Surgery

As I am nearing the end of my surgical rotation I am reflecting on the last five and a half weeks. Surgery has been stressful! In the beginning I was incredibly nervous to be in the OR, to make a wrong move, to cut the suture too short or too long. With time I have come to realize if I am doing something wrong Dr. Lanflisi will correct me. In the middle of the rotation I felt I was studying the wrong material, unable to answer any questions and was having some self esteem issues. Now, after a conversation with my preceptor and clinical coordinator and a few more weeks of practice I feel more confident in surgery. Answering questions during a surgical procedure is still challenging for me, especially when the question is completely unrelated to the surgery, I often times clam up and have difficulty articulating anything. This is partly because there are usually 4-5 other people in the OR that are quiet, not interrupting the conversation Dr. Lanflisi and I are having, this increases the pressure a bit! I think my preceptor has realized this and after I struggle for a bit he will walk me through the thinking which allows me to come up with the answer.

I have enjoyed surgery, but I dont think it is where my home will be as a provider. I have enjoyed being a part of procedures and look forward to seeing how this will be incorporated into my next few rotations.

During this rotation I have seen mostly abdominal surgeries. I haven't seen any breast cases (odd because they make up 30% of Dr. Lanflisi's practice). Last week I assisted in a lung resection for a patient that had lung cancer. The lung is a truly astounding organ. For the procedure the anesthesiologist must intubate the patient in a manner that allows him to control each lung separately, this is done with a double lumen tube.

 The photo above shows the trachea and bronchus with the intubation tube in place. See how there are two balloons, the first one (at the top of the photo) keeps external air out of the patients lungs, this allows the ventilation machine to ventilate the lungs. The second balloon in the patients left bronchus (on the right side of the photo) allows the anesthesiologist to control the lungs separately. The photo below shows photos of the inside of the trachea and bronchus, the camera is inserted to confirm the intubation was done correctly. With this intubation the anesthesiologist can "drop" one lung during the surgery to allow the surgeon to operate on that lung without it being ventilated. 

The best part of the surgery was watching the remaining lobe of the left lung re-inflate at the end of the surgery. Watching all the little alveoli pop open as the air fills the lung, bathing in the oxygen they had been deprived of.