr. Vegunta, my on-site advisor, and his assistant, Jeanne. Dr. Vegunta took me to watch three different surgeries, the first of which was performed to correct a hernia. The second case was an esophagoscopic balloon dilation of esophageal anastomotic stricture with X-ray, which means the surgeon slid a long tube with a camera at the end down the patient’s throat, and then expanded a balloon through the tube to increase the diameter of the esophagus. The esophagus was initially interrupted, but the two segments had been joined in a prior surgery. We had to wear lead aprons during this, because the surgeon would take an X-Ray of the patient occasionally to see the positions of the tube and the balloon in the patient’s body. In the third surgery, which was the longest of the three, Dr. Vegunta removed an abnormal growth in a patient’s leg. All of the surgeries were really interesting to watch, and they showed how much of a team effort a surgery is. There are at least 5 people at work in the operating room, or the OR, during a surgery at all times.

One interesting thing I learned while in the OR is that patients are given 3 different types of anesthesia: one to keep them asleep, one to block any pain signals caused by the surgery, and one to “paralyze” the patient, which simply relaxes all of their muscles. Because of this last anesthesia, patients actually can’t control their eyelids while under anesthesia, so the doctors place tape over their eyes to keep them closed to prevent injury. 

Hey followers!

The first few days of my senior research project have been really interesting. My advisor has rented a laparoscopic simulator and the tools to work in it. The simulator is basically a box with a camera on the inside that feeds video to a monitor that is built into the lid. There are seven holes on the front and sides of the box that the user pushes the shafts of the tools through. By watching the screen, the user is able to see the material that he or she is working on. In addition, my advisor has received an assortment of sutures, some barbed and some smooth. There are dozens of small white boxes, each of which contains sutures of a specific width, length, needle, and texture.

On Tuesday, we met with a representative from Ethicon, a section of Johnson & Johnson that specializes in biomedical devices, and she showed us the types of sutures that the company is working on. She also showed us a device with a plastic handle, a trigger, and a long metal rod with what looked like an open beak at the end. She placed a sheet of plastic in the “mouth” and pulled the trigger. The mouth snapped shut, clamping the sheet in place, and the device made a whirring sound for a few seconds. When the mouth opened again, there was an incision in the plastic, with tiny staples lined around the cut. The representative said these are the kinds of devices that Ethicon makes every year. The kind of work that Ethicon is doing is just what I want to do after college, so it’s a great opportunity to get to work with some of their products.