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Surgeon Makes Tutorial DVD For Conscious Open-Heart Surgery 170

Lanxon writes "Swaroup Anand, 23, from Bangalore, was fully conscious as he underwent open-heart surgery. An epidural to the neck, administered at the city’s Wockhardt Hospital, numbed his body during the procedure. Dr Vivek Jawali pioneered the technique ten years ago and has recently released a tutorial on DVD, which gives a step-by-step guide to the procedure for other surgeons to watch and learn from."

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Surgeon Makes Tutorial DVD For Conscious Open-Heart Surgery

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  • by Chris Burke ( 6130 ) on Friday January 08, 2010 @02:06PM (#30697404) Homepage

    I'd do it in a second, but I'm betting they put up a screen or something below your head so you can't watch, much less put a monitor/camera above my head so I can easily see what they're doing. Which kinda defeats the purpose, from my end at least. :)

    I've been given the option to be awake for several procedures, and I always say yes, but then they always change their minds at the last minute and knock me out. Maybe they're put off by how eager I sound. Kinda like when the phlebotomist is about to draw blood and sees me staring at vein on my arm, and she says "Do you want to look away?" and I go "nope!", their look changes from one of sympathy to one of being a little weirded out.

  • by Hurricane78 ( 562437 ) <deleted @ s l a s h dot.org> on Friday January 08, 2010 @02:36PM (#30697828)

    From what a nurse told me, it’s just that the narcotics have a very small area between “doesn’t do anything” and “kills you instantly”. So it’s very hard to get it right.
    Which is why still so many people die in the process!
    Especially older people often simply go crazy from it. And die more often too.

    She told me, from her experience, that whenever you can, avoid full narcosis at any cost! It’s very far from the convenient trick to get around experiencing it. The one deciding on the dose sweats blood and tears because every time, he makes a decision that can kill you.

  • Old people (Score:3, Interesting)

    by DarthVain ( 724186 ) on Friday January 08, 2010 @03:14PM (#30698392)

    The reason why this is big news is that some people (mostly old people) who get knocked out, never wake up again, and it has little to do with the surgery itself but with the drug induced unconsciousness. Having a method or ability to do this without knocking someone completely out would reduce risk for those in the high risk to die while under. This is why you always have to sign a consent form when getting a general. I had some oral surgery a couple of years ago in my late 20's and I still had to sign a bunch of stuff that says I am aware of the risks and that I might die from being knocked out, and please do not have your relations sue us if that is the case. Now if your in your 80's and have the same procedure, it might be better to keep you awake during the procedure.

    (I was awake for the "tooth extraction" which translates to the most horrific medieval hammer and fscking chisel, and horrible horrible sounds and pressures you do not want to remember. So when it came time for the "tooth implant" I decided to get knocked the heck out. It cost me an extra 300$ bucks I think, but I was not going through that nightmare again. Not sure if it was as bad, but I wasn't taking any chances. If I had to do it again, I would have had them knocked me out for the "extraction" and would recommend anyone who has to get a tooth implant in this fashion do the same.)

    However when I read the title I envisioned the surgeon performing open heart surgery on himself while awake... now that would take some balls!

  • by tugboat0902 ( 1339165 ) on Friday January 08, 2010 @04:14PM (#30699234)
    I cannot imagine anything more dangerous than a 'neck down' regional anesthetic. Now, IAAA (I am an anesthesiologist) and from my experience, the risk of a general anesthetic for open heart surgery would be far less than the risk of this. In order to be high enough, the block would have to deprive the patient of one remarkably important activity involved in being awake, the ability to breathe. Additionally, if a selective block could be done that would permit enough muscle strength to breathe, there are serious problems in trying to breathe with an open chest. Without a sealed cavity, the lungs simply collapse. If the surgeon could stay extra-pleural, and you had a remarkably healthy and motivated patient it possibly could be done, I just cannot imagine why. Maybe this was all explained in TFA, but this is slashdot after all........
  • by Rich0 ( 548339 ) on Friday January 08, 2010 @04:15PM (#30699250) Homepage

    Yup, my friend had a stent placed in a carotid artery while awake for precisely this reason. They apparently like to assess your mental state while it is going on to detect strokes immediately.

