78 year old male who presents from his dermatologist with a pigmented lesion of the left cheek which has been increasing in size over the past few months. The patient’s dermatologist performed a shave biopsy which revealed malignant melanoma in-situ, lentigo maligna type.
What is the best option for further management at this point?
A. Close monitoring with skin examinations every 6 months.
B. Punch biopsy of the central core of the lesion.
C. Excision of the entire pigmented lesion.
D. Wide local excision with 0.5cm margins.
E. Wide local excision with 2.0cm margins.
(Source: surgerytheater.com)
A 66 year old became the first person to have a total artificial heart implanted in his chest. This period which he names as the “bridge period” gave him time to wait for a natural heart without concern of a sudden heart failure. Once again improvements in science make life a more sustainable phenomenon.
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The earliest recorded attempts at hip replacement (Gluck T, 1891), which were carried out in Germany, used ivory to replace the femoral head (the ball on the femur).
Pictured above: a titanium hip prosthesis, with a ceramic head and polyethylene acetabular cup.
Stanford research restores sight in blind with Optoelectronic Retinal Prosthesis. It works like the solar panels on your roof, converting light into electric current, but instead of the current flowing to your refrigerator, it flows into your retina.
In the early 1950s, Professors Henrique and Ricardo Finochietto of Buenos Aires invented this instrument to hold apart the rib cage during open heart surgery.
In 2010, UC San Diego performed a clinical trial operation where they removed a woman’s gallbladder through her mouth. The surgery is called NOTES (natural orifice translumenal endoscopic surgery) which was done as part of a study to evaluate the safety and efficacy of the oral and transvaginal NOTES compared to laparoscopy, measuring primarily the differences in terms of pain levels, cosmetic outcomes and costs.
Watch this video to learn more about NOTES!
(Source: ucsdnews.ucsd.edu)
Julian J. Chisolm invented this inhaler to conserve the anesthetic chloroform, which was in short supply. The patient inhaled the anesthetic through a tube inserted in each nostril.
In 2008, the first baby was born via ovary transplant. A 39 year old woman who went through menopause early, was given an ovary by her identical twin sister!
The biggest problems in early surgery were:
These problems were gradually solved in the 19th and 20th centuries.
Joseph Lister in the UK developed ways to cut infection by sterilizing surgical instruments, hand washing and using a carbolic acid spray (see machine above) to kill germs in the air. Nowadays, air in operating theaters is carefully filtered to remove bacteria and a germ free area around the site of the operation (a sterile field) is maintained at all times. Modern antiseptics include betadine - the orange solution painted around operation sites prior to surger. (Source: infobarrel.com)