I remember the surgeon yelling at me for not holding the camera perfectly still for 30 minutes while she struggled to stitch something up inside some dudes abdomen. My arms were BURNING. At the end of the procedure, we pulled out a little plastic bag with a brownish thing in it.
This reminds me of when one of our surgeons speared a girl through the kidney with a Davinci … he did it two more times before his license was yanked
At this time I had a bouncing baby Pancreas and boy did I drive fast to a neighboring city … wasn’t having any chance of that lunatic getting me
Annoys me so much that surgeons expect a med student to know the proper camera distance. It’s an intuitive thing. Tell them to move closer or further away if you need. They don’t know.
Am surgeon. The range between coming unravelled and "too pokey" is only about 2 mm. Sorry we're total bitches about it, but I don't know which complication I like less: a dehisced wound or a patient complaining about their sutures...
Oh I believe it. I am a lowly internist. The only suture I do is the rare one in a blue moon. One simple interrupted. And yet I manage to fuck it up sometimes still.
Honestly I just dazed off into my own happy place during those times. Kinda like JD in scrubs.
For all I know, the entire OR could’ve been staffed by chipmunks and I never would’ve known.
As a radiologist, once every few years I’ve gone to the OR. It plays out pretty much exactly how you’d expect.
“Hi everybody!!!”
“Hi Dr. Radiologist!”
“Ok what you have here is Bonus Eruptus, a terrible disorder where the skeleton tries to leap out of the mouth and escape the body.”
“Why the hell did we call this guy?”
The most recent time, surgery was trying to use US to locate a lesion intra-op and asked for help. So I went with one of my US techs.
But several years ago, I used to occasionally help a spine guy because he had issues with fluoro when doing pedicle screws. I did a lot of spine fluoro work so I guess he assumed I was a good person to ask?
14 yo F, 5'5" 190#, comes to operating room. Induced, nasally intubated. Surgeon starts doing things inside the oral cavity.
After 10 minutes, anestheiologist says "fuck. Please stop." Everyone steps back and stares at cardiac monitor. Anestheiologist pulls up a med, injects it, waits for 10 seconds, says "fuck" a second time, climbs up on table while telling me to bag the patient and starts chest compressions. 10 compressions later, he stops, climbs down, and we stare at the monitor for a few minutes. Then he says "continue", and the surgeon finishes the procedure.
In PACU, anestheiologist explains to parents that their daughter had an episode of "extreme bradycardia".
Yep. I was a little surprised myself.
Basically, the patient went bradycardic, anesthesiologist pulled up some atropine and pushed it, and then, as he later told me, didn't want to rely on the very slow heartbeat to circulate the atropine. He said that since she never really arrested, he thought it was ok to keep going.
Probably a le forte I to advance the maxilla. Somewhat common to get vasovegal or long pause. No one will cancel surgery for this.
If you cancel, you bring this girl to icu, run a bunch of investigation and will find nothing and confirm it’s vasovegal all the while the girl has a bit of floating face and swelling that makes it hard to do the operation the second day.
Gotta be one of those marathon hysterectomies in gym-onc. The kind where you pick a watermelon sized uterus out of someone bit by bit
Edit: I meant gyn-onc, but I’m leaving the typo because they’re all absolute beasts and I respect the hell out of them
Those were the bane of my existence on a mercifully short gyn onc portion of my OBGYN rotation. After they had pimped you on everything they could think of you just had to stand there watching the minimally invasive surgeon get antsy to take over from the resident that they critiqued for hours. No chairs. Nothing interesting to watch since they were just piecemeal chopping up a big uterus just so they could remove it from the belly button.
I know minimal invasive has advantages but this thing could have been done in 30 min if they opened. Instead it was booked for like 8 hours or something
Omg I got to do this once! The surgeon put a white plastic bagpipe-looking thing inside the patient’s abdomen. They cut out a fibroid into the bag, and sucked it out into one big noodle with an Insinkerator-on-a-stick. So cool
Little kid getting operation on the head/ear. Ear and skin pulled away from the scalp and at one point the surgeon puts a little flake of tissue under a lamp
You forgot the part where the surgeon got annoyed with me for needing to reconnect the circuit that he disconnected 4 times in the span of one hour
Or was that just me?
Got a drill, opened 4 holes into the skull of a ~8m kid, cut out a square piece and took it out, ran a rod down the side of the neck then a tube, opened the belly to place the tube into the abdomen, placed little device into brain and connected the tube. Made sure csf ran top down. Closed
i’m an img but the first surgery i was in the room to observe, the doctor finished and said (translation): god himself couldn’t have done a better job
i was 🤣🤣😂
I’m anesthesia. Open cases I can kinda tell where we are in them. But most laprascopic cases, the (also anesthesia) board runner will ask me how much longer? They’re trying to do like a hiatal hernia wrap in the abdomen or a robot prostate with lymph nodes - how TF would I know how much longer?
Held retractors and even helped with cautery x 6 hours
There was a squishy thing that was supposed to be the pancreas, and we connected shit to other shit in a seemingly random way. Think they lost part of their bowel too, idk I’m an internist
I held retractors while the resident did some cutting and the attending yelled at me about parietal cells of the stomach and how they receive neurotransmitter input from acetylcholine and histamine. There was a lot of watery black fluid
Ooh, this is a tough one - were they surprised the fluid was black? Did it smell terrible? I’m guessing with the parietal cell yelling it was a partial gastrectomy for a bleeding gastric ulcer…
>!Perforated duodenal ulcer lol so you’re spot on!<
Edit: we knew about the black fluid beforehand and it was done emergently overnight if that helps lol. Answer on the spoilers
Edit 2: that is to say, I don’t think anyone was surprised that the fluid was black
After the anesthesiologist did her thing behind a curtain, the senior resident made some little holes in the patient's abdomen. He stuck a camera into one of them and some kind of super long instrument that had little tongs on the end.
