Manic Monday

Enough of the pseudo cursive.   Today was a busy day at work.   I had a junior student who had never done any chest surgery before.    She was nervous, honestly, I do not bite.   I do not rant and rave or belittle people.

The first case was a lung lesion.   It was done with a scope. First you have to insert a double breathing tube, this has the ability to isolate the affected lung so the surgeon can operate.   The lung is deflated so he can see what is going on.

Three incisions are made in the chest wall.   With the cat scan he can see where the mass is and then goes in and takes a chunk of the area.   The instrument staples and cuts at the same time.   You get a good chunk and it is stapled in a double row and is cut.   You need a special surgical stapler to do that.   Then the specimen is sent to the lab.

They have developed something relatively new.   It is a piece of mesh that is radioactive, it is an isotope of Iodine, the half life is sixty days.   It is placed over the area after the lesion is removed.   It will stay there.   This is called brachytherapy.

The recurrence rate with just the removal is about 15% to 20%, if the brachytherapy is included it goes down to 2% to 4% of recurrence.   Sounds like it is a good thing to do if you have a malignancy in the lung.

The student did good.  Guess she won’t be nervous the next time.    Tomorrow is ENT, Ear, Nose and Throat.