Advanced Suturing Workshop!!!
Today has been amazing. I’m only a first-semester medical student and I have already performed my first appendectomy! Well, at least on a cadaver, and much less strenuous and urgent as it would be on a live patient… Last month, I posted an entry about my experience at an introductory suturing workshop hosted by AMSA, where we learned different ways to suture the skin. This morning at 8, I again was happy to drag myself out of bed to attend the Advanced Suturing Workshop. As last time, it was hosted by AUC’s chapter of AMSA, and taught again by the charming Dr N. Today’s workshop was all about suturing internal structures.
During the first 20 minutes or so, we reviewed the suturing of skin, which I managed to do much more quickly, fluently, and better than the last time. It is always easier the second time, isn’t it? Then we learned to reattach a severed tendon using the Kessler’s stitch and Paul Bunnel’s Figure-of-8 stitch, as well as learned how to elongate a tendon in the case of patients born with Talipes Equinovarus (Clubbed Feet). Of course, we didn’t have any patients with clubbed feet or severed tendon, but we recreated them using the cadavers in our anatomy lab. Next we learned how to suture an appendectomy, which includes tying the appendix, cutting it, inverting and suturing it into the cecum like a draw-string bag. The style of suture is cleverly named the “purse-string stitch.” And finally, we learned to perform the Finney Pyloroplasty, used to widen the opening of the stomach into the intestines, in patients with pyloric stenosis (narrowing of the pylorus). This involves making a horizontal cut on the pylorus, then sowing it back vertically.
It’s kind of funny how most suturing is something that is considered “busy work” pushed onto the interns by their superiors. I may very well see suturing as such when I get to that point in my career. But for now, as a fresh-starting, first-semester student who doesn’t know much yet about the realities of medical practice, let me keep my fun and excitement while I still can.