May 29, 2015
Written by Vickie Nguyen (class of 2014-2015)
The first surgery I attended was performed by Dr. O’Shea, it was an ORIF of a tibia. The patient, fell out of his truck, and as a result broke his shin bone. He was already in a cast prior to the surgery, upon removal of the cast, I noticed that his leg was still very swollen. Later on in the surgery, I asked Dr. Krosin if the patient could heal well without the surgery. He replied that the patient definitely could, but this surgery speeds up the healing process and in fact, later after the surgery the patient would be walking!
The surgical preparation was unlike any of the other one’s I’ve seen before. The patient’s big toe was tied up with a white cloth, and this cloth was then later attached to what looked like an IV pole! It looked a little funny to see just his toe tied up so that his leg made a right triangle with the IV pole. I guess this way it would be easier to prep the patient’s entire leg from mid-thigh to in between his toes.
The surgery plan was to place a rod inside the tibia, that’s right, inside the tibia. Dr. Krosin explained to me that bones are hollow (for the most part), and with this surgery, they would be placing a rod inside the tibia. After that, Dr. O’Shea would then stabilize this rod with at least 4 screws to avoid torque when the patient walks. In essence, this rod would do a better job than a cast at stabilizing the broken bone and promote a faster healing process. The rod is made out of titanium, one of the metals that most human bodies don’t reject, so it will not have to be removed in the future! (but if he wants to, he can opt for another surgery to remove it, according to the x-ray tech, Analecia. I wonder what that surgery would look like!)
Surgery began with an incision above the knee, and from there, Dr. O’Shea went to work. Not only was it one of the most vigorous surgeries to watch, it used the scariest tools, and probably the most x-ray imaging. Keep in mind that in this surgery, only a few incisions were made, and everything that Dr. O’Shea was doing was very dependent on the x-ray technician. As a matter of fact, if we were take it back to a time without the technology of x-ray, we can say that Dr. O’Shea performed this surgery blindly. Basically, every centimeter in which he pushed the rod into the tibia, a picture was taken to see precisely where it was, and based solely on that picture, Dr. O’Shea was able to place a rod directly into the center of the patient’s tibia. I find it absolutely amazing what technology can do for the medical field.
The surgery lasted about 3 hours, I think that a majority of the time in the OR was spent taking x-rays to ensure that the rod would be placed in the proper alignment. Dr. O’Shea finished placing the rod in and took a little less time placing four screws into the patient’s leg. On a side note, Dr. Krosin also mentioned that it actually costs $200 per screw used in this surgery. So the amount of screws used really depends on both the surgeon and the cost!
After this surgery I attended a short procedure with Dr. MacDonald. I was invited in by the anesthetist, Dr. Reddy. This surgery called: laryngoscopy micro with excision of laryngeal mass. The patient came in complaining about hoarseness, and they found that he had a polyp growing on his vocal chords. Dr. MacDonald explained that the reason for hoarseness is because the polyp is heavy, and causes strain on the vocal cords. Before he began the procedure, he invited me to take a look at the patient’s throat through a microscope. The mass was hardly noticeable, and it looked like a small round fleshy part of the throat. Dr. MacDonald began the process of exposing the mass which took no more than five minutes. He then asked me to take another look through the microscope. This time the throat was bloody, and I could now see how large the mass actually was. Another ten minutes of surgical procedure and Dr. MacDonald finished! He removed the mass and placed it in a cup to be sent down to pathology and placed a piece of gauze to stop the bleeding. Once more, he allowed me to take a look through the microscope to see the finishing results.
This particular OREX day, I got to see two surgeries on both a micro and a macro level. That’s the beauty of surgery, whether big or small, this aspect of medicine makes a huge difference in a person’s life. Today it was inserting titanium into someone so he could hurry up and get back on his feet (literally) and for the other person it was removing a small piece of flesh so that they could speak with their own voice again.