First, I’ll define some of the stuff I saw yesterday:
(Warning: May not be fit for the light at heart)
Endometrial ablation – Done by an instrument called Novasure. This is done to treat people with heavy bleeding (aka menorrhagia) who no longer want to have kids. The cervix is dialated with some metal probes (pretty much, they stick in a small one, then a bigger one, then a bigger one, etc, until your cervix is big enough.. I can’t imagine this isn’t painful, but luckily you’re under general anesthesia) and then the Novasure is stuck in. A triangle-shaped metal net comes out of the end of the Novasure and expands to fit the uterus, then creates a vaccum that pulls the uterus walls in to fit snugly against the net. Then an electrical current is passed through the net until all the tissue is dead (aka cooked). To see an animation of this, go here. (This guy goes on about how he does it in his office with local anesthesia.. It is a super fast procedure, completely automatic, and fairly simple, but personally I’d go with the operating room and general anesthesia.) (The dr I observe with also used an endoscope inserted through the cervix to examine the uterine lining before and after the ablation to ensure it all went smoothly.)
Genital wart removal with laser – Not much to say, pretty much what you’d expect. Everyone puts on special laser glasses and the dr uses a pair of binocular-type-things with a laser attached, and fries the warts. They pop and fizz, and then turn black.
Laparoscopy – This was my favorite. They make a small incision in the belly button, punch through your abdominal wall with a big spike, then fill your abdominal cavity with air until you look nice and rounded. The air pushes the abdominal wall out and allows space between organs, so you can actually see things when you go in to look around, instead of just being trapped between some squished-up organs. They insert an endoscope through the incision, so the picture shows up on the tv. It really is an amazing view of the human body. The dr showed me the uterus, ovaries, intestines, appendix, and liver. She tried to find the ureters, but they were hiding. Everything was very colorful and lovely. She then found some endometriosis, and burned that off with the laser. They make a second very small incision just above the pubic bone (and use another spike) so they can put probes, scissors, etc in to manipulate things with. At the end of it, the air is allowed to escape, and the dr pushes on the abdomen to make sure as much as possible is out, or it can form bubbles in your shoulder joints and be pretty painful. (A little like ‘the bends’ but not so severe.) The incisions require only 1-3 stitches.
Tubal ligation – Starts out like a laparoscopy, then they stick a long probe with little clamp-like jaws at the end into the second incision. They clamp it round a fallopian tube and send a burst of electricity to it, which kills off the tissue of the tube. They do this until there a 2 to 3 cm section of the tube is nicely browned, then do the same to the other. Then scissors are sent in, and the tubes are cut (note: only the tube is cut, not the tissue that runs along the bottom of the tube, so the ovaries are still attached to the uterus through that, not just randomly banging around your body) and then the ends of the cut are re-electrocuted. (I couldn’t find any pictures that were close enough to what I saw for my taste.)
I thought some of you might be interested in these fun facts about the body that I discovered yesterday:
- the cervical canal is white with red splotches and dots
- the inside of the uterus is white
- inter-uterine polyps look like sea anemones pulled in (except white)
- ablated human organs look just like cooked beef
- ovaries are white
- the uterus is not a flat triangle. From the top, it looks like an apple, very hard and very round. (It’s also red.)
- the fallopian tubes don’t stick out nicely from the top corners of the uterus, nor do they start out much wider and get skinnier. They look like very skinny, floppy arms sprouting out of the uterus and hanging down by it’s sides. Not straight down, since there’s organs and such, but not nice and stretched out either.
- ovarian cysts are big black evil-looking balls (and are not always signs of bad things)
- small intestines look fun to touch
Owl pictures to come soon. Watch this space.