Surgery day!

Today was a crazy busy day. We had 4 surgeries, and it was so freaking cool! First I helped clean out a trephining wound on one of the horses staying at the hospital. I've never actual seen a trephining wound that wasn't on a skull, so it was interesting to see. Trephining is when the horse has an infection or mucus buildup in their sinus, and since hoses have terrible anatomy it's hard for their sinuses to drain properly, so you drill a hole in their head to get the mucus out. This one seems to be from a bad tooth, and it was ok for a while but then I guess the skin over it wasn't healing so they're going to extract the tooth possibly and maybe do some sort of skin graft over it, but it's healing we'll and doesn't smell too bad and the bacterial culture came back looking good, so I guess we'll see!

Then the surgeon came in and we were ready to go! Except apparently he didn't like by he just had the word of the trainers to go on for what was getting done for these horses, so there was a lot of calling the vet who told then to come I. And owners and back and forth, so that took up some time. Apparently 2 of the horses had endoscopy done while running to see the extent of the damage done, but the surgeon who came in didn't have the video he didn't just want to go on the word of someone else, so we ended up doing endoscopy on all of them! It was so cool seeing real video of the epiglottis and vocal folds! I was like I actually know what I'm looking at! So the vet seemed satisfied, though he would have rather had the one done while they were running but what can you do. 

So then it was time to start the surgeries! So doing equine surgery is bananas! First you take them into a room that is completely padded, like a mental asylum. Then you put on a special head collar  that is completely covered in vet wrap and is padded so they don't injur themselves when they are rolled on the ground. Then you close the doors and lock them from the outside whole the vet and nurse give the anaesthesia, and when you hear the THUMP, you can open the door and the horse is on the floor. Then you duct tape their hooves so the dont mess up the padding on the room and hurt themselves. Then you get these canvas hobbles and put them on, front feet together and rear together and tighten them. Then you get in a giant hook that's attached to a track on the ceiling and hook it to the hobbles and hoist the horse into the air! I was amazed! The track leads right over the surgery table and so the horse is brought to the surgery table and then lowered down onto it, and you unhook it and rest it's front legs on some metal hooks. So now the horse is laying on its back with its legs up in the air like a bug. The surgeon turned to me and said so how many times have you been in surgery? And I was like umm this is my first time, I'm still trying to wrap my mind around this!! It was so amazingly cool! 

So the surgery we did is to help these horses attain a better airflow when they are running, since they are racehorses and that's their job. It's called either the 4 in 1 or 3 in 1. We only did the 3, but still cool. So first you put a gag in the mouth and visualise the soft palate. Then, using hot irons you cauterise the soft palate as far back as you can see. The goal of this is that when it heals it will be tighter so it's less likely to displace and cause breathing problems. Then you make an incision slightly caudal to the jaw, fin midline, and go between the muscles and cut through tendons until you can see the intubation tube. Then you displace the soft palate so visualise the epiglottis. Then do a sub-epiglottal recession, which basically means that you cut away at the lingual part of the epiglottis so it doesn't lay so flat down against the soft palate. Then you find the vocal cords and stick this mace looking thing in a pocket behind them and twirl to expose the ventricle, which you then cut out. Then you cut off the vocal cord to complete it. And that's it! You don't need to close the wound, you just leave it as is. The surgeon even did it without gloves! So it was all pretty cool to see and it takes less time then it takes for me to explain it. The surgeon was really nice and very informative, though I'm sure I explained something wrong, but I need to investigate this more. Apparently only a handful of people actually do this surgery so I'm glad that I got to see it! I hope tomorrow I see something else interesting!