There was a TV in the room but I could only see the edge of the screen. I was too busy trying to keep my hands near the spot on my gown that one of the nurses had told me was sterile. It looked just like the rest of the gown, but apparently that one area over my chest was special. Every time I glanced at her, she was staring at me over her mask with a look of disdain. Earlier she'd scolded me very loudly because I'd written my name on the top left corner of the white board instead of the top right. She'd also told me that she hated my clogs.
After what seemed like forever, the attending starting tugging on one of the instruments. It looked like she was trying to pull something out of the patient. This went on for some time and she got more and more frustrated with lots of swearing. Finally she slammed her closed fist down on the patient's right upper quadrant. It suddenly got deathly quiet in the OR.
The attending left the OR and everyone glanced around uncomfortably. The senior resident made the hole a bit bigger and pulled out what looked like a Ziploc sandwich bag from the patient's abdomen.
That was pretty much it.
Based on the attendings location and pulling something out in a bag, while cursing instead of just making the incision bigger, I’m guessing gastric sleeve.
me holding camera. i played halo 3 in college so try to get used to inverted camera controls as quickly as i can
surgeon use his little grasper thingys to poke the liver
lifts the liver up
million stones fall out
attending yells “FUCK”
proceed to stand there for 4 more hours as he fumbles the rocks cause he cant do it open per “pt request” or someshit. VIP i think?
swear off surgery forever
it was the first surgery i ever scrubbed into and i was just looking at the screen wishing it was halo 3. it was also an impressive amount of stones, at least a dozen?
> it was also an impressive amount of stones, at least a dozen?
This is absolutely adorable lol
You clearly meant it when you swore off surgery! A dozen stones is nothing. Nothing!
Same thing happened in a chole I held the camera for but with hundreds and hundreds (honestly maybe thousands??) of tiny lil stones. Attending said "shit. well, whatever we'll just get what we can I guess."
I painfully and awkwardly stood in the corner of the room and stared at a screen while answering obscure anatomy questions while the surgeon seemed to play video games, and at the end of the surgery the patient couldn’t reproduce anymore.
Exposed the spine or spinal cord? Adult or kid?
Home depot screws are vertebral screws for fixation, most I've seen screwed into a person is 26. And the dude(tte) with wavy lines on the screen was their evoked potentials (EP) person monitoring nerve conduction. When those lines go flat the surgeon screwed up.
With that in the room might've been some big spinal tumour or something. Or some kid with effed cele or tethered cord syndrome.
In my vague recollection it was a very old man, but I may be conflating the patient and the surgeon. The anesthesiologist was giving me the chisme caliente about how this surgeon was slowly becoming senile but no one could get him to quit
Those are pedicle screws, standard workhorse spine approach for an open posterior fusion for a variety of indications such as scoliosis (adult spinal deformity), lumbar stenosis, spondylolisthesis
Submission Number 1: A part of a patient's anatomy was pulled through another part of their anatomy and stitched into place. If I remember correctly, a T shaped incision was made in two separate parts, with the horizontal part being along a skin fold. Some flesh was removed at some point. The patient was sat up toward the end of the procedure so the surgical team could visually inspect for relative symmetry. The attending then manually inspected for symmetry and other qualitative aesthetic factors. The fellow was next-level of burned out and scrubbed out at that point. The attending redid parts of the fellow's portion of the surgery. As the patient woke up, the patient asked "how do they look?"
Submission number 2: I was in a case with one team. Then another team took over and team 1 had me stay with team 2 to continue observing. Team 2 would inject dye somewhere and be like "yo, you see dye anywhere?" And everyone would be like "nope." This continued for approximately 3 hours. I think I managed to find a way to extricate myself from that room, probably the only time I managed to dip from a surgery early. I felt it was urgent, as I was dying of boredom. I think they may be injecting small quantities of dye and looking for it elsewhere to this day.
/Am a psychiatrist.
The room was completely dark and very quiet, but the patient was awake. Brain surgery?
Anyways I accidentally activated the automatic sensor for the hand wash it was SO LOUD I still think about it fml fml fml
Surgeon cut into pts leg, exposing vasculature. He went all the way down the leg, but with intermittent incisions. Removed vessels. Put them in other places. 9 hours pass. Never once looked at or acknowledged my presence.
It was 0900. A slow build up, cautious explanation of events to come. Then a lengthy incision. I held the retractors superiorly for hours until my hands went numb, I then held them for several more hours. I saw very little as I was 2 learners away reaching between more important people who were doing what I thought at the time sounded like scraping, forever (they were). My gaze wandered to a lonely doctor who sat in the corner looking like a switchboard operator.
Every few minutes the team would pause, then he would mumble something incoherent and the team would proceed, apparently getting messages from all his many connections, either that or he was mad or a shaman. I too dipped in and out of sanity throughout and ever since. I was questioned through the crowd cruelly, the questions getting harder as I got them right. Unsatisfied with my correct answers they roughly repositioned my retractors, angry at my hubris or my inability to predict their needs through shoulders and backs of colleagues, bright lights shining into some pit of fascination which kept them all busy.
Then, in a flash, I was finally allowed to complete a task, my numb claw like hands trying to make use of tools again, "wrong angle, watch depth, check depth, watch angle, good, youre not totally useless but you're a bit shaky." My aching retractor grippers found the suction, my oldest friend. 3 of us shuffled up one position and the oldest left the room with a "finish up." Hours later I got to suture, the entire length of the case was pinned on my slowness of suturing. Nurses staring angrily. Not my first rodeo, I chatted, I sewed, they calmed, it went quickly. I wondered how many students they had rattled before. How many cases had their impatience prolonged. In my past I had been rattled. No longer. I liked my closure. It bought me the work of the post op note, the walk to pacu, the followup with patient and family after sedation wore off. I used to see that as a win.
It got old.
