how to become knowledgable about surgery

[gouda]

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As a 2nd or 3rd year student are there any recommendations for things a student can do to become more comfortable or knowledgeable about surgery?

I have seen surgery kits - are they worthwhile? Any other suggestions short of watching cases and reading up on them beforehand?

 

[smq123]

As a 2nd or 3rd year student are there any recommendations for things a student can do to become more comfortable or knowledgeable about surgery?

I have seen surgery kits - are they worthwhile? Any other suggestions short of watching cases and reading up on them beforehand?

Knowledgeable about which aspect of surgery?

As a medical student, you don't need to be too knowledgeable about the right techniques. You should know, though, why they're doing this surgery, what post-op complications you might see, why the patient needs surgery in the first place, and have a rough idea of how the surgery is done.

For instance (since we're in the oto forum) - I saw a few thyroidectomies while on my oto rotation. I didn't need to know why they chose to use a certain type of suture over another, how long the incision needed to be, or anything like that. I did need to know, though, what to look for when I checked up on the patient the next morning (i.e. check for Chvostek's sign, make sure that we sent for calcium levels, listen to the patient's voice to listen for any new hoarseness, etc.)

I don't think that surgery kits really help. The only useful thing about surgery kits is that they (might) help you do better on the clinical skills portion of your final surgery exam - if your school makes you do a clinical skills exam, that is.

Do you have a surgery rotation coming up?

 

[neutropeniaboy]

As a 2nd or 3rd year student are there any recommendations for things a student can do to become more comfortable or knowledgeable about surgery?

I have seen surgery kits - are they worthwhile? Any other suggestions short of watching cases and reading up on them beforehand?

Here's a great surgery kit: borrow a needle driver; borrow some suture material, and go buy some chicken breasts. Practice.

Learn to tie knots. Nothing is more painful than watching someone who has no idea how to tie a knot.

 

[gouda]

I have a rotation in June doing clinical research with an ENT doc and she mentioned that she would let me see a variety of surgeries if I'd like. I had shadowed an head neck oncologist before this and loved the variety to her patients, but felt like I was missing so much because I don't know a thing about surgery ... I'd like to make my experiences with these doc's as meaningful as possible, so I am wondering what expectations are out there and what I can do to become adept with my hands.

On a side note we just learned suturing the other day and it was great! The surgery club at my school is pretty intense and I was starting to think that I am way behind the pack, which also prompted this post.

 

[gouda]

Here's a great surgery kit: borrow a needle driver; borrow some suture material, and go buy some chicken breasts. Practice.

Learn to tie knots. Nothing is more painful than watching someone who has no idea how to tie a knot.

Lol - that is what my fiance said ... really? Can the public at large really purchase suture material?

 

[smq123]

I have a rotation in June doing clinical research with an ENT doc and she mentioned that she would let me see a variety of surgeries if I'd like.

Before you shadow the ENT doctor in the OR, try to find out what you'll be watching. And then read up on those surgeries in Schwartz (surgical textbook) and Zollinger (surgical atlas). I'm sure that there are other books that are more favored by ENTs, but Schwartz and Zollinger are probably the easiest ones for med students to get their hands on.

This is what you'll need to do on your third year surgery rotation, by the way.

I'd like to make my experiences with these doc's as meaningful as possible, so I am wondering what expectations are out there and what I can do to become adept with my hands.

There is no need to try and be that adept with your hands. It's not like you'll be doing the operation or anything.

Whatever she does let you do will probably be fairly basic stuff - retracting and such (and a chimp could retract - it's not that hard). And, maybe it's different with her, but I had to earn my way up towards doing anything with my hands. After patiently watching the resident do several FESS's, I was finally allowed to suture (and he taught me the instrument tie). After volunteering to pre-round on patients in the AM, I was finally allowed to make the incision for a trach. So don't be surprised if you don't get to do much more than retract.

On a side note we just learned suturing the other day and it was great! The surgery club at my school is pretty intense and I was starting to think that I am way behind the pack, which also prompted this post.

Yeah, you're probably not. Don't let peer-pressure get to you. 🙂

Lol - that is what my fiance said ... really? Can the public at large really purchase suture material?

Buying suture material from the manufacturer can be expensive. Some sutures can cost $5 a pop.

You might be able to get bulk sutures from ebay.

I used cheap cotton twill to practice knots with - it was roughly the same diameter as a 2-O tie. I was also lucky enough to get a couple of sutures and practiced suturing an old pillow - if I used chicken breasts, then I wouldn't have been able to re-use the sutures. The key to practicing suturing isn't necessarily the suturing part - it's learning how to open and close the needle driver with one hand, without looking like a total idiot!

 

[resxn]

Lol - that is what my fiance said ... really? Can the public at large really purchase suture material?

sutures are not prescriptions, anyone can get them, but they are expensive. However, there's lots of suture that is available in the OR and if your real nice to the circulating nurse or scrub techs they'll usually make sure you get some.

Here's my advice for handling needles. You can suture all the chicken breasts or pig's feet in the world and it won't make much difference when you're doing it for real in my opinion. When you throw that first needle and the exit point starts oozing like mad, you'll freak. Experience with chicken will not slow your heartbeat in that situation.

I recommend getting your hands on a pair of needle drivers--disposable or OR ones or whatever. After you've used up the suture, or even better while suture is still left, practice handling that needle. Learn to turn it so it's back loaded or front loaded without touching it and without letting it completely go in the needle holder. Learn how it feels to move it around. I used to just sit in the call room watching TV and do that. I can't tell you how that helped me in the OR. I had several comments from attendings when I was able to regrasp a needle or reposition it without using another instrument or my fingers. They thought it was great.

 

[drfunktacular]

I recommend getting your hands on a pair of needle drivers--disposable or OR ones or whatever. After you've used up the suture, or even better while suture is still left, practice handling that needle. Learn to turn it so it's back loaded or front loaded without touching it and without letting it completely go in the needle holder. Learn how it feels to move it around. I used to just sit in the call room watching TV and do that. I can't tell you how that helped me in the OR. I had several comments from attendings when I was able to regrasp a needle or reposition it without using another instrument or my fingers. They thought it was great.

When you say this, are you talking about releasing the needle onto a surface (skin, e.g.) and picking it back up with the needle-driver in the appropriate position? Or being able to roll the needle around without touching anything else?

 

[resxn]

Not exactly on either. I think it's nearly impossible w/ suture attached to roll the needle in the needle driver without the needle touching something, but I do not advocate burying or sticking the needle in anything to do it.

What I mean is, say you've just thrown an awkward suture, the next will be even more difficult and you'll need to backhand throw it to get a good symmetric bite. Attendings will watch how you handle this. Another would be when the scrub hands you the needle backhand thinking you're R-handed when your actually L-handed.

Lighten the grip on the needle so it can be rolled in the needle holder and then very lightly drag the tip of the needle across the drape so it flips into the appropriate direction. When you get good at that you can do it in under a second and it just looks cool. You can also practice doing it so that you can reposition how much you "lead" your tip or how close to the end of the needle you grasp it. If you're good at repositioning the needle without touching it with your fingers or another instrument, it just makes it look like you know how to handle stuff in the OR.