Base Hospital #33. Portsmouth, England. Fractured jaw alignment and immoblization apparatus.

Welcome to edition 304 of SurgeXperiences, the one and only biweekly collection of surgery-related blog posts.

The pictures in this edition are all from the US National Museum of Health & Medicine’s collection of public domain photographs, available at Flickr. Click on the pictures for larger versions.

Hope you enjoy both the pictures and the posts!

Surgery in observation theater. Undated.

Wired Science wonders if Virtual Reality Could Keep You From Being a Surgical Guinea Pig.

Kevin M.D. presents some online cardiac surgery simulations for aspiring heart surgeons, which will definitely not keep you from being one.

Sid Schwab of Surgeonsblog wishes he could remember the color of his patient’s hair, in Local News.

How To Live a Longer Life knows The Most Important Question To Ask Before Surgery.

Surgery being filmed at Walter Reed Hospital, Washington, DC. Note the patient is awake and watching the preparation for surgery. 1918.

Plastic Surgery 101 shows that can substantially add to a person’s quality of life, in Breast reduction surgery and quality of life – Addition by Subtraction!

Suture for a Living reviews two articles on Nipple Sharing &/or Sparing Breast Surgery.

The Sterile Eye mends his jacket and discovers the organic staple, in Living for a Suture.

A horse strapped and being lowered into position to be operated on for a gunshot wound by 1st LT Burgett. Le Valdahon, Doubs, France. 01/28/1919. Veterinary Hospital #3. The lettering under the horse says "The Simplicity Equine Operating Table."

Notes of an Anesthesioboist encounters a hostile patient, in Patient: “One Who Suffers”.

Running a Hospital tells an extraordinary story of luck and heroism, in My Son’s Story, part 1/part2/part3/part4.

scan man’s notes reports on  Case 21: Chronic total occlusion in left coronary circulation with collaterals from the right coronary artery.

Filming autopsy during the Korean War.

other things amanzi has a lot on his mind:

• mad as in crazy or just plain nuts
• stand back, i’m a doctor!!
• savages
• awkward

Pvt. Fred L. Walling. Operating a microtome, which is used for cutting thin sections of tissue and bone; these thin sections are placed on microscope slides and are used for the diagnosis of the cause of death. New Guinea. 02/16/1943.

Notes of an Anesthesioboist argues that End-of-Life Preparation Is a Responsibility, NOT a “Death Panel”.

NYT Health writes about Treating Patients as Partners, by Way of Informed Consent.

MedGadget reports on the HeartAssist 5, The Latest DeBakey LVAD Keeping First Patient Alive.

Newswise says an Eight-Hour Surgery Removes Life-Threatening Blood Clots From 17-Year-Old’s Lungs.

Construction and repair of model training aids. Activities, Armed Forces Institute of Pathology. Sgt Cortiza at work shop, 06/23/1950

The Register wonders what it would be like If surgery was like Wikipedia…

Fluffy Bricks moulds The Surgeon.

NursToon wants to play doctor.

Lucid TV got some Bad News.

SP5 Lawrence E. Blackman (Darlington, SC) USASTC, receives the first typhus shot administered by Hypospray Jet Injector at Fort Gordon. 08/26/1959.

That concludes this edition. The next edition will be hosted by Amanzimtoti on September 6th. Submit your blog articles to the next edition of SurgeXperiences using this submission form. Check out past and future editions here. Please contact blog carnival foubnder Jeffrey if you’d like to host and edition.

Edition 303 is up now at Dr. Bruce Campbell’s Reflections in a Head Mirror blog. Be sure to check it out!

The hypophysis cerebri in position. Shown in sagittal section. Click to enlarge.

Welcome to edition 219 of SurgeXperiences, the one and only blog carnival dedicated to surgery! I suggested “anatomy” as the theme for this edition, and anatomy you’ll get. Gray’s Anatomy.

Now there’s a lot of really impressing and advanced medical illustrations available to students of anatomy and medicine today. But nothing appeals to me like the simple and effective lithographs that accompanied the early editions of the tome of anatomical knowledge that is Gray’s Anatomy. The 1918 edition is in the public domain, and is available in its entirety online. All illustrations here, relating to the submitted posts, are taken from this edition. So once again I present you with a very visual edition. Hope you enjoy it!

Dissection of the lower half of the mamma during the period of lactation. Click to enlarge.

Dr. Ramona Bates at Suture for a Living, writes a short review of two good articles on Breast Surgery

Buckeye Surgeon is concerned about the overuse of MRI in breast cancer, and a recent UK multicenter trial seems to support his notion. Moving into the abdomen, Buckeye also treats us to a rare finding of portal venous gas in a patient with an infarcted cecum.