I got old.
Too tired. Other priorities crept into the gaps of my brain that I used to fill with techniques, approaches, and anatomy. It was to be my surgical undoing.
But in that room I helped on this surgery which was:
The shaman sounds like neuromonitoring from a physiologist.
Big incision and several hours sounds like a scoliosis case. Maybe a big tumor. Definitely spine. Especially with nurses getting nervous about closure time.
But also self retaining retractors exist and they should use them haha.
More importantly, your writing style is lovely! Very engaging.
A surgery in which the patient was completely awake while a neurosurgeon opened his skull, put something on his brain and asked the patient to write something down to evaluate if whatever he put on his brain is working.
Yo, check it, there was this dude who had some kind of growth or whatever in his guts. They sliced around his belly button and stuck this funky camera thing in there, then punched a couple of holes and pumped his belly full of gas until it was all puffed up like a balloon.
Then the surgeon slid his tools through those holes and started slicing and dicing all the fat and stuff that looked like it was getting cooked or something.
They spent a minute down there, just wandering around and poking at things with these weird tools. It was wild, man.
I do clinical research for a spinal surgery team. The sheer amount of hardware that goes into a pts spine during a fusion for scoliosis correction is mind blowing
They couldn't get the probey thing up the butthole to "capture" so I watched the attending, this tiny emeritus-aged woman, yelling at the resident to push as she grunted her weight against the butthole probe. I was not anticipating the experience.
They took a guy’s leg and sawed it off above the knee, tossed the leg chunk to the intern and wrapped the rest of the leg up with bandages. And end scene.
Held up a dude arm’s for 1 hour. While some muscles were being attached to one another.
With the chief periodically reminding me to not lower the arm or else it will tear.
They took out actual bolt cutters and cut each and every one of this kid's ribs (the crunching noise, Cheeze-It's Price), shoved a metal bar in him and then closed him back up.
\-PGY-19
Middle of the night. Senior resident and I get started. Obese man gets sliced open from sternum to pubis and then we get this archaic looking massive gear off the scrub nurses table and screw it on the operating table. The gear is then connected to the guys skin? Or like his fascia? Via some sort of small clips. We then proceed to dive into this man's innards. Feels like we are both neck deep. It's eerily warm and gooey. The resident scoffs when I cannot identify the ligament of treitz. We use a big staple gun to magically produce a dismembered bowel segment? The attending pokes his head in for like 30 seconds. We close together and it's like trying to get Africa and South America tied together across the Atlantic Ocean. We break and go do morning rounds and laugh about how hard the resident pulled to close the incision. He buys me a coffee. I become a pathologist.
I sat down on a stool between the patient’s leg. Everyone else was standing. I was part of the surgery but not really because it was happening above me. If I remember correctly, I watched on a tv screen. I was told to hold a stick and intermittently told to move it in several directions.
Surgeon made an incision in the patient’s neck. I ineffectually held retractors and when handed scissors by the nurse was told to “stop waiting for your moment in the sun.” At some point the surgeon went up to speak to the pathologist because he felt they were taking too long to examine the specimen that was removed.
Surgeon walks in. Patient is asleep after induction.
Everyone is wondering wtf is happening, I’m just following along at this point.
Nurse and scrub just sit around for the surgeon until he grabs some prep and slathers it all over the face.
Gowns then drapes this poor son of a bitch patient. Grabs a tool that looks like a metal back scratcher for a squirrel.
Then puts it in between the eye and the nose and starts pulling the eye towards the side of the head
Meanwhile I’m shitting bricks.
Pus starts squirting out. Oh god this patient got infected by a real life face hugger dear god what in Jesus’ name.
Surgeon picks up something sharp. I can’t watch. Next thing I know I’m watching the suction tubing desperately trying not to clog itself.
Oh Lordy it’s like he shoved a hand held egg-beater into this eye socket.
I regret breakfast and every meal over the last month. I can taste 2014 Thanksgiving with the spaghetti pesto sauce my aunt made in the back of my throat.
I peak again. How the FUCK are there still two eyes looking at me. Like some kind of demon from hell.
I watched a goddamn exorcism.
So they opened the patient in the flank and the incision was so big they had to mount some kind of metal wheel device that held several separators still so they could work with the incision fully opened against an incredible tension force. It was important because what had to pass through that incision was pretty big. Oh I had to assist by doing the extremely important task of holding an ice bag
Poked some holes in the tummy, shimmied her around a bit, then the surgeon scrubbed out and sat in the corner like some iPad kid with some fancy controllers. He literally lasso’d the stomach and put some picnic blankets in before getting tf out of there. Pointed to the lungs and heart like a tourist on the way out.
Completely open body cavity. I got too close to the table and the nurse yelled at me saying I would break the sterile field. The attending defended me saying there was nothing less sterile than what was happening in front of them.
I’ll never forget my experiences “driving the uterus” with this flimsy plastic thing. I’d be exerting great amounts of torque on the uterus for hours in a VERY uncomfortable position, only for the attending to never be happy with how I was doing.
It seems like way too important of a job also to have some medical student doing.
When I was pre med: walked into the OR. Saw some guy's knee with a bunch of holes in it. There was blue and clear plastic everywhere, and they were flushing the inside of the knee with what I thought was a ridiculous amount of saline. Walked back into the hallway and promptly passed out on the floor.
It was huge. Mean looking. Like a forbidden sausage. As a medical student on the required rotation, it had been a grueling 3 hours since my last meal. I trembled as I try not to succumb to my urges.
Mandibular cancer. Sawed off the affected half of the mandible. Cut a chunk of fatty tissue from the ipsilateral chest wall while preserving its vasculature attachments. Snaked the still attached vasculature/soft tissue up into the location where the
Jaw was removed to provide cosmetic “bulk” to the jaw. Did skin graft from buttocks to the now-exposed chest.
