Sorry it's been so long since I posted anything... last week was full of end-of-rotation exams, packing, and traveling, so I didn't have much of a chance to write anything!
My last few days in Maine were uneventful but very nice. Monday and Tuesday were a lot of typical clinic visits (prenatal and annuals), and Wednesday was a light surgery day. However, I did get to see (and assist on) a ruptured ectopic pregnancy, which was pretty cool. I got to drive the camera and do some suturing!
Yesterday, I flew out to Kansas, where I am for my general surgery rotation. Today was my first day, and I think it went pretty well! My preceptor seems nice, but very intense. Everything she does is at lightning speed, and she wants everyone around her to be on the same wavelength. It was intimidating at first, but to be honest, it reminds me of how I'll be someday when I've been at a job for a while and am comfortable where I'm working. The rest of the staff at my new hospital is also very nice and patient with me, though they don't seem as eager to teach as the staff at my last hospital. Today was a long day - 11 hours - but luckily I recently bought compression socks so my legs and feet didn't get too sore!
Anyway, today I got to scrub in on four surgeries - two laparoscopic cholecystectomies, one laparoscopic colon resection, and one portacath insertion. I did sutures for all of them, and drove the camera for all of the laparoscopic procedures. I also helped to write post-op notes for all of these patients. This rotation is definitely different material from my last one - I really need to review my abdominal anatomy and disorders!
The surgeries were really cool! The colon resections were probably the craziest. They start out laparoscopically to separate the colon from the anterior abdominal wall, then open up to take out the big piece of colon they're removing. The way they reattach the remaining colon pieces together is pretty wild ... it's basically this big stapler that goes all the way around the bowel, then cuts it and staples it at the same time. They do that on both ends, and then somehow magically do one more between the two pieces and it joins back together as one tube. I'm still not entirely sure how that works ... something to watch on YouTube! But what I do know is that the patient ends up with a functional colon at the end of it, which is pretty amazing.
The cholecystectomies were also pretty cool, and pretty quick! Basically, after the four laparoscopic incisions are made, the gallbladder is just dissected away from the liver, the cystic artery and cystic duct are cut, and then the gallbladder is taken out in this little bag through one of the port holes! Then you just close the incisions. The portacath placement was interesting, and also really quick. It's for patients who are going to get chemo, and it's basically an easy way to get continuous access to a vein so the patient doesn't have to have an IV placed every time they go for treatment.
So, that's all for today! Tomorrow I'm seeing a robotic surgery of some kind, which will be a first for me, and Wednesday is a busy clinic day. Based on those facts alone, I'm thinking that the next time I write something will be Wednesday!
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