Tuesday, March 30, 2010

Belly Button

I saw another hernia repair last week. This man had both a para-umbilical and an epigastric hernia, but the surgical registrar doing the operation decided he could repair both using the same long, squiggly incision. The operation itself seemed pretty standard (I’ve seen two now, so I should know) – poke the omentum back in, block the deficit up with some mesh, sew the hole up, and then close the skin. The registrar could probably do with some more suturing practice, because a lot of his knots were tightening before the actual suture was tight, and I had to cut them so he could try again. But eventually he managed to close up the abdominal wall, just like a real surgeon.

Then it was time to close the skin. The incision was long and squiggly, so it wasn’t very easy to line up, and it caused the registrar much frustration. Eventually he had it lined up as best he could and began to staple the poor patient’s skin back together. The theatre nurse, newly graduated, timidly asked the question, “pardon my ignorance, but will he still have a belly button after this?” The supervising surgeon answered, “yes of course – in fact, the way [the registrar] is going, he’ll probably have two!”

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