SurgeXperiences 121

May 11, 2008 § 15 Comments

Welcome to the 21st edition of SurgeXperiences – the one and only surgical blog carnival – collecting the best from the surgical department of the medical blogosphere. I chose to call this edition “Tools of the Trade”. So what are those tools, and what exactly is the trade? I think the great variety of posts collected here shed some light on the many challenges encountered by surgical people everyday, and the different instruments – be they of steel or grey matter – utilized to overcome them.

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:

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