I’m getting my posts kind of out of order, but I did want to talk about General Surgery from Wednesday.
One of the Emergency/Critical Care technicians had mentioned to me that she wanted me to do surgery on her dog while I’m on General Surgery. She has a 5 year old Bassett Hound named Flash who is adorable, but had nine different masses on various parts of her body. They’re all small, with the largest two being about quarter sized. The technician wanted us to remove as many of them as possible, and she had prioritized them in case there was a problem during the surgery and we had to abort mission.
I was pretty nervous about doing surgery on Flash since the tech was explicitly trusting me with her. I really wanted to do a good job, and I hoped things would go smoothly. When we anesthetized her, Flash immediately began having issues. She wasn’t breathing very well on her own, and every time my classmate would try to breathe for her she would buck and breathe against the machine. It made for a hairy moment while we tried to decide if we were going to go forward or if we should just postpone for another day.
The decision was made by our clinician to continue, so we got to work. I started on one of the largest masses which was located on Flash’s chest, while one of my classmates tag teamed and did three tiny masses that were able to be removed by punch biopsy. I made an elliptical incision around the first mass with electrocautery and began undermining the skin. The mass appeared to be a simple lipoma (fatty tumor) so I tried to dissect out as much of the fat beneath my incision as possible without disrupting the muscle layer underneath. A small amount of the fatty tissue appeared to penetrate the muscle, so it was unable to be excised completely. I got as much out as I could, leaving approximately a pea sized amount of tumor. I closed the subcutaneous tissue and skin and then moved onto the next mass.
This one was located on the back of her head. We knew it was some type of cyst, because it’s been drained and has filled back up multiple times. I was anxious to excise it completely, because if I left any of that cystic tissue it might still secrete fluid and would cause problems post-op. I used the cautery again for the incision and undermined the cyst down to the muscle layer. I was able to remove it completely without rupturing the cyst, which I was fairly proud of. This incision didn’t close as easily as the other had, and I was a bit nervous that the technician wouldn’t be happy with it. The ends of the incision pooched out a little bit, which isn’t a big deal other than it’s not extremely cosmetic. It should look fine in a few weeks once the sutures dissolve, but until then it’s not the best looking :(
The other masses were all removed by punch biopsy and closed fine with just a few sutures to hold the skin together. It’s been a pretty nerve-wracking experience for me since the technician is placing so much trust in me. I hope that she is satisfied with our work and the results, and that our little Flashy friend does well post-op. She did text me last night to let me know that the incisions were still oozing a bit, I’m hoping this is okay and told her if she was really concerned to give our clinician a call. Here’s a picture of Flash resting at home post-op:
I’ll keep you guys updated as to how she is doing. That’s about it for Wednesday, I’ll be back in a little bit with an update on our adventure!