Gallbladders!

So, it's been down to medical business for the past days.  I'm already in my second week, and still recuperating from a terrible cold, whilst the gastroenteritis has succumbed to ciprofloxacin.
Christmas and New Year's was somewhat different to what I've experienced before, yet it seems that universally there is lots of food and drink; for me probably a bit too much food...

But that's done and the fun is sort of over, and the reality of elective surgeries has arrived.  Last week was easy going, as the department slowly got ready after the Christmas holidays.  This week however is business as usual, and up to now it's all been cholecystectomies.  Yesterday I viewed 4 laparoscopic cholecystectomies.  Only one was a bit difficult, and the liver in that one was nodulous too, so biopsies were taken.  Today it was young ladies only, all under the age of 30.  Two gallbladders were removed without hassle, and then there was a semi-acute appendicitis as well.  After that it was administrational stuff and reading, however tomorrow it's all hernias and the day after that it's the first "turno", Spanish for shift.  That should be an interesting 30 hours at Hospital Roosevelt.

Today I learnt a few things, which are important for successful laparoscopic surgery:
1. Make sure that the CO2 canister contains gas, and is open.
2. Make sure that the light of the laparoscope is on.
3. Make sure that the port for the carbon dioxide is open, in order to insufflate the abdomen.

Keeping these in mind, among other basics, one can expect easier surgery :-)

I have not noticed a lot of differences between appendicectomy and cholecystectomy here, except that the organs being removed are not placed in a plastic bag, after having been resected, and before being pulled out through the skin.  Whether this is good, bad or just different, I don't know, but in one case such was performed, in quite an ingenious manner:
A sterile glove was taken, the proximal part of it (the wrist) was suture, and then cut.  Thus a latex bag was ready and was used instead of a ready-made bag.  Very simple, cheap and effective!

I'm looking forward to writing about my first "turno, which will take place in the Emergency Department, which is most certainly very different to all those I have seen before.