 there is blood yes yeah i did you do see blood i saw like huge colon cancer like the quintessential apple core lesion what's up you guys sit down and welcome back to my channel so um if you have not already done so go ahead and subscribe right now to my channel and follow me on instagram and on a pa and go ahead and hit that notification button so you can know every time that i put up a new video for you guys as many of you know i just completed last year in december my general surgery rotation and so um i wanted to talk to you guys and give you guys all the juicy details about everything that um i did as a pa student on that particular rotation so for me um my rotation was a little bit different than i would think um some other pa students might have because i was not just in general surgery so general surgery is like the overarching branch of what i was in but um the surgeons that i would like that were my main preceptors they were actually surgical oncologists so i saw a lot of cancer you guys which was really sad actually um and pretty hard uh you know seeing these people navigate that particular disease but i saw a lot of cancer and um as general surgeons um everything is pretty much in like the abdomen or like you know like in that area so you know your thoracic surgeons would be in the upper chest cavity but your general surgeons are in your lower abdominal cavity so i saw a lot of like you know gastric stuff and and and the those related things but i also got to see you know speaking about gastric i got to see a lot of bypass in bariatric surgeon um and with my bariatric surgeon that i rotated with um for a week just to get a varied view of the general surgery realm so i'm going to talk to you and just kind of give you a walkthrough of what i did on my days with the surgical oncologist and then what i did with my bariatric surgeon on my general surgery rotation so typically the general surgeons the surgical oncologist general surgeons that i did my rotation with um our day started at seven ish with respect to surgery days so that was monday wednesday friday we would be in the operating room and then tuesdays and thursdays were our clinic days so on mondays if i woke up or you know again monday friday i'd wake up very early like around five ish in the morning because i had to drive about 30 minutes or so 35 minutes to get to the hospital and then i wanted to look up cases um the cases that we were going to do so i was just familiar with them um so i would get there early uh get into my scrubs change and then go look up the cases that we were going to do see when they were scheduled for there's a bore that tells you um essentially like what room you're in who the anesthesiologist is who your circulator nurses um who your scrub surgical tech is and gives you all that information and what the start time is and so um i'd go look at the board to see what the various different start times were and then what room i was in typically if you were in like operating room let's say 13 then you would be well there's no there's no operating room 13 because it's like superstition so like if you were in operating room 12 um so uh you would be in that room all day uh and so we'd start surgery at 7 30 um when i went in i would always scrub with chlorhexidine first um so i would do like my three minute scrub or scrub with that first and then um i would pat dry and then throughout the rest of the course of the day i would just um kind of dry scrub or wash um so i always made sure i did that prior so that when i'm going in i would just do like the surgical gel and scrub with that so um once i got that and got all that information i'd go look up the patients go look at the cases and i would also pre-round on any patients that we had like the week before that may have been um still in the hospital or they were added on to our caseload overnight so those are the things that i did in the morning and then our case would start at 7 30 you always go in introduce yourself to the scrub tag i would write my name on a little whiteboard um and who like who i was so pas2 so they know who i was and then i would always get my own gloves get my own um gown and then i would ask them do you want me to open it onto your field or do you want me to just open and pass it to you do you just want me to give it to you um depending on if they were already gowned and um gloved up or not so once i've done that um then i kind of just wait around like because um i would sometimes leave my number on the whiteboard but you know like they don't have your number like they have their residence number they have the physician's number um so you're just kind of like ducking in and out to make sure like you're not missing the case because cases i i don't know if i've ever been on a case that actually like went on time like started on time maybe one started at 7 30 but they rarely start on times there's always something going on like the patients running late or whatever like you know the turnover was a little bit longer than expected so um i would just kind of hang out in either locker room or in the little like general lounge area for staff and like study um while i waited to see if the case was in once the case came in and the patient was there um i'd go in and i would help so i'd help move them to the bed to the operating um table i would help like you know set them up like i said we did a lot of like abdominal cases so um if it was like an inguinal hernia or if i had to do if we were doing like an umbilical hernia or hiatal hernia with a bariatric surgeon or anything gallbladder related or a mat liver mass resection or a colon resection those are all different types of um surgeries that i saw then like sometimes you have to like shave them and so i would do that and take the tape and like take the the hair off of them or we're fancy we had one with like the actual like sucks it up um in but not always so i would do that tape them up make sure everything's like all their scd's which is the thing that like squeezes your leg so you don't get a blood clot um and then i just kind of hang out there see if they need me to do anything else and if not i go outside get my dry um scrub like with the surgical gel and then do my scrub and scrub my hands and wash it up and go all the way up to like an inch above elbow and then you come in like this you know like you walk in hands kind of up you're really gonna be dry by the time you get to your surgical tech but always do that so that your sleeves don't touch in and you become contaminated so then i go in i put my hands in my coat and my little my um my gown and then um i'm ready to like get you know my gloves and glove up and then i go and i stand where i need to stand so depending on if there was a resident in on the case with me or not obviously i got to do more i got to stand closer to the physician or right across from them um and also depending on the case so uh with respect to a lot of the cases that i saw