Scalpel's Edge

A surgeon's notes

Friday Cases – June 26

As a demonstration of my surgical life at UMN Tansen, I have been sharing what I do each Friday in theatre.  I operate on most days of the week, and Friday is not a particularly special day. 

Yesterday (Friday) I was not on call, and there were two senior surgeons in theatre, myself and Dr Yam.  We were joined by another surgeon for the first laparotomy, as it was her patient.  I started in theatre at 9:30am and left at 6:30pm, with a half hour lunch break.  This is a really long day here, and probably means we overbooked our elective cases, leaving not enough space for the emergency case.

IMG 4571

So today’s cases:

  • Neonatal laparotomy on 4 day old infant for bowel obstruction.  Yes.  This is the youngest patient I have operated on and I was grateful I was not holding the knife.  I think I’m still shaking.
  • Paediatric Inguinal herniotomy for hydrocoele, 6yr old male
  • Subtotal laparoscopic cholecystectomy for acute cholecystectomy: I’m still trying to convince the other surgeons to do acute lap choles.  However, this case was not very convincing.  Very difficult.
  • Excisional biopsy of 5cm skin lesion over left lower ribs with rotation flap reconstruction.  The wound looks really nice this morning
  • Large midline incisional hernia on a 35 year old guy who had a perforated ulcer last year.  It looked like his entire wound dehisced.  The defect extended up to his xiphisternum, which was difficult to close.  I did my standard for large hernias, a retro-rectus mesh reconstruction, which works really nicely in this resource poor environment – all open surgery.  For the first time I did an anterior component separation.  It gave me a bit more stretch, and I was able to get the anterior sheath closed nicely.

My colleague, Dr Yam also did an excision of a skin lesion on the face, and a sphincterotomy for anal fissure.  However, most of the cases needed two surgeons so we worked together.

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