Week 2: Seo-Ho/Dr. Fahey

This week was full of new kinds of surgeries and procedures that truly made it feel like multiple weeks in one. Dr. Fahey performed two robot surgeries on Monday- both hernia repairs. Using the DaVinci probes, Dr. Fahey pushed the bulging part of gut back into the abdomen and secured the opening with a few stitches. He then covered/stitched over the opening using a very thing mesh fabric, which is intended to prevent the hernia from reforming more effectively than just stitches. In these surgeries. Dr. Fahey used sutures that looked barbed, allowing for their securement without tying. Later in the day, I watched Dr. Finnerty, another endocrinologist, remove an 18 cm adrenal tumor. This tumor is nonfunctional (does not affect hormone production), so it went unnoticed until the size of the mass became detrimental to the patient’s health. While I was not there for the entire surgery as it went on past midnight, I was able to see the tumor inside the abdomen area, and it was very vascularized and ellipsoidal.

On Tuesday, I watched Dr. Fahey perform a robotic-assisted cholecystectomy. This patient had gallbladder stones, so he decided to remove the full gallbladder. The most interesting part was watching the doctors drain the bile from the gallbladder and then package it inside a small bag that was delivered into the body by a doctor attaching it to a robot arm from outside the body.

Dr. Fahey’s clinic day is on Wednesday, so during this time I get to observe patient-clinician discussions about different conditions. I watched Dr. Fahey perform fine needle aspiration of a patient’s thyroid cysts and had the chance to interact with patients for the first time. I also worked with a cytologist to look at the patient’s samples immediately after collection and was able to identify histiocytes, macrophages, and thyroid cells.

Friday’s shadowing consisted of a few more surgeries. I saw a total thyroidectomy and an isthmusectomy. The total thyroidectomy was due to a very large goiter throughout the entire thyroid that was obstructing the patient’s swallowing. The patient also has Graves’ disease, which is an autoimmune disease attacking the thyroid that can lead to a goiter forming. This was my first time seeing both of these procedures, and it was cool to see the many procedures a surgeon can do to try to minimize impact on post-operative life.

On the research side, I have been practicing culturing a pancreatic beta cell line and will soon start working with stem cells to do macrophage and beta cell differentiation. I will also start analyzing pancreatic neuroendocrine tumor spatial transcriptomic data over the next few weeks.

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