The gall bladder (section of "The portal vein and its tributaries"). Click to enlarge.

Dr. Piltz with the Ant Ears found his mind working in mysterious ways during the early ours of a night call. Though I can understand that the implications of a previous surgery can slip your mind, its strange when it slips everybody’s minds.

bongi over at other things amanzi, doesn’t know when to shut up, making even the sternest professors laugh with a perfectly timed remark at the expense of an internist. One thing he does know, however, is to stay awake during surgery. Many don’t, but few have perfected it into an art form like this assistant.

Martin, who blogs about his life with ulcerative colitis, shares a post on a talk with his surgeon before getting a colostomy last week.

Diagrammatic transverse section of the medulla spinalis and its membranes. Click to enlarge.

Anesthesioboist T. loves the elegance of the epidural and explains what sets it apart from spinal anesthesia in an informative and fascinating post. Anatomical knowledge is paramount to the work of anesthesiologists, and recognizing this T. wrote a poem in honor of her cadaver from anatomy class. Elegant.

Femoral sheath laid open to show its three compartments. Click to enlarge.

Alice at Cut On The Dotted Line has a flashback to a vascular surgical case as she reads up on pseudoaneurysms in Cameron’s Current Surgical Therapy. Scrubbing in on what seemed to be a simple repair of a leaking femoral patch angioplasty, she learned the hard way exactly what the textbook emphasizes; the importance of both proximal and distal control of blood vessels before manipulation.

Staying in the femoral area, make mine trauma at IntraopOrate, recounts two days of back-to-back ortho cases that left her stomped, beat up and whooped (Day 1/Day 2), including several femoral shafts, a few total knees and a revisional total hip. Mixing bone cement for the last case, she utters the immortal words: “There’s nothin’ better than the smell of polymethylmetacrylate in the morning!”.

Vessels of the uterus and its appendages, rear view. Click to enlarge.

Dr. P presents the fascinating story of the invention of the Sims speculum at The Blog that Ate Manhattan. The inventor Dr. J. Marion Sims was surrounded by controversy as he conducted repeated surgeries on African slaves with vesicovaginal fistulae in an attempt to find a procedure that would cure them. He ultimately succeeded, but was it experimentation or just desparation?

Transverse section across distal ends of radius and ulna. Click to enlarge.

GrrlScientist, who’s Living the Scientific Life, found herself laying on the ice with a broken right wrist in Helsinki, Finland. In this post she details her experience with the Finnish emergency medical care as compared to the USA. The most astonishing observation in my opinion: “Unexpectedly, the surgeon is a funny, caring and personable man.”

Horizontal section of the eyeball. Click to enlarge.

March 12th was World Glaucoma Day, and ophthalmologist Joey MD wrote about the disease, the nature of which, he says, is little understood by the general public. A fun fact: In Norway, glaucoma is commonly known as “grønn stær”, which translates directly as “green starling”, while a cataract is known as “grey starling” (“grå stær”). Most people think this is related to the starling bird, but the word “stær” is in fact derived from the German word “starren” which means “staring”. A correct English translation would thus be “green stare” and “grey stare”. Not hard to tell why they were named like that, but it makes no sense novadays, as the word “stær” is only used for the bird.

After all this surgery, it’s good to have Nancy Miller present us with 4 Tips for A Successful Rehab, and Vanessa Ruiz at Street Anatomy treat us to some sweet skulls. You might also like to end your weekend with a real life suspense story from the daring Anatomy Detective.

That concludes this edition. The next SurgeXperiences will be up on March 29th. No host has been found yet, but you can start submitting your blog posts now via the carnival submission form, and check out all the previous editions. If you would like to host an edition, don’t hesitate to contact SurgeXperiences founder Jeffrey Leow.

Please send me your posts via this form by Friday, March 13th.

Suggested theme:

anatomy
→ noun (pl. anatomies)
1. the branch of science concerned with the bodily structure of humans, animals, and other living organisms, especially as revealed by dissection and the separation of parts.
2. a study of the structure or internal workings of something: a detailed anatomy of a society and its institutions.
- origin late Middle English: from Old French anatomie or late Latin anatomia, from Greek, from ana- ‘up’ + tomia ‘cutting’ (from temnein ‘to cut’).

- Oxford English Dictionary

Edition 218 will be up at scanman’s notes on March 1st.

SurgeXperiences is a biweekly blog carnival, collecting the best of the surgical department of the medical blogosphere. Check out season 1 here. Read this if you would like to host an edition (highly recommended! I’ve hosted three editions myself).

The next edition will be up on October 12th. No host announced yet. Submit your posts here.

SurgeXperiences ambigram created with Ambigram.Matic. Thanks to T for the tip.