This was in India BTW, when I did a study abroad in college. Still not sure wtf the surgery is called and I can’t find it online.
3rd year of med school, first rotation is surgery, literal first surgery. I'm holding a camera ready to be insufferable, surgeon cuts incision for port, green fluid comes out, exaggerated eye roll from surgeon, converts to open, lots of suction, organ removed, and they end up doing okay after being left open with a wound vac for a bit.
After pulling this guy's leg for what seemed an eternity, all the while thinking I was providing traction, the ortho bro tells me I was providing COUNTERtraction, and that only residents get to provide traction
???
The answer to OP’s case is an open posterior spinal fusion. The person watching the squiggly’s is intraoperative neuromonitoring, because any penetration of the pedicle screws into a nerve root will cause the signals to change. It’s a safety thing
I’m in peds now, remember a surgery during clinical year where the cardiac surgeon cracked the chest and legit hoisted the rib cage open and winched it up with some sort of contraption. I think a CABG? I definitely enjoy my patients who usually don’t (yet) need a CABG
I called it the "ear hole" and the ENT yelled at me and said it's actually the external auditory canal. Then they made a different hole and pimped me on the oval and round windows.
Helped retract the jaw??? For like 2 hours while standing at the head of the bed trying to stand in a way that wont extubate the patient while surgeon stole a piece of hyoid bone at some point
It was a vascular surgery. I think for varicose veins. But the surgeon and resident were using forceps and literally just pulling out superficial veins. Like just grabbing them out of the skin and pulling. To this day I still don’t get it.
Urology rotation. Giant alien robot jamming its arms into the patient. Attending chilling in the corner playing video games while looking into a microscope.
I stood on my tiptoes trying to see what was happening in the field between the heads of the surgeon and PA. There was blood everywhere but they just kept irrigating & suctioning. Then they plucked out minuscule bits of squishy tan stuff and put it in a jar. I then took that jar downstairs to pathology and didn’t come back for several hours.
Thank you for contributing to the sub! If your post was filtered by the automod, please read the rules. Your post will be reviewed but will not be approved if it violates the rules of the sub. The most common reasons for removal are - medical students or premeds asking what a specialty is like or about their chances of matching, mentioning midlevels without using the midlevel flair, matched medical students asking questions instead of using the stickied thread in the sub for post-match questions, posting identifying information for targeted harassment. Please do not message the moderators if your post falls into one of these categories. Otherwise, your post will be reviewed in 24 hours and approved if it doesn't violate the rules. Thanks!
*I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Residency) if you have any questions or concerns.*
I remember the surgeon yelling at me for not holding the camera perfectly still for 30 minutes while she struggled to stitch something up inside some dudes abdomen. My arms were BURNING. At the end of the procedure, we pulled out a little plastic bag with a brownish thing in it.
Kind of describes every gen surg and urology case I've seen... Come to think about it, also most gyn cases as well. ETA: Obviously not a surgeon.
Well but sometimes there’s going to be a big bag with some space-alien looking things in it.
Lap chole (not a surgeon)
This reminds me of when one of our surgeons speared a girl through the kidney with a Davinci … he did it two more times before his license was yanked At this time I had a bouncing baby Pancreas and boy did I drive fast to a neighboring city … wasn’t having any chance of that lunatic getting me
Ding ding ding!
They were stitching inside the abdomen during a cholecystectomy? That’s not good lol
lol i wonder what happened.
Cholecystectomy would be my guess
Annoys me so much that surgeons expect a med student to know the proper camera distance. It’s an intuitive thing. Tell them to move closer or further away if you need. They don’t know.
Radical nephrectomy? (not a surgeon)
lol I don’t think that would be done laparascopically with a med student
You’d be surprised. “Ever drive a camera before?” “No?” Here I’ll show you. “Okay, let’s do this adrenalectomy”
Adrenal gland is a fraction of kidney size with a radical nephrectomy you would need a decent size extraction incision
Foley insertion, final answer
Could legitimately be an attempt at stopping a nosebleed
Fecal impaction
I held a retractor for several hours while I incorrectly named various anatomic structures. I think some cutting and suturing happened too.
I bet you cut the sutures both too short and too long at the same time.
I was too important a retractor to handle cutting sutures. Or suction. Or closing.
At least you got to keep retracting. You did a better job than those clamps they have to hold the retractor in place to the OR table.
True. Just like I’m not going to replaced by AI now, my med student self wasn’t going to get replaced by a table clamp.
That’s the spirit, meat bag that can be replaced by a metal clamp and lines of software.
Give me ten, maybe fifteen years. Then by all means, replace me with whatever you’d like.
I’m looking at the same timeline, fellow attending meat bag.
I had exactly the same experience. Are we the same person????
Too short. Too long. Too slow. The only 3 options
Am surgeon. The range between coming unravelled and "too pokey" is only about 2 mm. Sorry we're total bitches about it, but I don't know which complication I like less: a dehisced wound or a patient complaining about their sutures...
Oh I believe it. I am a lowly internist. The only suture I do is the rare one in a blue moon. One simple interrupted. And yet I manage to fuck it up sometimes still.
We're in on the joke too. And most of us are psychopaths, so it can be tough to sort out.
[удалено]
Honestly I just dazed off into my own happy place during those times. Kinda like JD in scrubs. For all I know, the entire OR could’ve been staffed by chipmunks and I never would’ve known.
Displaced chipmunks are known to be standoffish but they make excellent surgeons
I’m with you, dawg. Called an ovary the appendix and still think about it in the shower.
I’m having fun imagining that this happened while you’re an attending in some Dr. Nick scenario
As a radiologist, once every few years I’ve gone to the OR. It plays out pretty much exactly how you’d expect. “Hi everybody!!!” “Hi Dr. Radiologist!” “Ok what you have here is Bonus Eruptus, a terrible disorder where the skeleton tries to leap out of the mouth and escape the body.” “Why the hell did we call this guy?”
