After getting breakfast with Team Taiwan (that's all of us, by the way), we all dispersed in groups to our respective departments. Being the only person who signed up for General Surgery, I decided to tag along with the group whose preceptors' offices were closer to mine. As they left to go meet their preceptors, I waited for my later scheduled meet time. At this point I was really anxious to see what I would be doing for the first day, and was wondering how soon it would be before I could see some surgeries. Well it turns out that my preceptor was already in the operating room when I got to his office and he had sent one of his foreign fellows to get me. Luckily, he grew up in Australia, so he spoke perfect English and was able to explain a lot of things about the hospital and the department to me.
After walking through what seemed like a maze to get to my preceptor, I found myself changing into surgery scrubs (cap, mask, and shoe covers included!). I even received my own locker to store my clothes and whatnot. I then learned that the changing room was above the OR and that I would have to take this weird spiral stairway to get below.
It has kind of a creepy but cool feel.I finally got to meet my preceptor, Dr. Yu, and immediately was able to sit in on the removal of a mass in a patient's right breast. In the connecting OR next door was a cyst removal in the popliteal region of another patient's right leg. It was then that I learned it was normal for one attending surgeon to oversee around three surgeries at once. From what I could tell, Dr. Yu relies heavily on the skills of the residents training under him. In the surgeries he participated in, I could sense his seriousness in training his residents. This was definitely more obvious in the more complicated surgeries.
I spent the rest of the day in the different ORs and got to see two more major surgeries. The first was a partial hepatectomy. Seriously, this was an amazing procedure. Overall it took around 4.5 hours, but it was an awesome experience. The technique used to control the bleeding when resecting a chunk of liver was something that I never would have imagined. The surgeon uses a clamping forceps type tool to crush a small line of tissue. Although this loosens up the liver tissue for suctioning, it leaves behind the bile ducts and blood vessels that are intertwined in the mesh of the entire liver. If the diameter of these structures is less than 3mm, an electrical cautery rod is used to basically burn through them sealing them in the process. If, however, they are larger than 3mm, the structures require suturing.
The second major surgery was a Laparoscopic Cholecystectomy. I was told that this procedure is the "bread and butter" of being a General Surgeon here in Taiwan. I guess it's because a lot of skill and technique is required to maneuver the view scope, to suction, and to remove the gallbladder itself. Just a couple of noteworthy things about the surgery: 1) surgical staples were used to staple off the gallbladder from blood supply, etc. 2) a sterile glove is insterted into the abdominal cavity once the gallbladder has snipped off --> loose gallbladder is dropped into the glove, and the glove is pulled out through one of the 3 Laparaoscopic entry points.
That's pretty much it for my first day in the surgery ORs. At the end of the day, I just could not believe that I was able to see so many things. Stay tuned for Days 2 and 3 and some random pics of the trip so far.
I spent the rest of the day in the different ORs and got to see two more major surgeries. The first was a partial hepatectomy. Seriously, this was an amazing procedure. Overall it took around 4.5 hours, but it was an awesome experience. The technique used to control the bleeding when resecting a chunk of liver was something that I never would have imagined. The surgeon uses a clamping forceps type tool to crush a small line of tissue. Although this loosens up the liver tissue for suctioning, it leaves behind the bile ducts and blood vessels that are intertwined in the mesh of the entire liver. If the diameter of these structures is less than 3mm, an electrical cautery rod is used to basically burn through them sealing them in the process. If, however, they are larger than 3mm, the structures require suturing.
The second major surgery was a Laparoscopic Cholecystectomy. I was told that this procedure is the "bread and butter" of being a General Surgeon here in Taiwan. I guess it's because a lot of skill and technique is required to maneuver the view scope, to suction, and to remove the gallbladder itself. Just a couple of noteworthy things about the surgery: 1) surgical staples were used to staple off the gallbladder from blood supply, etc. 2) a sterile glove is insterted into the abdominal cavity once the gallbladder has snipped off --> loose gallbladder is dropped into the glove, and the glove is pulled out through one of the 3 Laparaoscopic entry points.
That's pretty much it for my first day in the surgery ORs. At the end of the day, I just could not believe that I was able to see so many things. Stay tuned for Days 2 and 3 and some random pics of the trip so far.
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