Orthopedic Surgery

Wow.  The first word that comes to my mind.

Orthopedics was absolutely jaw-dropping.  Every surgery was dynamic and intense, yet generally short and sweet taking anywhere from 45 minutes to 2 hours.  I am not sure if it was the bone sawing, the prosthesis, or the encouraging doctors, but I could totally see myself becoming an orthopedic surgeon, maybe even a pediatric orthopedic surgeon.

The orthopedic surgical team was a fun group of individuals who are all very good at their jobs, but still have a good time.  There was often music in the background of the OR and the surgeons and nurses all seemed to be good friends.

The surgeons and scrub nurses really went the extra mile to explain the medical procedures to me.  One of the scrub nurses was one of my students in the English class so she introduced me to the staff, told them to not say anything bad in Portuguese since I speak it, and basically explained that she loved me and they should too.  I was extremely flattered.  She showed me how they fit the prosthesis and pick the sizes from the storage.  They also let me have a birds eye view at the surgery.

Surgeries:

  • Partial Hip Replacement
  • Complete Hip Replacement
  • Femur reinforcement – DHS (dynamic hip screw) & EMOS (Extraction of Osteosynthesis material)
  • Shoulder Dislocation – acromioclavicular dislocation
  • Total Knee Prosthesis

These surgeries were absolutely incredible.  Dr. António Melo and Dr. Luis Soares even let me take a photo of the knee replacement surgery.  It is quite graphic so *trigger warning*. Knee Replacement

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Two More

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.

First Surgery

Today I watched my first surgery: a pediatric urethroplasty. This surgery is all about finesse. A baby is fragile enough, but a surgery on a baby’s reproductive organs is incredibly sensitive since it is a functional organ that needs to be able to react and respond as well as grow with age. I never would have thought my first experience in an OR would have been watching rerouting of a urethra to the proper urethra opening, but it was, and it was still awesome. The surgeon told me that this is a very frequent and common procedure done on infants from a very young age (months old). The surgeons were very gentle with his organ and had to make many small sutures, which one day will not be seen. Tomorrow I believe I may be able to watch a kidney surgery, however it is up to the digression of the surgeons. I was so nervous watching the surgery since I have always said I wanted to be a surgeon without actually seeing a surgery. Good news! I did not faint, vomit, or even freak out. Honestly, the whole time my jaw was dropped, gaping in amazement at their technique and skill. Thank goodness I had a mask on and they couldn’t tell!
I hope that one day I have the same precision and accuracy and will be able to have as successful of a surgery as the doctors did today and many more. This is why the Atlantis Project is so incredible. I get to live my life for five weeks right behind the doctor and almost step into his/her shoes and see if this is the life I want for myself, and so far I think that med school is a pretty good next step. Hopefully I can get my EMT certification at Wellesley during wintersession!
*Edit – the specific surgery was due to Hypospadias

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