Today I watched two more pediatric surgeries. I also was able to learn more about the surgeons. One of the surgeons, a colleague of Dr. Juan does not actually live in Azores, but rather Porto. He comes every two months to do pediatric surgeries. He was explaining that he prefers to do the most minimally invasive surgeries back in Porto, using high tech tools and techniques to limit risk and scarring. However modern I found the São Miguel Hospital to be, I guess it is not the most current on cutting-edge technology and thus sometimes they have to do some surgeries “the old-fashioned way” (which was probably only changed in the last few years).
The first surgery was a herniorrhaphy. This surgery took about one hour and left only two inch sized incisions around the pelvic area. The second surgery was a nephrectomy, in which I saw an entire kidney removed due to dysfunction. The incision was quite large, probably about 6 inches long and obviously went as deep as the kidney. This patient was not very lean and the doctors had to cut through many layers of fatty tissue to reach the organ. They had to use spreaders and were hands deep to reach the arteries, ligaments, and other tissues connecting the kidney to the whole system with a super precision scalpel and cauterization device. The surgery took about 2 hours and a half from the first cut until the last stitch. It was really amazing how much technique and checklists go into one surgery. I feel as though most people take losing a kidney as a minor procedure, a common thing, living with one kidney is completely do-able, however the actual procedure it extensive, even if it is frequent. So many people complain about the cost of surgeries and health care, here in Portugal it is practically free. Today I was calculating in my head just estimates of how much each piece of equipment cost in addition to the operating room, the lights, the doctors, the nurses, and anesthetics. I could see how a kidney removal could cost more than a machine manufactured car. People take so much for granted when in reality it is truly a detailed spectacle. It makes taking a test or learning choreography for a show seem like minor tasks.