28 September 2011
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| Laparoscopic surgery is routine at this hospital, but not on children this age. |
We left for the hospital promptly at 7:30. I was assigned a slower room with the general surgeon. We did a rectal dissection via laparoscope and an anoplasty on a child with imperforate anus. It was a long but uneventful procedure. We finished about two-thirty. I gave a couple of lunch breaks and was then told that we had an added case, an 11 month-old boy with a diaphragmatic hernia. It was more along the lines of a hiatal hernia, but he had so much guts stuck up in his chest that the breath sounds were diminished on the left. A little bit disconcerting but I finally convinced myself that the tube position was okay and we proceeded. It was another long but uneventful operation.
During the course of the day I was called over to the other room where they were doing plastic surgery, two tables in one room. One of the children for a cleft palate repair was difficult to intubate, but they put the tube in just as I got there. Later, during a break, I helped manage this kid’s airway in the PACU. That was when I noted that he had a very small mandible. I later found that the child started to bleed in PACU and had to be returned to OR. He had a very rocky course after that and was ultimately transferred to the CCU for ventilation and pressor support. So no complaints from me about long, boring surgery.
When we returned to the hotel a wedding party was arriving for their reception. It seems the Hotel Marshal is quite the chi-chi reception venue. The bride was gorgeous; my picture doesn’t do her justice.
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