Getting Closer to the Kidney

I scrubbed in my first surgical case yesterday. Before I scrubbed in, I placed the Foley in the patient. I first cleaned the vaginal area and then advanced the yellow rubber tube through the urethra, what looks like a dark whole.

When I walked into the OR, my arms were up in front of my face, dripping. I realized I was about to get the closest to the surgical field I had ever been. Once I donned the blue gown and plunged my hands in the gloves, I made my way to the operating table, gaining a whole new vantage point, so much different than looking from the corner or over the shoulder of others. I was actually part of the field, my gloved hands rested on the patients abdomen as we began the partial nephrectomy, a procedure that involves removing a portion of the kidney. In this case, the procedure was indicated to remove a suspicious mass.

An incision around the lower ribs was made and we moved through layers of fat and muscles until we got deeper to the fatty pouch containing the kidney. During the process, I helped retract (hold tissue back) and suction. Once fat was removed and the essential vessels (the ureter, renal artery and veni)were identified, we were rewarded with the a view of the left kidney.

The pink kidney was glistening and we could make out the mass on the lower border. Before cutting the mass, the arteries were pinched off to prevent bleeding. In such an ischemic state, "time is kidney," so we need to work quickly to prevent irreversible renal damage.

The mass was cut out and the kidney was eventually sewed back together. Layer by layer, the tissue was sewed up. Assisting at the table was quite an experience and has given me a whole new perspective. We'll see what other organs I will get to see even closer.