A false alarm

January 19, 2008 § 3 Comments

“Have you ever fainted,” is a question I often get. Fortunately I have not. There were a couple of close calls during my first year in this job, but my body has adapted and I’ve learnt some tricks along the way. Falling unconscious over the patient with camera and all, that would really be a nightmare.

Some time ago I witnessed a senior resident having her worst nightmare come true. Almost.

Midfacial degloving

I was filming a midfacial degloving. This is an approach used to get access to the nasal cavity. In this case to remove a tumor on the nasal wall (septum). An incision is made under the upper lip, making it possible to lift the soft tissue of the upper lip and nose from the mid portion of the face.

An experienced surgeon was performing the operation, assisted by two senior residents. Things were proceeding as planned. The surgeon was controlling bleeding with some hemostatic gauze, while the assistants chatted a bit absent-minded about another operation.

“OK. Hand me the Hall drill,” the surgeon said. “I’m now going to free the septum from the premaxilla.” He started drilling. Then all hell seemed to break loose.

The drill made a horribly wrong sound and blood sprayed all over the surgeon. “Oh fuck!” he yelled. The two assistants had turned white. “You stay here,” the surgeon said and rushed out of the OR. I was shocked and completely confused. If he had drilled through something he shouldn’t, why did he leave? And why didn’t the residents do anything?

After what seemed like an eternity (but was probably a minute) the surgeon returned and put on a new gown. The blood washed from his face. He broke the silence. “Well, that was a bitch. Let’s proceed”. “I thought you had hurt him bad,” said one of the residents. The surgeon laughed it off.

It turned out that nothing serious had happened. The drill had got caught in the blood saturated gauze still in the wound. Resulting in blood from the gauze being splashed around like a large vessel or something had burst.

The atmosphere loosened a bit as the surgeon proceeded. But one of the residents was still pale, drops of sweat running down her face. After ten minutes of doing nothing she asked to be excused and left the OR quickly. “I guess I really scared her,” chuckled the surgeon.

Later the unfortunate resident opened the door to the OR. “The anesthesiologist has forbidden me to come back in,” she said. “I almost threw up.”

She looked like she wanted to vanish into thin air.

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§ 3 Responses to A false alarm

  • Funny! but in that morbid sense that most of us in the O.R. have.
    Feel bad for the resident, nobody wants to show “weakness” especially a women in such a boys club arena.

  • Hello,

    I read you filmed a midfacial degloving. My wife underwend one in the Netherlands because there was something on hetr skull base what there should not be. I still wonder how it is done and wonder if there is any film material public about this kind of operation.

    Sander Frelink

  • Øystein says:

    Hi Sander!

    The video I made of the operation was never published, so you won’t be able to see that, unfortunately.

    I don’t know of any other videos available, either. Sorry.

    This article is a good overview of surgical treatments for sinonasal lesions.

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