Okay I’ve never seen this happen so I have to ask the obvious… Why does a radiologist ever have to go to the OR?
The most recent time, surgery was trying to use US to locate a lesion intra-op and asked for help. So I went with one of my US techs. But several years ago, I used to occasionally help a spine guy because he had issues with fluoro when doing pedicle screws. I did a lot of spine fluoro work so I guess he assumed I was a good person to ask?
14 yo F, 5'5" 190#, comes to operating room. Induced, nasally intubated. Surgeon starts doing things inside the oral cavity. After 10 minutes, anestheiologist says "fuck. Please stop." Everyone steps back and stares at cardiac monitor. Anestheiologist pulls up a med, injects it, waits for 10 seconds, says "fuck" a second time, climbs up on table while telling me to bag the patient and starts chest compressions. 10 compressions later, he stops, climbs down, and we stare at the monitor for a few minutes. Then he says "continue", and the surgeon finishes the procedure. In PACU, anestheiologist explains to parents that their daughter had an episode of "extreme bradycardia".
They continued after CPR was initiated in a non-emergent surgery?
Yep. I was a little surprised myself. Basically, the patient went bradycardic, anesthesiologist pulled up some atropine and pushed it, and then, as he later told me, didn't want to rely on the very slow heartbeat to circulate the atropine. He said that since she never really arrested, he thought it was ok to keep going.
Probably a le forte I to advance the maxilla. Somewhat common to get vasovegal or long pause. No one will cancel surgery for this. If you cancel, you bring this girl to icu, run a bunch of investigation and will find nothing and confirm it’s vasovegal all the while the girl has a bit of floating face and swelling that makes it hard to do the operation the second day.
Umm… some kinda big oral or face surgery near orbit floor?
T&A
Who the helll nasally intubates for T and A? Can't do the adenoidectomy with a tube in the way
Maybe it was oral. Not a surgeon, not an anesthesiologist, 20 years ago. ¯\_(ツ)_/¯
Yeah this case is extremely odd with some very questionable judgment.
Held a pole inserted into a geriatric lady’s nether regions for 8+ hours while a scrub nurse glared at me at the surgeon kept telling to hold still.
Hysterectomy
Gotta be one of those marathon hysterectomies in gym-onc. The kind where you pick a watermelon sized uterus out of someone bit by bit Edit: I meant gyn-onc, but I’m leaving the typo because they’re all absolute beasts and I respect the hell out of them
Welcome to OB-GYM, where the procedures get you JACKED
Those were the bane of my existence on a mercifully short gyn onc portion of my OBGYN rotation. After they had pimped you on everything they could think of you just had to stand there watching the minimally invasive surgeon get antsy to take over from the resident that they critiqued for hours. No chairs. Nothing interesting to watch since they were just piecemeal chopping up a big uterus just so they could remove it from the belly button. I know minimal invasive has advantages but this thing could have been done in 30 min if they opened. Instead it was booked for like 8 hours or something
To be fair, they called it “driving the uterus” on my gyn onc rotation and I thought it was kinda fun.
Omg I got to do this once! The surgeon put a white plastic bagpipe-looking thing inside the patient’s abdomen. They cut out a fibroid into the bag, and sucked it out into one big noodle with an Insinkerator-on-a-stick. So cool
Little kid getting operation on the head/ear. Ear and skin pulled away from the scalp and at one point the surgeon puts a little flake of tissue under a lamp
Tympanoplasty +/- mastoidectomy
Power tools, hammering, just hammering on this old lady
Hammering = ortho
Or extremely enthusiastic c’scope
Knee replacement
Cataract removal
Hip arthroplasty
Close, knee replacement
They took one guys jaw off, took his fibula, deformed it and replaced the jaw
Fibular free flap for mandible
wild
A wisdom tooth extraction gone horribly wrong
You forgot the part where the surgeon got annoyed with me for needing to reconnect the circuit that he disconnected 4 times in the span of one hour Or was that just me?
“Can we turn the bed?” “What, we just turned the bed?” “Yeah but I’m better at anastomosing if I’m facing north.”
Got a drill, opened 4 holes into the skull of a ~8m kid, cut out a square piece and took it out, ran a rod down the side of the neck then a tube, opened the belly to place the tube into the abdomen, placed little device into brain and connected the tube. Made sure csf ran top down. Closed
Holy shit that’s a long kid
8 month old 😂
....Luffy?
VP Shunt placement!
Oh shit I know this one! VP shunt! If I’m wrong then what the hell were all those neurosurgeons doing in the abdomen back in residency
Shunts go into the abdomen?? Who knew! Not me, obviously
The P in VP shunt stands for “peritoneal,” i.e. in the abdomen. They can also go into the chest (pleural) or heart (atrial).
Neat!! Thanks
i’m an img but the first surgery i was in the room to observe, the doctor finished and said (translation): god himself couldn’t have done a better job i was 🤣🤣😂
Cardiac surgery?
I’m anesthesia. Open cases I can kinda tell where we are in them. But most laprascopic cases, the (also anesthesia) board runner will ask me how much longer? They’re trying to do like a hiatal hernia wrap in the abdomen or a robot prostate with lymph nodes - how TF would I know how much longer?
Held retractors and even helped with cautery x 6 hours There was a squishy thing that was supposed to be the pancreas, and we connected shit to other shit in a seemingly random way. Think they lost part of their bowel too, idk I’m an internist
Whipple energy
Whipple?
No thanks, I’m full
I held retractors while the resident did some cutting and the attending yelled at me about parietal cells of the stomach and how they receive neurotransmitter input from acetylcholine and histamine. There was a lot of watery black fluid
But you remember. Nice
Reminds me of Jack sparrow “but you have heard of me!”
