I was dismissed from my 6 AM- 2PM duty at the Pedia ward in a General Hospital at 12 as a consideration so I could still prepare for my Operating Room Duty in the Doctor’s Hospital where I met the dancing CI. Actually, although we had had a lot of experiences (at the medical mission and in different DRs) with surgeries, this was the first time that we’ll have a really legitimate OR experience. The last time we’re here, there was no scheduled operation so we just watched a movie at Mara’s house.
I was at the hospital as quarter to one, the morning shift were still there. To my dismay according to them they had 4 cases just that morning and there is only one left for the afternoon. The last time it was the other way around, we were the morning shift and they are for the afternoon. We didn’t have any case and all the operations were scheduled at the afternoon. I was not very optimistic that I’ll have a case that afternoon.
However, when my groupmates came, I was really surprised when Angelo said that I should have the case for today since I lost my notebook (where I listed my case numbers inm the last medical mission). Kawawa naman daw kasi ako (I am pitiful according to him.)
The case was Lap Chole (Laparoscopic Cholecystectomy- removal of the gall bladder through a laparoscopic surgery). I took the case with Hanzel. I haven’t been in any major operation so I told him that I’ll just be a circulating nurse to acquaint me a little with the work and he can be the scrub. Both of us wore our respective mask and bonnet; however he scrubbed his hands from the elbows to the fingertips while I just did the normal handwashing. He wore the sterile OR gown while I remained in my clean scrub suit helping him not to touch any part the inside part of the gown. He helped the doctors wear their gowns while I stared… dumbly. Heck, I shouldn’t have switched work with him, I already know the steps. And a CD of the band Side A hummed with us. It was 2:30.
Laparoscopic surgery is virtually a bloodless surgery. The surgeon will just use a camera entered through a 12-millimeter-trocar (that acts as the portal) at the umbilicus. Another 12 mm trocar is inserted on the hole made at the Epigastric region while another two (5 mm trocars) were made on the sides. Istead of looking at the tummy, the surgeons look at the TV monitor in front do the surgery by manipulating the instruments. It is like a computer game with sterile joysticks.
While Hanzel was still dressing up, I saw the real circulating nurse cleaning the sleeping woman. She started with an alcohol at the umbilicus. She made sure that it was very clean. Then she brushed betadine at the girl’s abdomen to the groin and to her reproductive organ. She opened the vulva and also inserted the sponge and brushed it with betadine. It dawned to me later on that she did this so she can insert the folley catheter. I haven’t tried inserting any folley catheter so I took the chance to observe. She first looked for the urinary meatus. For a while I thought she was inserting it at the vagina because she seemed to be having a hard time putting it in and the hole looks a little bigger; however she successful in the end.
Then one by one they covered the girl with different assortment of linens until only the right side of the abdomen is visible. Everything is covered from head to foot.
The trocars were inserted at their respective places. They inflated the abdomen with Carbon dioxide. The inside was very visible, I saw the depositede fats that resemble the yellow part of balut with all the veins in it. The veins, the faschia, the liver are all clear, think you’re watching the National Geographic. I was asked to yhand them unsterile stuff like hot water (where they dip the camera to wash, or IV. I even had the chance to place the Naso Gastric Tube in the patient’s nose (since the anesthesiologist, the real circulating nurse who went somewhere, to eat I supposed, and I are the only unsterile people who can touch the unsterile face of the woman) while the operation is in the process.
They used different extra elongated instruments that are called as grasper, scissor, and many many many more.
When they have finally reached the gallbladder, the surgeon tear a hole in it and an exudate of purulence issued out. It was pearly to whitish, slimy liquid. While th3e surgeon was vacuuming the slime, my CI said, “ay parang sipon.” (It’s like a mucus.)
Then another doctor replied, his eyes naughtily twinkling, “hindi ah… para syang ano… ano…, “ (of course not, it is like a… a…) then he paused then grinned which is still discernible in spite of the mask, “ano parang… alam mo na kung ano.” (You know… you know what it is….)
Everybody laughed because everyone knows what the slimy, pearly, viscous, stuff was like. Then he added, “Basta tayo nagkakangitian na alam mo na yun.” (When we have finally smiled at each other, you already know what I mean.)
The Side A band incessantly rumbled in the background and the operation still go. The scrub nurse was really nice to teach us and the observers some of the equipment being used. I asked her a lot of times and she’s more than happy to reply. She looks like Dra. Peaches.
Although there were momentary episodes of jokes, none has really laughed out loud, the operating room seems like a sacred place… and nobody dared to ruin that atmosphere… although sometimes the scrub nurse or the anesthesiologist sang a line or two of the songs by Side A that is being played.
The operation has ended at exactly 6:45. The funny thing is, just as when the lights were turnede on, the mellow song of Side A was immediately replaced by the original version of Beyonce’s song…
The song was like… “Heyyyy love to love you baby.” Everyone noticed this and a really crispy set of guffaws erupted.
