My father-in-law just had his gallbladder removed. There was a small complication with the surgery (due to pus leakage from the gallbladder) and a laparoscopic procedure needed to become an open surgery. He did fine and is recovering nicely. I’m very glad that his surgeons did what they needed to do to get that infected organ out of his body safely.
However, his very minor “complication” reminded me of a gallbladder horror story that I once heard about from a surgeon friend of mine. I have changed many details of this story to protect the privacy of the patient (whom I’ve never met), but I think it’s important to talk about the event, especially in light of the recent surgical errors being discussed in the blogosphere.
A young man had suffered from gallstone “attacks” and was scheduled for a very routine laparoscopic cholecystectomy. It was the end of the day, and the surgeon scheduled to do the procedure had been working a 24 hour shift, and was quite tired and irritable. He wanted to do the procedure as quickly as possible and get home to dinner and an early night’s rest. The nursing staff remained quiet as he fumed and sputtered, preparing the patient with a betadine scrub and letting them know that he wanted to set a new record for speed of gallbladder removal.
The small incisions were made and some trocars were inserted so that the belly could be inflated and a camera and instruments inserted through the holes. The surgeon went to work quickly dissecting and preparing to remove the offending organ. In his haste, however, one of the instruments fell out of the skin incision. Enraged, he asked for a new one and began inserting a trocar blindly into the skin incision without guiding it with the camera. He had some difficulty getting it in, and began applying more and more pressure to puncture its way through to the middle of the abdomen. Exhausted, he jabbed it back inside with a final twist, inserted the instrument and then picked up the camera to continue the procedure.
Confusion gave way to terror as the internal camera showed the belly filling up rapidly with arterial blood. The surgeon had punctured the abdominal aorta during the trocar reinsertion. This was a surgical emergency. Ashamed of his mistake he decided to try to handle this himself, opening the belly wide to cross clamp the aorta and repair it without the patient needing to know about his near brush with death. Unfortunately, the repair took far longer than the surgeon expected, and blood flow to the legs was compromised for several hours (causing internal clots). Many units of blood were ordered for transfusion, nearly draining the blood bank of its reserves.
Tragically, although the young man did survive the surgery, he required an eventual double amputation of his legs. And all this after what he thought would be a simple gallbladder removal.
This is a sobering example of how serious any surgery can be, and why it’s so important for every procedure to be handled with the utmost patience and care. Many people have told me that surgeons don’t need to have a “good personality” because they mostly deal with anesthetized patients, but I think that this is a shallow view. A surgeon’s character is uniquely tied to his or her performance, and if they have a propensity towards a short fuse, it could result in tragic errors like this one. If you are considering surgery, you should feel comfortable with your surgeon’s style and personality. Don’t be afraid to get a second opinion or seek out a different surgeon if something doesn’t seem right. Your life may depend on it.This post originally appeared on Dr. Val’s blog at RevolutionHealth.com.