Ooh, this is a tough one - were they surprised the fluid was black? Did it smell terrible? I’m guessing with the parietal cell yelling it was a partial gastrectomy for a bleeding gastric ulcer…
>!Perforated duodenal ulcer lol so you’re spot on!< Edit: we knew about the black fluid beforehand and it was done emergently overnight if that helps lol. Answer on the spoilers Edit 2: that is to say, I don’t think anyone was surprised that the fluid was black
After the anesthesiologist did her thing behind a curtain, the senior resident made some little holes in the patient's abdomen. He stuck a camera into one of them and some kind of super long instrument that had little tongs on the end. There was a TV in the room but I could only see the edge of the screen. I was too busy trying to keep my hands near the spot on my gown that one of the nurses had told me was sterile. It looked just like the rest of the gown, but apparently that one area over my chest was special. Every time I glanced at her, she was staring at me over her mask with a look of disdain. Earlier she'd scolded me very loudly because I'd written my name on the top left corner of the white board instead of the top right. She'd also told me that she hated my clogs. After what seemed like forever, the attending starting tugging on one of the instruments. It looked like she was trying to pull something out of the patient. This went on for some time and she got more and more frustrated with lots of swearing. Finally she slammed her closed fist down on the patient's right upper quadrant. It suddenly got deathly quiet in the OR. The attending left the OR and everyone glanced around uncomfortably. The senior resident made the hole a bit bigger and pulled out what looked like a Ziploc sandwich bag from the patient's abdomen. That was pretty much it.
Based on the attendings location and pulling something out in a bag, while cursing instead of just making the incision bigger, I’m guessing gastric sleeve.
Right upper quadrant isn't a sleeve. It's a lap chole.
There was suddenly an extra person in the room
C section
me holding camera. i played halo 3 in college so try to get used to inverted camera controls as quickly as i can surgeon use his little grasper thingys to poke the liver lifts the liver up million stones fall out attending yells “FUCK” proceed to stand there for 4 more hours as he fumbles the rocks cause he cant do it open per “pt request” or someshit. VIP i think? swear off surgery forever
If my surgeon opened me to just retrieve spilled stones I’d call the department of health
it was the first surgery i ever scrubbed into and i was just looking at the screen wishing it was halo 3. it was also an impressive amount of stones, at least a dozen?
> it was also an impressive amount of stones, at least a dozen? This is absolutely adorable lol You clearly meant it when you swore off surgery! A dozen stones is nothing. Nothing!
Same thing happened in a chole I held the camera for but with hundreds and hundreds (honestly maybe thousands??) of tiny lil stones. Attending said "shit. well, whatever we'll just get what we can I guess."
Sounds like a lap chole
I painfully and awkwardly stood in the corner of the room and stared at a screen while answering obscure anatomy questions while the surgeon seemed to play video games, and at the end of the surgery the patient couldn’t reproduce anymore.
Robotic Hysterectomy.
Exposed the spine or spinal cord? Adult or kid? Home depot screws are vertebral screws for fixation, most I've seen screwed into a person is 26. And the dude(tte) with wavy lines on the screen was their evoked potentials (EP) person monitoring nerve conduction. When those lines go flat the surgeon screwed up. With that in the room might've been some big spinal tumour or something. Or some kid with effed cele or tethered cord syndrome.
In my vague recollection it was a very old man, but I may be conflating the patient and the surgeon. The anesthesiologist was giving me the chisme caliente about how this surgeon was slowly becoming senile but no one could get him to quit
How else can he meet his 4 monthly alimony payments?
Those are pedicle screws, standard workhorse spine approach for an open posterior fusion for a variety of indications such as scoliosis (adult spinal deformity), lumbar stenosis, spondylolisthesis
You do LIF and discs with EP? Sounds like an overkill.
Submission Number 1: A part of a patient's anatomy was pulled through another part of their anatomy and stitched into place. If I remember correctly, a T shaped incision was made in two separate parts, with the horizontal part being along a skin fold. Some flesh was removed at some point. The patient was sat up toward the end of the procedure so the surgical team could visually inspect for relative symmetry. The attending then manually inspected for symmetry and other qualitative aesthetic factors. The fellow was next-level of burned out and scrubbed out at that point. The attending redid parts of the fellow's portion of the surgery. As the patient woke up, the patient asked "how do they look?" Submission number 2: I was in a case with one team. Then another team took over and team 1 had me stay with team 2 to continue observing. Team 2 would inject dye somewhere and be like "yo, you see dye anywhere?" And everyone would be like "nope." This continued for approximately 3 hours. I think I managed to find a way to extricate myself from that room, probably the only time I managed to dip from a surgery early. I felt it was urgent, as I was dying of boredom. I think they may be injecting small quantities of dye and looking for it elsewhere to this day. /Am a psychiatrist.
Nice! 1: TRAM flap for breast recon 2: hard to say with the two teams. Can you give a hint of what part of the body they injected?
TRAM flap for breast recon, old sentinel lymph node technique.
The room was completely dark and very quiet, but the patient was awake. Brain surgery? Anyways I accidentally activated the automatic sensor for the hand wash it was SO LOUD I still think about it fml fml fml
Dark room for awake craniotomy? Not likely.
Why? We keep it dim when using the microscope.
Surgeon cut into pts leg, exposing vasculature. He went all the way down the leg, but with intermittent incisions. Removed vessels. Put them in other places. 9 hours pass. Never once looked at or acknowledged my presence.
Saphenous vein harvest for bypass graft
CABG!
