Getting to Operate

I’m now on a new rotation – Vascular Surgery.  The way the team is setup is a little different than my last rotation.  There are multiple junior residents now and one senior.  The person who is on call for the night also takes the day pager.  The senior goes to the operating room.  That leaves the rest of the junior residents to stick around and help with the occasional consult or……. go to the OR and operate, either as second assist with the staff and senior or as first assist in a separate room!

I have only been first assist a handful of times before, and usually not for the entire case.  It truly is a different experience from being the med student standing off to the side holding a retractor.  It’s also a bit intimidating at first.  You’ve seen a bunch of people operating before and everything looks like it makes sense.  But, when someone hands you instruments and expects you to know what to do before having to tell you – well let’s just say you need to be on your “A” game and always thinking two steps ahead.

Today I spent the entire day at a daycare surgery facility doing vein surgeries.  It was just me and the staff.  We did six cases, all the same.  High ligation and greater saphenous vein stripping.  This is a procedure to fix varicose veins.  You make two incisions, one in the groin and one near the knee.  You dissect the greater saphenous vein at each location, cut it, and then feed a plastic wire through the vein so that it goes in the knee and comes out the groin.  Then you put a plastic cap on the wire and literally rip the entire vein out.

It’s a pretty simple procedure which makes it a good one for a junior resident to learn.  By the second and third case I was getting the hang of it, calling for sutures and instruments, ligating vein branches, and closing incisions.  I have to say that this is the first time in residency so far that I have really felt like I was operating.  And it was awesome!

These past six weeks have been gruelling and I realize that it’s mostly ward work and consults that are a drag.  But, those brief moments I go to the operating room and do what I signed up to do still make me leave work with a big smile on face.