Wednesday, May 5, 2010
My first appendicectomy, skin-to-skin, an awesome experience...
I clean, draped, , palpated and made the mark with the forceps. Made a silent prayer.
With the scalpel in the right hand, the Lanz incision was made.
‘Deeper’, he said, ‘Do not be afraid’ he offered words of encouragement.
‘Proceed’ he said, ‘Don't worry, I am here, I will assist you’ he continued, holding on to the retractor. The rectus sheath gently cut. External oblique muscles, internal oblique muscles and transverse abdominalis muscle split respectively. The peritoneal layer gently lifted.
‘Now, look for the culprit’ I whisper to myself.
The small bowel stared at me. ‘No, not you’ my heart seemed to talk. The small intestines pushed aside gently with the swabstick.
Now there you are. The ceacum was smiling at me. I traced my way along the Teania Coli with the Babcock, and finally, the little mischievous appendix was there. No more running away. It was green in color, gangrenous, swollen.
‘See, this is a gangrenous appendix, impending perforation’ he commented.
Wow, I thought. ‘Don’t panic’ he said, reassuring.
‘Remember, the window of opportunity’ he said, guiding me.
‘Yes’ I nodded obediently. The artery was gently pushed through and mesoappendix clamped.
‘You know your hand-knots?’ he asked.
‘Yes’ I replied.
So, I tied them, tight and carefully.
Then the mesoappendix were snipped away from the appendix.
‘Finally, the most-awaited moment’ he said, as he hand me the kidney dish with the scalpel inside.
And this is when they called it APPENDICECTOMY. He said, smiling, as I gently cut the appendix. Clean.
The incision area was rechecked for bleeders. Dry swabbing done. Hemostasis secured.
Today, I did my first appendicectomy with Dr Mitesh, skin-to-skin.
'Appendicectomy of a gangrenous appendix in 50 minutes, with lessons in between. Not bad for a start,' he said.
And guess what??
It was the most awesome experience in my whole surgical posting and perhaps one of the notable best experience in housemanship.
I think I idolized him. Dr Mitesh.
You know, a teacher’s contribution never ends. It continues to shine in the works of their students.
To him, I may be just another houseman, eager to learn.
13/05/2010, 1500Hour – 1550Hour, OT6.
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