    They do tend to dope you up quite a bit though, mainly to avoid anxiety and they don't want you squirming while they put a 2mm piece of tubing in a largely-clogged artery servicing your brain via a catheter that extends from your leg to your neck...

  • I had a wisdom tooth pulled. The anesthetic shots(all 6 of them) were terribly painful, extracting just a couple of precious tears from my eyes.

    About 15 minutes later, I couldn't feel the right lower half of my face and talking to the incredibly attractive assistant was becoming amusing. Oral surgeon walks in, sticks a prybar looking thing between a couple teeth, yanks it a couple times, puts funny looking pliars in my mouth and picks up my tooth. Good fucking god it's amazing how long the roots are for wisdom teeth.

    All in all, the worst part of the procedure was the shots, and the inability to form words using the mass of meat I once called a tongue. Luckily the entire experience, including anesthetic was over in a few hours and was quite tolerable.

  • by Rick17JJ ( 744063 ) on Friday January 08, 2010 @05:24PM (#30700294)
    I once had a colonoscopy where I was awake for most of the procedure. I was told that I might be awake in sort of a twilight sleep, but that I would not remember anything afterwards. However, I actually did remember everything afterwards.

    The procedure started a small camera being shoved up my rear end. In front of me, I could see a color television screen showing the constantly the changing view of the inside of my colon. I was surprised at how spotlessly clean it was (except for occasional puddles of dirty water). I jokingly asked if I could get a VHS tape to show to other people. They said that the best that they could do was give me a printout with color photos.

    After a while the doctor and the anesthesiologist (or someone) started asking each other why they were not there yet. As time went on they sounded increasingly puzzled and concerned that they had not yet reached where they were going. They would say things like, we should have been there long ago. They briefly considered the possibility of it having somehow having turned around and started going back the other way.

    They were having increasing difficulty getting the cable with the camera to go much further and were discussing the possibility of having to give up. But then, the entrance to my appendix came into view in the distance as well as two polyps also visible up ahead. But, for a while they were not able to get the cable to move any further.

    I asked what they would do if they could not reach the polyp. I was told that they would fire a harpoon and reel it in. But, then a moment later, I realized that he was kidding.

    I then mentioned, that I could feel two places in my abdomen were it felt like the cable was binding up with the most pressure. The anesthesiologist (or the doctor) than pushed firmly on certain portions of my abdomen which finally brought the camera up to the two polyps. I remember them then taking a sample from the first polyp, and then I fell asleep after that.

    Afterwards, they gave me a printout with several high resolution color photos, showing the inside of my colon (sorry about not having a link). Later on, I was eventually told that both polyps had been removed and that one of them would have probably eventually turned into cancer.

    When I had a follow-up colonoscopy from another doctor a couple of years later, I was out the entire time. But, before the procedure, I warned the doctor that she should use the longest cable that she had.
  • by mbourgon ( 186257 ) on Friday January 08, 2010 @06:13PM (#30700888) Homepage

    And it wasn't 100%. I think that either way, effective or not, you'd want to say "Ow! That hurts!"

  • by Tiger4 ( 840741 ) on Friday January 08, 2010 @06:45PM (#30701344)

    Yep, I noticed the "dirty little secret" with my father after a heart bypass. He was a retired mathematician, learned in the old days with slide rules. He could do sums in his head faster than most people with a calculator. After the surgery, not so much. It took weeks and months before he got close to being as sharp as before. He's still very good, but not at the top pitch he was before the surgery.

  • Re:Advantage? Yes. (Score:3, Interesting)

    by mqduck ( 232646 ) <mqduck@@@mqduck...net> on Friday January 08, 2010 @07:28PM (#30701872)

    Well he did say he volunteered at a blood drive. Doesn't that count?

The key elements in human thinking are not numbers but labels of fuzzy sets. -- L. Zadeh

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