A few questions about surgeries???

Question

Hi!

A few days ago, I got to view a surgery (my first one, as I am only still in high school!!)...It was a partial mastectomy with an axillary dissection (removal of a tumor and surrounding tissue in the breast and also removal of some lymph nodes)

The surgeon was extremely nice and explained everything to me/let me get a good view.

But I still have a few questions...

1. What is the lymphatic channel?

2. What is the process called in which they insert a tube into the patient's airway, and what is the purpose?

3. What exactly is the purpose of the wires inserted into the breast? Also, what is the purpose of the wires that are inserted into the tumor? after removal?

By the way, everyone on yahoo! answers is right...surgery does rock!!!! And although it was quite different from whats on tv, it was probably the most exciting thing I have ever seen!

Any answers would be great! Thanks so much!!!! =]]

{And yes, I know I already posted this question, but I figured I might get better response by posting at night...}

Answer 1

Interesting and good questions.  I hope you got a lot from the surgery and become a surgeon yourself some day.

1.  Your body pumps blood from the heart out through arteries to your body where the red blood cells give up oxygen to tissues and take carbon dioxide.  Then the blood returns to the heart through the veins.  Along with red blood cells that carry oxygen, you also have a bunch of white blood cells that work in various ways to fight stuff the body thinks is bad, like infections, allergic material, and sometimes, cancer cells.  Local cells identify the bad stuff and call for help with chemicals that cause you to send lots of white cells to the trouble spot where they attack.  After they attack, these white cells are often killed, damaged or infected themselves, so the body can't just dump them back into the blood stream (veins) and have them circulate everywhere.  So the body has a second, smaller system of tubes - a lot like veins- called lymphatic channels.  The used white cells go through these channels and through a bunch of filters, called lymph nodes and then the healthy ones can go back into the circulation, and the unhealthy ones get cleaned up and recycled, so to speak.  You have experienced this if you ever had a sore throat and swollen "glands".  The glands are the lymph nodes swollen as the process the white cells you fight the throat infection with.  Since white cells also often attack cancer, it is possoble to spread the cancer (in used white cellls) through the lymph channed to the lymph nodes, so commonly, in surgery for cancer, lymph nodes will be checked to see if the cancer has spread.

2.  Intubation is the process of inserting a tube in the airway.  Modern surgery is very safe compared to just 20 years ago because we do everything in a standardized way - every time so there is less risk of error.  One of the big error sources is the patient themselves, so we try to reduce their input.  We do that by not only anesthatizing them (no pain) and putting them to sleep, but also by paralyzing them so they can't move at all (you wouldn't want a patient to roll over during surgery, or even twitch).  But the paralysis makes them unable to breath or even hold their airway open, so we have to put a tube into their airway (to hold it open) and breath for them.

3.  Wires used in surgery is not my area, so someone may know more.  But generally we put wires in to be able to find something.  So if we can localize a tumor on 2 different view of an x-ray or ultrasound, we can put wires in from both sides and they should meet in the tumor, which makes finding the tumor much easier for the surgeon in the OR.

Hope this was helpful.  Best wishes.

Answer 2

A lymphatic channels are what lymph are moved through. This website can explain it in more detail if you'd like. http://www.ispub.com/ostia/index.php?xml...

Putting the tube down their throat is called intubation and it's used to keep the airways open because sometimes when people are under anesthesia for a long time their airways relax a little and it can make it hard to breathe. It isn't done when the throat collapses, it's done before surgery starts. It's more of a precaution than anything and it's rarely used in short surgeries because of the risks associated with it.

I know sometimes with breast cancer they do something called wire localization which is where the radiologists mark the abnormality they see in the mammograms with a wire inserted under the skin into the area of breast that's going to be removed. Following that the surgeon can use the wire to find the abnormal spot in the breast so they can remove it.

But I don't know why they'd put one in the tumor after it was removed.

Answer 3

I'll address the intubation issue - your 2nd question.

In anesthesia, part of what we do is control the airway.  There are several different ways to accomplish that, and one of the most common is intubation.  Airways do not "collapse".  What happens is, the soft tissue becomes relaxed and can obstruct the upper airway (mild versions of this while sleeping = snoring; severe = sleep apnea).  We also do frequently paralyze our patients, for a variety of reasons (for example, smokers might cough and buck the whole case, and that makes surgeons yell).  Paralysis is also frequently required for surgical exposure.  Anyway, paralysis includes the diaphragm, so we have to take over breathing.  We frequently control respirations anyway, as most anesthetics depress respiratory function.

The wires are localization needles.  They are put in under radiologic guidance, and then the removed specimen is xrayed to make sure what was seen on the mammogram has been removed.

If you like hanging out in ORs, consider a career as an anesthesiologist  :)  All the fun without the tedium of standing and staring into a bloody hole all day.

Answer 4

1. The lymphatic channels are the vessels that Lymph travel in.

2. Intubation, they do it when the throat collapses or is obstructed.

3. The wires were probably monitoring something, can't think what though.