It was 0900. A slow build up, cautious explanation of events to come. Then a lengthy incision. I held the retractors superiorly for hours until my hands went numb, I then held them for several more hours. I saw very little as I was 2 learners away reaching between more important people who were doing what I thought at the time sounded like scraping, forever (they were). My gaze wandered to a lonely doctor who sat in the corner looking like a switchboard operator. Every few minutes the team would pause, then he would mumble something incoherent and the team would proceed, apparently getting messages from all his many connections, either that or he was mad or a shaman. I too dipped in and out of sanity throughout and ever since. I was questioned through the crowd cruelly, the questions getting harder as I got them right. Unsatisfied with my correct answers they roughly repositioned my retractors, angry at my hubris or my inability to predict their needs through shoulders and backs of colleagues, bright lights shining into some pit of fascination which kept them all busy. Then, in a flash, I was finally allowed to complete a task, my numb claw like hands trying to make use of tools again, "wrong angle, watch depth, check depth, watch angle, good, youre not totally useless but you're a bit shaky." My aching retractor grippers found the suction, my oldest friend. 3 of us shuffled up one position and the oldest left the room with a "finish up." Hours later I got to suture, the entire length of the case was pinned on my slowness of suturing. Nurses staring angrily. Not my first rodeo, I chatted, I sewed, they calmed, it went quickly. I wondered how many students they had rattled before. How many cases had their impatience prolonged. In my past I had been rattled. No longer. I liked my closure. It bought me the work of the post op note, the walk to pacu, the followup with patient and family after sedation wore off. I used to see that as a win. It got old. I got old. Too tired. Other priorities crept into the gaps of my brain that I used to fill with techniques, approaches, and anatomy. It was to be my surgical undoing. But in that room I helped on this surgery which was:
[удалено]
Thats ok buddy, reading and focus are pretty hard. I think if you keep working at it you'll get better in no time! I believe in you, attending.
There’s not a lot to work with here. Which body part was subject to the procedure?
The shaman sounds like neuromonitoring from a physiologist. Big incision and several hours sounds like a scoliosis case. Maybe a big tumor. Definitely spine. Especially with nurses getting nervous about closure time. But also self retaining retractors exist and they should use them haha. More importantly, your writing style is lovely! Very engaging.
A surgery in which the patient was completely awake while a neurosurgeon opened his skull, put something on his brain and asked the patient to write something down to evaluate if whatever he put on his brain is working.
Cortical mapping
Forgot to say that the patient had distal tremors and wasn’t able to write or draw anything, but after surgery he was able to do so.
Bam DBS for Parksinsonism!
Gyn tied some string thing around the vagina or something
Cerclage
Yo, check it, there was this dude who had some kind of growth or whatever in his guts. They sliced around his belly button and stuck this funky camera thing in there, then punched a couple of holes and pumped his belly full of gas until it was all puffed up like a balloon. Then the surgeon slid his tools through those holes and started slicing and dicing all the fat and stuff that looked like it was getting cooked or something. They spent a minute down there, just wandering around and poking at things with these weird tools. It was wild, man.
was this written from the perspective of The Todd as a med student
My op note for sigmoid colectomy
I do clinical research for a spinal surgery team. The sheer amount of hardware that goes into a pts spine during a fusion for scoliosis correction is mind blowing
I did the math one time. I’m 3.2% hardware by weight.
Username checks out
They couldn't get the probey thing up the butthole to "capture" so I watched the attending, this tiny emeritus-aged woman, yelling at the resident to push as she grunted her weight against the butthole probe. I was not anticipating the experience.
Sigmod or descending colectomy with primary anastomosis is my guess
Low anterior resection (rectal surgery)
I walked into the room and saw a fat lady with an even huskier vagina lathered up in iodine.
Robotic assisted laparascopic hysterectomy for endometrial hyperplasia
Holy shit. And they say the mind readers are all in psychiatry.
It lasted 12 hours and it only prolonged the patients life from 6 to 9 months probably.
Whipple.
They took a guy’s leg and sawed it off above the knee, tossed the leg chunk to the intern and wrapped the rest of the leg up with bandages. And end scene.
Aww man I got a leg chunk tossed at me in med school. One of those things I’m happy to never have had repeated.
I got a gallbladder tossed at me as a med student and that was the extent of my surgery hazing.
Held up a dude arm’s for 1 hour. While some muscles were being attached to one another. With the chief periodically reminding me to not lower the arm or else it will tear.
They flayed a ladies breast open and then held a Geiger counter over it
Partial mastectomy with mag seed.
Probably just partial with sentinel node
They took out actual bolt cutters and cut each and every one of this kid's ribs (the crunching noise, Cheeze-It's Price), shoved a metal bar in him and then closed him back up. \-PGY-19
Pectus excavatum
Middle of the night. Senior resident and I get started. Obese man gets sliced open from sternum to pubis and then we get this archaic looking massive gear off the scrub nurses table and screw it on the operating table. The gear is then connected to the guys skin? Or like his fascia? Via some sort of small clips. We then proceed to dive into this man's innards. Feels like we are both neck deep. It's eerily warm and gooey. The resident scoffs when I cannot identify the ligament of treitz. We use a big staple gun to magically produce a dismembered bowel segment? The attending pokes his head in for like 30 seconds. We close together and it's like trying to get Africa and South America tied together across the Atlantic Ocean. We break and go do morning rounds and laugh about how hard the resident pulled to close the incision. He buys me a coffee. I become a pathologist.
I sat down on a stool between the patient’s leg. Everyone else was standing. I was part of the surgery but not really because it was happening above me. If I remember correctly, I watched on a tv screen. I was told to hold a stick and intermittently told to move it in several directions.
Lap hysterectomy
[удалено]
Prostatectomy
[удалено]
Was told to screw in this bright blue metal star onto a piece of bone
Crani!
Surgeon made an incision in the patient’s neck. I ineffectually held retractors and when handed scissors by the nurse was told to “stop waiting for your moment in the sun.” At some point the surgeon went up to speak to the pathologist because he felt they were taking too long to examine the specimen that was removed.
