Archive for the ‘ Surgical technique ’ Category

Prolene suture

When tying prolene suture in a two-handed fashion, to avoid tying an air knot, throw the knot that starts with the suture over the thumb first. This will make it easier to hold tension on the two strands so that you can subsequently throw the other knot.

Beaver scalpel

A Beaver blade works very effectively during mastectomy. A few well-placed sweeps in each quadrant and the whole specimen is off the field.

Cervical dilators

Cervical dilators can be used to raise mastecomy skin flaps because they are helpful in finding the relatively avascular plane between the breast and the skin flap. The technique uses progressively larger dilators to develop the dissection plane that can be difficult to find during skin-sparing mastectomy.

Hard lesson

Despite attending presence in the OR, sometimes cases do not go as planned and things can go wrong.  Don’t beat yourself up over it, but use it as a learning experience.

Appendectomy

For a first appendectomy, 46 minutes from incision to closure isn’t too bad.

Supra-clavicular central access

Despite all teaching to stay superficial when performing a subclavian approach, the supraclavicular method requires one to go deeper (more posterior) than one would expect to find the vein.

Resecting anatomy

Always place clips, ties, sutures on your “stay” side first.

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