Myelomatosis

Welcome to the 6th edition of season 2 of SurgeXperiences, the one and only surgical blog carnival. It’s my third time hosting this, and it’s been a very interesting each time. I initially came up with the theme “visuals” for this edition. But as the submissions started to flood my inbox, I soon abandoned it. So although I provide you with some visuals, the blogging this time is too diverse to box in.

The images in this edition are all microscopic photos of stained histologic sections and cytologic smears of different types of cancer. In all its horror, even cancer can at some level be beautiful. This edition of SurgeXperiences presents posts on both the beauty and horrors of the surgical world.

Papillary thyroid carcinoma

We’ll start off with two posts from South African general surgeon bongi. He writes about what work is like when there’s surgery to be done and not a glove to be found.

Or when you operate on an HIV positive patient and accidentally stab yourself with the suture needle.

Harsh reality.

Capillary hemangioblastoma

In her brilliantly titled “Doctors Wanted – No Women Need Apply” – NOT! posted at Mothers in Medicine, anesthesiologist T writes about some of the first female physicians in America, fighting their way up in the (then) male dominated medical world.

Also at Mothers in Medicine, general surgeon G wonders if the parentheses around “then” should be dropped altogether, as the concept of a pregnant surgeon still is a foreign one to a lot of (male) surgeons.

Over at Scalpel’s Edge, Cris Cuthbertson advices a friend who’s studying medicine to consider both children and all other life projects when choosing her medical speciality. And to be ready to compromise.

Mammary ductal carcinoma in situ

Occupational Therapist Grace Young writes about minimally-invasive Quad-Sparing (QS) knee replacement, a procedure she went through herself, but has found little information about.

rlbates at Suture for a Living shows us her surgical loupes. It seems that wearing a pair comfortably may involve a lot of tape.

In one of her more encyclopedic posts, the same rlbates describes Mondor’s Disease, an uncommon disease of the pectoral region that can be intiated by trauma, infection, or surgery.

Colorectal adenocarcinoma

bongi considered not telling the story he’s called the last goodbye. A very hard story about when there’s nothing more to do, nothing will probably be the right thing to do. I’m glad he told it.

In an anatomically related post scanman Vijay presents some interesting CT images of colorectal malignancies.

Chronic myelogenous leukemia

Surgical resident Dr. Piltz writes a very vivid and engaging recap of a 24 hour call. You feel you’re standing beside the surg as he’s hurrying to place an artery line on a patient who’s coded. A very stressful read. Recommended.

Med student Kendra Campbell was also on call – her first surgical night call. It ended with her coming close to running out of the hospital. She wonders if med school really have to be pure hell.

Chordoma

Dr. Keagirl shares the indescribable frustration of loosing cancer patients who, ignoring her advice, put their trust in alternative medicine.

James J. Gormley also writes about alternative medicine, but in relation to treatment of terminal patients. In his post Medical Futility …. or Failure to Hope?, he argues that it’s not the technical abilities of medicine or surgery that fails for these patients.

Small cell lung carcinoma

Alvaro Fernandez at Sharp Brains offers an interview with Lee Woodruff. She is the wife of reporter Bob Woodruff, who suffered a life-threatening traumatic brain injury while working in Iraq. An injury he later completely recovered from, despite spending 37 days in a coma and having his skull surgically rebuilt. Now he’s helping other traumatic brain injury survivors.

Intratubular germinal cell neoplasia

Time to wrap up. Here’s a tip on what to wrap up in gift paper for Christmas, if you want to win the heart of a surgeon. And as I love puns, I’ll let bongi end this edition with his story of a macerated nipple.

That’s it for now. The next edition of SurgeXperiences will be hosted on September 28th by Buckeye Surgeon. Submit your posts by September 26th using this form.

All images from www.oncolex.no.

Heart-lung machine in use during cardiac surgery.

On Sunday, September 14th I’ll be hosting the one and only surgical blog carnival SurgeXperiences for the third time. SurgeXperiences is a biweekly carnival collecting the best of blog post related to surgery (photo credit).

The theme for this edition will be “Visuals”. Interpret it as you like. All posts will be accepted. Start writing and submit your posts here by Friday, September 12th.

The current edition, called “Evidence”, is up at Scalpel’s Edge. Check out the schedule for season 2, and the season 1 archive.

Photo by Christophe MOUSTIER.

Edition 124 of SurgeXperiences, the one and only surgical blog carnival, is up at Notes of an Anesthesioboist.

This is the last edition of the first season of this truly unique biweekly collection of blog post related to surgery. The season finale brilliantly sums up the great variation of subjects and writing styles SurgeXperienes collects. Be sure to check it out!