they were camera ran cases uh you know laparoscopic camera ran cases so um i would get to drive the the camera um which is a lot harder than you think you guys like you you know you see this and and they make it look really easy especially like really really um experience pa's and registered for nurse first assist they make it look really easy but it's not so um because you're kind of like your orientation is off like you want to make sure like things aren't blurry and you know there's there's so many components that makes it a lot harder than you think um but i'd run the camera i you know they'd let me know like if they want me to turn left or right um after a couple days of doing it you kind of get used to where you need to go where you need to push the camera in more back it up from you always you know they i was told you always keep the working instrument in the center of the screen um and you always you know follow it for them so they can see where they're cutting where they're going uh you don't want them to nick something um you know cut a vessel or something along those lines so um that is what i would do i'd hold the camera um with my surgical oncologist i got to like pull out some tissues you know clamp some stuff which is really cool um you know using the actual laparoscopic tools which again like when i was trying to staple for an umbilical hernia and you have to staple on the um the abdominal wall like i'm there and i'm pushing on the outside but also on the inside so that the staple can hit like that and it's like not easy you guys like because how you're holding it it's just not the most comfortable way but you make it work um so i would do that and then once the case was over you know after you've you've been told what to do then the patient will wake up um from anesthesia and then again i'd help out so i would take off the scd's i would take off the the kind of band that's holding them to the operating table go out and get the bed and bring it in and then take them help them um transfer the patient to the bed um after that we go when we walk to the pack you for a recovery and then the physician will dictate and i'll ask any questions that i didn't ask while i was in on the case and then you just kind of go and you wait for the next case that's really your day in surgery um with bariatric surgery it was pretty cool because you got to see um the patients in clinic as well and then you got to see like you know ruin wise done and i got to see an actual like bariatric sleeve removal or i mean a bariatric sleeve done or or the black band removal and and you know i got to see a gastric bypass and just learning about these various different procedures and the different indications the different complications that come with it um how it affects your life it was really interesting to see so that was also pretty cool running the camera with that was a little bit more you know like taxing and learning because it's again you're dealing with like larger individuals so you have to like maneuver a little bit more you know push up on the abdomen wall a little bit more but still pretty um pretty interesting on clinic days so clinic would start at eight or eight thirty depending on when the first patient came in so again like you would go in but for me it was like a little bit more of a shadowing experience because unless they were coming in for the first time so a lot of these patients like i said they were surgical oncologists so they've been following them so they have a relationship with them so it's hard for me to come in and be like hi i'm adana the PA student um you're coming back from you know your three weeks post op you know because i really don't know them like that so i did a lot of shadowing in that sense um when dealing with established patients but new patients i get to go in and kind of see what's going on with them ask them questions what what they were coming in for then go present to my preceptor and then we'd go in together um he would then come in and just like do the actual physical exam um bring me in and um i would also like you know feel the hernia or feel um you know where they're they say they're feeling a mass and those type of things or where the pain is um on clinic days we also did like inds and then we also did uh port removal so a lot of what we did in the or as well was port placements which is kind of just a glorified central uh central line um you know in the subclavian and so uh we did like a good amount of those i think like i was pretty proficient in understanding like the step by step procedure of how to put a port in um and i also got to do like a lot of like suturing with the port placements and then like my melanoma removals we also got to do port removals in the clinic which was pretty cool um it's just kind of done on a local anesthetic so we put it in um you make the incisions so you lidocaine them up make the incision and then you have to go in and like kind of cut the port out because although you suture them in with dissolvable sutures it's kind of scarred down so you cut it out a little um and then you have to pull the whole port out um and then suture up the layers um and and i did quite a few of those as well not by myself obviously um always under supervision supervision but um i did a few port removals um in my tenure in my four weeks um at that rotation which was pretty cool um but ultimately that was it uh thursdays were kind of like a shorter day so that was something that um i thought was really cool it varied the length of your day so some days were longer than others i might be in surgery from 7 30 a.m to like 7 30 p.m um and then other days i might be in surgery from 7 30 to 10 and then my day is done and i actually have to now go and study you know um but having that time to myself or having that time to see like how the surgeons work or even go pop into another surgery which you can do you can always ask if that's possible um it was cool so that was it that was my surgical rotation you guys um so if you're interested in surgery um i hope this video was helpful to you there is blood yes i did you do see blood you do see some really cool things you do see some you know like pomas you see uh various different things coming out i did see a lot of cancer i saw like huge colon cancer like the quintessential apple core lesion and that was like amazing to me but it's also pretty cool seeing um these patients afterwards you know seeing the follow-up and seeing like how well they've been doing um and hearing oh you know like we got all the cancer out so yeah but that was it that was my rotation in a nutshell i hope you guys like this video i will also be doing um just all the details of my ovgyn rotation as well and then my critical care rotation hope you guys liked it if you haven't already done so subscribe and follow me on instagram and on the pa hit that like button and um leave me a comment in the comment section below i will talk to you guys next time