Today was the second day at the hospital, and it was just as amazing as the first. Saman and I arrived a little early for our rotation, so we found the hospital library and began to read up on the surgery that we would be observing today: a partial nephrectomy.
In a partial nephrectomy, the surgeon removes a tumor that has formed on the kidney, without removing the kidney. This surgery was performed using a laparoscope. Laparoscopy came before the Da Vinci robot, and consists of the surgeon making small incisions to insert a camera and perform the surgery inside the patient. This patient had a golf-ball sized tumor on the superior portion of the left kidney.
The surgeon first exposed and clamped the renal vein, then began to expose the kidney. The trickiest part about this surgery is that as soon as the renal artery is clamped, the tumor has to be removed within 40 minutes or the kidney will stroke. The tumor looked like a ball-shaped trunk covered in fat, kinda like a strange-shaped cauliflower. Once the tumor was exposed, the surgeon clamped the renal artery. I looked at the clock: 11:51.
Saman and I watched in anticipation as the surgeon began cauterizing the tissue around the tumor, loosening it from the kidney surface. The camera angle was amazing, I could clearly see the spleen snuggled up against the lateral abdominal wall, and in the background the diaphragm slowly rose and fell like a red sunset in an alien movie. The tumor was finally free! However, now the kidney was cut open, and the surgeon began suturing the hole created by the tumor. By the time he was done suturing, I looked at the clock: 12:15! He performed the whole procedure in only 24 minutes! Amazing!
The residents finished closing up the patient and asked us if we had any specific questions. After the surgery, we changed back into our lab coats and went to the cafeteria to eat and tell the other fellows of the things we saw.
Later that night we went out for dinner at a Chinese resturant and went shopping a little bit. Liliana, Irene, De’Ryonne and I walked together and chatted, we had a great time exploring the city as the sun went down. I can’t wait for another great day at the hospital tomorrow! Ciao!
Anna-phylactic Shock 