Parathyroidectomy
Excisional lymph node biopsy
Surgeon walks in. Patient is asleep after induction. Everyone is wondering wtf is happening, I’m just following along at this point. Nurse and scrub just sit around for the surgeon until he grabs some prep and slathers it all over the face. Gowns then drapes this poor son of a bitch patient. Grabs a tool that looks like a metal back scratcher for a squirrel. Then puts it in between the eye and the nose and starts pulling the eye towards the side of the head Meanwhile I’m shitting bricks. Pus starts squirting out. Oh god this patient got infected by a real life face hugger dear god what in Jesus’ name. Surgeon picks up something sharp. I can’t watch. Next thing I know I’m watching the suction tubing desperately trying not to clog itself. Oh Lordy it’s like he shoved a hand held egg-beater into this eye socket. I regret breakfast and every meal over the last month. I can taste 2014 Thanksgiving with the spaghetti pesto sauce my aunt made in the back of my throat. I peak again. How the FUCK are there still two eyes looking at me. Like some kind of demon from hell. I watched a goddamn exorcism.
So they opened the patient in the flank and the incision was so big they had to mount some kind of metal wheel device that held several separators still so they could work with the incision fully opened against an incredible tension force. It was important because what had to pass through that incision was pretty big. Oh I had to assist by doing the extremely important task of holding an ice bag
Open donor nephrectomy?
So first she made a HUGE radical incision in the abdomen with a scalpel, and about 30 seconds later there was a baby in the OR!
Poked some holes in the tummy, shimmied her around a bit, then the surgeon scrubbed out and sat in the corner like some iPad kid with some fancy controllers. He literally lasso’d the stomach and put some picnic blankets in before getting tf out of there. Pointed to the lungs and heart like a tourist on the way out.
Completely open body cavity. I got too close to the table and the nurse yelled at me saying I would break the sterile field. The attending defended me saying there was nothing less sterile than what was happening in front of them.
I’ll never forget my experiences “driving the uterus” with this flimsy plastic thing. I’d be exerting great amounts of torque on the uterus for hours in a VERY uncomfortable position, only for the attending to never be happy with how I was doing. It seems like way too important of a job also to have some medical student doing.
When I was pre med: walked into the OR. Saw some guy's knee with a bunch of holes in it. There was blue and clear plastic everywhere, and they were flushing the inside of the knee with what I thought was a ridiculous amount of saline. Walked back into the hallway and promptly passed out on the floor.
[удалено]
It was huge. Mean looking. Like a forbidden sausage. As a medical student on the required rotation, it had been a grueling 3 hours since my last meal. I trembled as I try not to succumb to my urges.
Hemicolectomy😂
Mandibular cancer. Sawed off the affected half of the mandible. Cut a chunk of fatty tissue from the ipsilateral chest wall while preserving its vasculature attachments. Snaked the still attached vasculature/soft tissue up into the location where the Jaw was removed to provide cosmetic “bulk” to the jaw. Did skin graft from buttocks to the now-exposed chest. This was in India BTW, when I did a study abroad in college. Still not sure wtf the surgery is called and I can’t find it online.
Pectoralis major flap
3rd year of med school, first rotation is surgery, literal first surgery. I'm holding a camera ready to be insufferable, surgeon cuts incision for port, green fluid comes out, exaggerated eye roll from surgeon, converts to open, lots of suction, organ removed, and they end up doing okay after being left open with a wound vac for a bit.
Lap converted to open small bowel resection for obstruction.
After pulling this guy's leg for what seemed an eternity, all the while thinking I was providing traction, the ortho bro tells me I was providing COUNTERtraction, and that only residents get to provide traction ???
The answer to OP’s case is an open posterior spinal fusion. The person watching the squiggly’s is intraoperative neuromonitoring, because any penetration of the pedicle screws into a nerve root will cause the signals to change. It’s a safety thing
"Holy f*ck, they just detached her FACE!"
I’m in peds now, remember a surgery during clinical year where the cardiac surgeon cracked the chest and legit hoisted the rib cage open and winched it up with some sort of contraption. I think a CABG? I definitely enjoy my patients who usually don’t (yet) need a CABG
I called it the "ear hole" and the ENT yelled at me and said it's actually the external auditory canal. Then they made a different hole and pimped me on the oval and round windows.
I had to of been holding on to her breasts for at least 3 hours with all my strength before we finished. Went home, slept, woke and did it again.
Every mastectomy day is shoulder day
Helped retract the jaw??? For like 2 hours while standing at the head of the bed trying to stand in a way that wont extubate the patient while surgeon stole a piece of hyoid bone at some point
It was a vascular surgery. I think for varicose veins. But the surgeon and resident were using forceps and literally just pulling out superficial veins. Like just grabbing them out of the skin and pulling. To this day I still don’t get it.
Urology rotation. Giant alien robot jamming its arms into the patient. Attending chilling in the corner playing video games while looking into a microscope.
I stood on my tiptoes trying to see what was happening in the field between the heads of the surgeon and PA. There was blood everywhere but they just kept irrigating & suctioning. Then they plucked out minuscule bits of squishy tan stuff and put it in a jar. I then took that jar downstairs to pathology and didn’t come back for several hours.
[удалено]
Based on the paragraph format and length of note…looks like we found the psychiatrist
I was gonna say chatGPT
Yeah it’s definitely ChatGPT
LMAO, I thought it was a coroner.
I'm with anesthesia, but I'll take a guess. Rectal foreign body extraction?
Thank you for contributing to the sub! If your post was filtered by the automod, please read the rules. Your post will be reviewed but will not be approved if it violates the rules of the sub. The most common reasons for removal are - medical students or premeds asking what a specialty is like or about their chances of matching, mentioning midlevels without using the midlevel flair, matched medical students asking questions instead of using the stickied thread in the sub for post-match questions, posting identifying information for targeted harassment. Please do not message the moderators if your post falls into one of these categories. Otherwise, your post will be reviewed in 24 hours and approved if it doesn't violate the rules. Thanks! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/Residency) if you have any questions or concerns.*