Soft tissue surgery is a great rotation for witnessing and assisting in surgeries of all types (just non-orthopedic). The service has a lot of fancy tools (laparascopy, LigaSure, etc.) that makes these procedures faster or less invasive but also makes it less applicable to what most of us are going to be seeing and doing when we graduate.
# of Students: 2-4, but most likely 3-4
# of Residents: 1-2
# of Faculty: 1-2
And some fantastic techs to help you!
Hours: 7am-8pm
Rounds: Daily case rounds to update the group on inpatients and plans for them. Less frequent topic rounds on topics you request, which are great since they cater to your needs and interests. If the service is busy, topic rounds are usually the first thing to go.
Caseload: Expect to have 1-2 surgeries per day but emergencies come in and may need to be fit in, so anything can change at a moment’s notice.
Your Role: You are the caretaker of the patient while it is in the hospital, calling owners twice per day with updates. The initial meeting/examination doesn’t always happen with you being involved. During surgery you scrub in and assist/watch but you will rarely, if ever, be performing surgery yourself. While most of my classmates were not as fortunate, I was able to neuter a dog after I assisted with it’s gastropexy. Unfortunately, most students say that the most involved they have been has been placing skin sutures.
On Call: You are likely scheduled to be on call one day during your 2 week rotation in the evening. This is predetermined before your 4th year starts so you can pencil it into your schedule. The on-call pool for surgery consists of all of the small animal track students, so just because you are on the service doesn’t mean you have to cover all of the evening and weekend on call shifts.
Records: You are responsible for history, physical exam & surgery report, daily SOAPs, discharge instructions and summaries.
Weekends: You may or may not have a weekend free depending upon whether you are able to discharge your patients on Friday. Sometimes it happens, sometimes it doesn’t. If you have patients in the hospital on the weekend, expect to do 8am and 8pm treatments but you should otherwise be free.
Pros:
- Lots of fancy equipment that you get to witness in use.
- Great faculty!
- Becoming familiar with the amazing things that boarded surgeons are capable of so that when we see a truly complicated case in practice, we can refer them to a specialty hospital rather than resorting to euthanasia.
Cons:
- The downside for having so many fancy pieces of equipment is that the practical applicability is not there. Most of us will not have these pieces of equipment in the practices we join and that is unfortunate.
- The most common complaint I hear about soft tissue and orthopedic surgery rotations is that it is a lot of standing around holding things but not really doing much. This is true for the most part. I was fortunate enough to have be able to perform a routine neuter on a dog after the resident and I performed a gastropexy. Most people I’ve talked to said that they haven’t heard of other students getting to perform any surgeries like I did, so don’t get your hopes up.
- Residents are hit or miss from what I’ve heard, though I personally had fantastic residents when I was on the service.
Highlights:
- There was a dog that came in with what seemed like a fatty mass on it’s belly/inguinal region, which we thought may be a hernia but an ultrasound showed it to be mostly fat. We went to surgery and as we were cutting into this mass, I noticed anatomy that I immediately recognized. It was a testicle! This poor dog’s testicle had herniated (or had never descended normally — hard to say which is the true reason). It was so much fun to not know what you were going after and then have the end result be a neuter!
- Foreign body removals were tons of fun to watch and participate in. It’s always a fun game to guess what a dog ate before finding the obstruction and cutting out whatever was clogging things up. I’ve seen everything from peach pits, to grass and hairballs to an entire slipper (though chewed into multiple pieces).
- Witnessing extrahepatic shut surgery repairs with ameroid ring placement is absolutely amazing! I am in awe of the doctors who are able to find that little pesky vessel that is causing so many problems and place this little ring around it that will gradually close down over time and occlude the vessel, fixing the shunt. A lesson I will never forget regarding why you want to avoid placing a ligature around the shunt vessel — we tried to temporarily occlude the vessel in surgery to see how the patient’s body reacts and one patient’ reaction was profound enough to stand out in my head, within seconds the cat’s intestines looked hypoxemic and angry and the patient’s blood pressure plummeted. This is why an ameroid ring is such a fantastic, life-saving invention! 🙂