All 24 editions of the first season are collected here. If you’d like to host an edition, contact carnival founder Jeffrey. He will also be hosting the first edition of season 2, on July 6th at his great blog Monash Medical Student.

Sheepish offers a good tip:

My tip – never let a sound recordist into your theatre, and if they do, insist that they remove that hairy dog from their microphone, unless you are happy for your patient to have their wound infected with bizarre and rare bacteria or fungi.

I couldn’t agree more. A zeppelin shotgun mic (as they’re called) with a windscreen is the exact opposite of clean. They start to smell after being used for a while, and I never heard of a windscreen being washed. A windscreen should, however, be totally unnecessary in an OR, where there’s usually no wind.

SurgeXperiences is a biweekly blog carnival, collecting the best of the surgical department of the medical blogosphere. Check out the back catalogue here. Read this if you would like to host an edition (highly recommended! I’ve hosted two editions myself).

The next edition will be up at Israeli anesthesiologist QuietusLeo’s blog The Sandman, on June 8th. He’s chosen the theme “The Philosophical side of Medicine” and is looking for some introspective blogging. Submit your posts here.

As I am no ancient mariner, I won’t attempt to rhyme. But as recent studies show that a picture says exactly the same as 1014 words, I’ll stick with what I know – visuals. I’ve decorated this edition with some photos I’ve taken of aesthetic surgical instruments. Enjoy.

We start off with some hands-on, physical instruments. A steady provider of informative blogging, Suture for a Living brings us a post on barbed sutures – a type of suture that don’t need tying. From the same blog comes a post on dermatomes – a device used to cut thin layers of skin for grafting.

The guys over at OpNotes offer some news on the latest gadgets in minimally invasive surgery, including the EndoBarrier, AnchorPort and NeatStitch. GreatInventions or just DisposablePlastic?

A lot of surgical instruments are beautiful and exquisite in their design. I am especially fond of the hemostat myself. Professor Thomas Söderqvist of the blog Biomedicine on Display has been to a medical history museum turned art gallery in Paris where the instruments are presented as little works of art.

Sid Schwab’s Surgeonsblog has featured several great posts on the use and abuse of different surgical instruments. In two of my favorites he writes about surgical clips and electrosurgery/diathermy.

Talking about abuse – this is what a retained surgical sponge looks like on an x-ray, as brought to us by the fascinating blog Radiology Picture of the Day. It’s mission is simple and effective: a new medical image daily, with a brief description.

As we’re about to move from physical to more metaphysical instruments we turn to eye surgeon David Korram and his blog Marianas Eye. As a young student he found himself about to be seduced by a stethoscope. Fortunately he was saved from committing the cardinal sin of gadgetry. As the blood rushed back into his brain he realized the patients make appointments with doctors, not instruments.

T at Notes of an Anesthesioboist also had a realization about meeting patients. Interpreting the human Rorschach test we’re put to everyday correctly is an all-important tool in handling patients.

Being able to concentrate on the moment can be challenging in a busy workday, but is vital to really see the person before you. From Dr. Bruce Campbell comes a post on smoking that captures two of these moments clearly.

Surgical first assistant, and self-declared ambulance chaser (or trauma slut if you will) makeminetrauma at IntraopOrate uses an unconventional instrument to get a head start on trauma calls. Keep on chasin’!

Buckeye Surgeon questions if restricting more and more sub-specialities of surgery to “Centers of Excellence” is such an excellent idea. Maybe an exam is a better tool to ensure operations are handled by competent surgeons?

I reckon nobody has come up with a special forceps to remove what’s causing the bowel obstruction monash medical student Jeffrey Leow presents in the post a rare cause of SBO. Talk about stomach wrenching guts…

In the end, education and practice is perhaps the most important tools of them all. Bongi shares two stories from his surgical training. Being thrown into an operation he’s trained for but haven’t actually performed, he finds himself very alone. To some (professors) doing an operation by the(ir own) book is more important than a succesful operation. Though not alone this time, Bongi found himself being skewered for saving a patient’s life.

Aggravated DocSurg compares his medical education to drinking wine from a fire hose. Must have made him wet, but did it whet his appetite?

I’d like to end this edition with what is without a doubt the most interesting surgical blog post I’ve read in a long time. Respectful Insolence discusses, in a very detailed post, the ethical and practical problems with clinical trials in surgical intervention. A critical view on the tendency of surgeons to adopt new procedures before studies show it to be safe or more efficacious than the procedure it’s designed to replace. Highly recommended.

That concludes the “Tools of the Trade” edition. Did you learn anything? Go here to find out. The next edition will be hosted at The Paper Mask on May 25th. Submit your posts here by May 23rd. All previous and upcoming editions of SurgeXperiences are listed here.

Oh, I almost forgot to mention – there’s a new plastic surgeon in town: