On my birthday, we got another opportunity to watch an
operation. This time we watched the entire thing, including the set up of
machines etc, which was really interesting. The Anaesthetist explained to us
what the operation would entail, but through his broken English we couldn’t understand
too much, just that it was something to do with his throat.
The surgeons began drawing a line from just above the mans Adams apple, to between his collar bones. We realised they were going to cut this line, which made us all feel a bit queasy (I don’t like Adams apples). First they cut the line and basically dug around in the hole, cutting into the trachea. Then they inserted a tube attached to a breathing machine, and stitched it in place.
We thought that might be the whole operation, but they then started to cut around the larynx (the top part of the trachea, made of cartilage and containing the voice box). They removed the entire larynx and showed us the vocal chords, which was interesting, but pretty disgusting. Then they stitched up the hole, leaving a dent in the man’s neck. I was wondering why they had to remove the larynx, so I asked the Anaesthetist to write down the man’s condition. He shook his head, and asked me to meet him on Monday. I did, and he’d written out a case report for me in English, which was really kind of him. Here is the report overview:
Operation: Total laryngecotomy (with permanent tracheostomy)
Cause of operation: Increased risk of accidental aspiration due to amyotrophic lateral sclerosis (ASL, progressive disease with systemic muscular dystrophy, leading to reduced breathing and coughing power)
General condition: Severely deteriorated, needed support of breathing by mechanical ventilator
Preoperative condition: Pneumonia (left lung) diabetes mellitus, past cerebral infraction (right hemisphere)
Then there is a short paragraph about the anaesthetics used, propofol, remi-fetanyl and sevoflurane.
Operation time 3:09
Postoperative period: after cessation of propofol, his ability of oxygenation became stable so that aspiratory oxygen concentration could be decreased from 30% to 25%. Now he can recognize what we are saying, and sometimes smile. He is also able to make movements with his left hand (right hand has been paralyzed due to past cerebral infraction)
This report was very interesting to me, but made me quite sad, because the operation we saw was not going to save the mans life, or really improve it in any way, just prolong it.
The surgeons began drawing a line from just above the mans Adams apple, to between his collar bones. We realised they were going to cut this line, which made us all feel a bit queasy (I don’t like Adams apples). First they cut the line and basically dug around in the hole, cutting into the trachea. Then they inserted a tube attached to a breathing machine, and stitched it in place.
We thought that might be the whole operation, but they then started to cut around the larynx (the top part of the trachea, made of cartilage and containing the voice box). They removed the entire larynx and showed us the vocal chords, which was interesting, but pretty disgusting. Then they stitched up the hole, leaving a dent in the man’s neck. I was wondering why they had to remove the larynx, so I asked the Anaesthetist to write down the man’s condition. He shook his head, and asked me to meet him on Monday. I did, and he’d written out a case report for me in English, which was really kind of him. Here is the report overview:
Operation: Total laryngecotomy (with permanent tracheostomy)
Cause of operation: Increased risk of accidental aspiration due to amyotrophic lateral sclerosis (ASL, progressive disease with systemic muscular dystrophy, leading to reduced breathing and coughing power)
General condition: Severely deteriorated, needed support of breathing by mechanical ventilator
Preoperative condition: Pneumonia (left lung) diabetes mellitus, past cerebral infraction (right hemisphere)
Then there is a short paragraph about the anaesthetics used, propofol, remi-fetanyl and sevoflurane.
Operation time 3:09
Postoperative period: after cessation of propofol, his ability of oxygenation became stable so that aspiratory oxygen concentration could be decreased from 30% to 25%. Now he can recognize what we are saying, and sometimes smile. He is also able to make movements with his left hand (right hand has been paralyzed due to past cerebral infraction)
This report was very interesting to me, but made me quite sad, because the operation we saw was not going to save the mans life, or really improve it in any way, just prolong it.
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