Indigo

I held intestines.

We were taking down a colostomy, which is basically attaching the colon back together. There is a very large midline incision for visualization, and those darn intestines just keep getting in the way.

This surgery, in itself, is a pretty interesting surgery - cool procedures, nifty equipment, but it became a much more interesting case when, as we were dissecting around the rectum to clear a spot for anastamosis, we could see the foley (catheter placed in the bladder). Uh-oh. Apparently the bladder had, after the origional colostomy, adhered to the blind pouch which was the rectum (I wish I could draw a picture so you could know what I'm talking about). It was basically wrapped around the rectum - the site we wanted to reconnect to. So now there's a tear in her bladder.

After some swearing, we sutured it shut and consulted the urologist. He came in to take a look, put a camera inside and filled the bladder with saline. It was amazing to see the bladder looking down from the open abdomen! It was full and you could see the light from the camera inside. Up on the screen the images were being shown of the interior of the bladder. The repaired tear was identified and it was closed well, and then we looked at the inlet for the ureters.

Just as we were looking at one of the ureters it shot out a blue liquid! The urologist had ordered Indigo blue when he got in the room and apparently it takes about 5 minutes to get through the system and through the kidneys. As we peeked over to the other ureter it shot out some blue urine as well. Wow. It was pretty much amazing! We now know that we did not cut any of the ureters, and the bladder is in wonderful condition. The patient peed blue for quite a while.

The rest of the surgery was, although amazing, uneventful (which is good... for the patient).

I like surgery.

lap banding

Today was my first day of Surgery. It was so exciting! I was able to scrub in on various cases from a sebaceous cyst removal to laparoscopic banding of the stomach. Good times. I really think I'm going to like this rotation.
Tomorrow I'm taking out a few gallbladders.