Friday, June 20, 2008

Total Hip Replacement

Minimal invasive surgery (MIS) is a word frequently uttered in the seminars and conferences. Big versus small incision surgery is a never ending debate. Of course it is of cosmetic value for patient but struggling for surgeons.

Even orthopaedicians are running after MIS. Spine, joint replacement, fracture, or complex trauma, MIS stands front line. Being done with knee replacement thesis I was always fascinated with replacement surgery.

Mr.... your joint is burnt up and needs replacement. Sounds so amazing for the patient. They have hundred queries, but since there is no option for painless mobile life ultimately give their consent. Worth for exhausted joint and painful arthritis.

Don’t know the exact number of cases I assisted for joint replacement. I was lured to incise, cut the neck of femur, prepare acetabulum, put the metal inside it, and close it. Show the x ray to the patient he takes a long breath and imagine half of his thigh and hip area must have been cut like anything to put that big metal implant. But the small scar in the back of thigh and hip really build up the confidence to his surgeon.

I had done most of the part of surgery many times. But was always waiting for my turn right from A-Z of the hip replacement surgery. And today was my day. My seriousness toward work, interest to it, optimal knowledge to the subject, and faith of my boss and in fact his hang up to the next case made my dream come true. Boss said you start the case, expose and I will join after that. But after a long time I was a master of the surgical blade, why should I miss the opportunity of proceeding smooth till I wish. With in no time I exposed the joint, dislocated it, marked the neck cut and prepared the neck. Started the acetabulum preparation. In between I keep informing my boss. Boss was confident enough so he bothered not. The moment boss came to see my progress, I was almost through. I was about to put the acetabulum component. My boss was so kind that he did not want me to interrupt. Said sail smoothly. In between he told you are fast just because your exposure was fantastic. Exposure was with small incision, well prepared, and with utmost tissue respect. Boss was happy to see it. I thought it’s my progress towards perfection. I did not that I wanted appreciation but to master my skill. Shortly I finished. Must have taken one and half hour for the entire procedure, very smoothly and as expected and predicted beforehand. Everybody came and see and commented as they like. I mind them for their praise only. Only thing I objected in my mind is party again. Party means 1000 rs minimum. Oh god I gave party last week only for latissimus dorsi. But I don’t mind it, because it’s a tradition. Of all those I have started the new tradition, a new event and possibly a history of being a junior resident, replacing hip joint, though I am over with my MS degree.

Till now the post operative progress is fine and encouraging. Let’s see the post operative x ray and will be able to review the faults if there are any.

Thanks for all, my boss, my senior colleague who assisted me, nurse, and the anesthetist mam, who had doubt that I can do it and asked for the consultant to join to finish it quickly. Thanks for your anaesthesia mam because of which I could do in time frame and smoothly.

( will update with photograph soon)

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