Weeks 5 and 6 as a RREH Surgery Tech Student

Weeks 5 and 6 marked another transition for me. I’ve started to shift from a need for help acting as a tech for most surgeries to a greater independence in the surgery room. The more I learn about routines and where things are located, the more comfortable and relaxed I can be during a surgery. Screw placements to correct for angular limb deformities (ALDs) are the surgery in which I’m most comfortable. These surgeries are generally simpler to tech because once you have helped the clinician “set up” for the surgery (connect the drill, drape the patient) you have more time to set up for the next surgery; the room should be ready for the next technician to bring a patient in when you are done. Taking radiographs is a guarantee with screw placement regardless of the clinician involved, which means that you can be ready for them. Radiographs are taken to confirm that the screws are placed appropriately to correct for the ALD. I have yet to see a screw placement that had to be adjusted! Arthroscopies (joint surgeries to clean out bone fragments and cartilage buildup) are a little more complicated however. Because of the high number of arthroscopies each day and the high cost of the instruments (it takes a camera, and a light among other things), the instruments are sterilized between surgeries in a very strong chemical that you have to be careful working with. As technician you are responsible for sterilizing the instruments for the next arthroscopy and assisting in removing the instruments from the chemicals for your surgery. Additionally, fluids are run through the joint that is being scoped in order to provide a clean camera view for the surgeon while simultaneously acting as a joint flush. The technician is responsible for hanging and hooking up fluids to the fluid pump, hooking up the camera and light all the while keeping up with the surgeon’s needs. Needless to say, it takes a bit more finesse and experience to tech an arthroscopy as well as I can tech a screw placement. I also teched my first tie forward at the end of week 6, and a couple of closed castrations. A tie forward is performed to suture the larynx in such a way that the epiglottis sits closer to the pharyngeal opening so as to correct for dorsal displacement of the soft palate (over the epiglottis), a problem that can hinder performance horses by making their airway smaller. A tie forward is widely considered to be the most beneficial and successful surgical option for a displaced soft palate in a horse. Teching a tie forward is most involved in the preparation for the surgery. Clipping around the neck and jaw area of the horse is a more sensitive and particular procedure. Prepping the surgical site involves covering the horse’s eyes so that the cleaning solution doesn’t drip into them and damage the cornea. Finally, closed castrations are a more simple surgery to tech, as there are no fluids to run or radiographs to take (etc.). Prep the surgery site (with a less intense chemical scrub), adjust the lighting, keep some extra suture on hand and you’re good to go! Add a few intermittently placed colic surgeries to the list and you’ll have a good idea of how the past two weeks have gone.

A couple of the interesting sights these past two weeks include a miniature horse colic that had abnormally formed intestine with unusual (and sometimes lacking) mesenteric attachments, and a laceration that had devolved into something much more aggressive-looking (which ended up looking much better after a few days of treatment).

 Some of the intestines from the miniature horse colic.

 The laceration!