Indexing Title: MPADUA’s Medical Anecdotal Report [04-4]

MAR Title: Patient undergoing Thyroidectomy

Date of Medical Observation: June 30, 2004

Narration:

Having performed thyroidectomy for quite some time, I am aware of the common complications and difficulties in performing the procedure. I thought I was prepared for whatever surprises that may come my way, but I was wrong.

On June 30, 2004, Dr. DeGuzman and I was about to perform a routine thyroidectomy on a 42-year-old male with colloid adenomatous nodule on the right, I was confident that everything would go on smoothly. Cutting of the skin started at about 11 a.m., 50 minutes later we are on the area of the right recurrent laryngeal nerve, there was a power failure and the generator overheated, forcing us to stop because there was no emergency light and we were afraid that we may injure the recurrent laryngeal nerve.

After an hour the generator worked again, we continued our operation and identified the recurrent laryngeal nerve. We were informed that the generator would work for the next two hours, by that time we should have been finished. But fifty minutes later, there was another power interruption, the generator overheated again!

We still do not have emergency light, no cautery, and no suction. But Dr. DeGuzman and I managed to gain some courage to continue the operation for the patient’s sake, since we are on the 3rd hour of the operation.

A flashlight from a nursing instructor was shined to our operating field, he and one of the Department’s parasurgical staff, took turns in holding the flashlight. There was some bleeding encountered near the area of the nerve but we pushed through and completed the operation, the specimen was out after 4 hours of sweat and tension.
 

Insights (Reinforcement):

It was not merely because of the discomfort we experienced that moment and the frustration we felt for not being able to continue the operation but the worse thing is the feeling of uncertainty for the patient’s condition. I can only surmise the anxiety that the patient’s relatives at that time, of not hearing news of what was happening inside the operating room.

This experience made me appreciate the modern technologies we usually take for granted, OR lights, suction machine and specially cautery machine. It also made me grateful to my mentors for instilling in me not only the knowledge and skills but also resourcefulness and patience.
 

Insights (Stimulus):

Learn thryroidectomy without the use of cautery machine.