February 2012 (Part 1)
By Priscilla Huang, OREXer ’11-12
I’m really glad I went in to the OR today. This was my first time to have an opportunity to see an ophthalmology surgery, which I have been interested in for a while. The attending was Dr. Gill and the resident was Dr. Wilkes. The operation they performed was on a patient with thyroid eye disease, Grave’s disease. People with Grave’s disease have eyes that are bulged out, mostly due to the muscles behind the eyes swelling. This patient’s swelling was compressing her optic nerve, resulting in impaired vision. The operation performed was a bilateral orbital decompression, where they made incisions on the floor of the orbital, and chipped away pieces of the bone and removed some fat tissue. All of this helped create more room for the eye to expand, and improve vision. Upon the end of the surgery, they also inserted contact lenses into the patient’s eyes to help with the pain due to corneal abrasion from the surgery. Dr. Gill and Dr. Wilkes were both really nice, along with the intern too. They answered a lot of my questions and walked me through a lot of the procedure. Dr. Gill even taught me how to tie a square knot. After the surgery was done, the intern explained to me the different types of sutures and blades. I went with them to talk to the patient post-op, and it was great giving good news to a patient. She was able to see with both eyes, and move her eyes bilaterally and up and down.
The second surgery that I saw was performed by Dr. Harken and Dr. Wood (resident). The patient was diagnosed with renal failure, and had to have an atrial venous fistula put in to make dialysis possible. Upon getting into to the left arm, the veins were so weak and small that the doctors decided that they needed to graft it. Sewing the graft onto the veins and connecting it ot the artery was the most difficult part of the surgery. The needle they used to sew on the graft was incredibly tiny, and Dr. Wood had to be really careful not to tear any of the tissue. He accomplished this by pushing the needle straight through the wall of the vein perpendicularly, rather than twisting the needle up. After they secured the graft, which cost around $1000 for a little tiny piece of tubing, they created a path for the graft to go with the two preexisting incisions to the arm that was already made. This was pretty gross, as they just forced the object in subcutaneously.