Hear me out….do you think you could perform an appendicitis if you had to?

[Ettubrutus]

Let’s say you had 48hrs to practice

Plus a surgical dummy to practice on

And books (you don’t have the internet)

And all the equipment you’d need

AND the person is going to die if you DONT do it

a) Do you think you could pull it off?

*surgeons of MN please come and tell us if the average person could or not given the above

** you get an assistant to suction and stuff

Word for word my first thought 🤣

Yes, but I'm going 'field medicine' I'll use a Stanley knife. Rum to knock out the patient plus give them a stick to bite. I'll tie off any ends with dental floss and cover the wound with cling film and parcel tape. Then I'll make them an antibiotic tea from twigs.

OR I'll say 'this seems to be a 'you' problem'

I woke up early. I've been sitting here in bed with a cuppa, quietly pondering over whether or not I could perform an abdominal surgery.

I reckon I could do it.

I'm awful at sewing, no skill in this area whatsoever.

I'm imprecise, heavy-handed and don't have much patience at all. I'm easily distracted.

I'm squeamish about blood, body inners and bodily fluids.

In school, human biology was a mystery to me.

BUT....life is precious and I would give it a go. I'd practice again and again on the dummy. I'd give it my best shot. I feel ready to give it a bash.

I've assisted many surgery's and done plenty of surgical procedures, but not in that area and I'm going to say no.

I don't know the anatomy. I might damage the bowel and if it started bleeding I wouldn't know where the vessels would be. Plus are they awake?

I guess I could give it a go, if the alternative was they died and if I had an anaesthetist and an assistant between the three of us we might be able to cobble together some knowledge. But I suspect it wouldn't be successful

I've never seen Grey's but I used to play operation as a kid.

😁 On the basis of this alone, I definitely don't think I should be wielding a knife.

ThreeTreeHill
I’d say you’ve knocked the confidence and changed a few of the answers on the thread of people who were ready to just go for it😅

A cheering thought, thank you 🙏

This thread 😂.
I'd give it a good crack, if they're going to die anyway then nothing to lose right.

Thank You!
I've been reading the whole thread back just to make sure that someone corrected that!

Why are people planning on eating it?! It's about as long as a little finger and would literally taste like infected shit. Even if it would fill you up you'd definitely get, at best, a dodgy tummy!

I would like to say I'd give it a go if there was absolutely no alternative but would probably just make them comfortable before they died. Would also need an anaesthetic (or preferably an anaesthetist who would have a better idea than me anyway so they can operate instead!), sterile instruments, and definitely diathermy. Wouldn't hold out much hope at all.

I used to sing in a choir whose conductor wrote us a song about performing an emergency tracheotomy. I think I can still remember the words so I'm ahead.

Nah, I'm a very seasoned nurse but an appendectomy is a pretty fiddly job. My eye sight is shocking and my glasses would probably fall into the abdomen 🤣

There's a lot of other surgery's Id give a go, c section, amputations, repairing broken bones. I'd insert drains and chest tubes fairly confidently too. I'd even quite happily give a thoracotomy a go in a dire situation. Oh and tracheotomies... So I wouldn't be completely useless in a desperate situation but fiddly abdo surgery is not something I would be confident with.

Well if the operation wasn't a success, you would have removed the infected part anyway and you are left with plenty of food 😉

Am probably investing far to much brain in this for a saturday morning, but am interested by the number of people who'd have a go at a c-section but not an appendix! The blood supply to the gravid uterus is phenomenal - there's a lot more that can go wrong doing that than an appendix. If there was really no one available who was more used to holding a blade then I'd do a perimortem section as a resuscitation manoeuvre for a mother in cardiac arrest, but there's not a chance in any other scenario.

Also interested by the number of people who'd want an anaesthetist for an open appendix - as the man who did it on himself demonstrated eloquently, it is an operation that can be done with just local anaesthetic and a delicate hand...so long as it's a simple one and not a horrible gammy mess on the inside or some weirdy anatomical anomaly. Historically it was a bog-standard house officer's middle-of-the-night operation with the (usually much more experienced) scrub nurse assisting (/telling the HO what to do). These days it's so unusual to do an open appendix, that actually I suspect the vets would have a better chance at pulling it off most other HCPs!

I assume that the anaesthetist is to make sure the patient doesn't move and isn't panicked by the amateur surgeon watching a YouTube video on "how to do an appendicectomy" 😂

These days it's so unusual to do an open appendix, that actually I suspect the vets would have a better chance at pulling it off most other HCPs!

I seem to remember vets are allowed, in an emergency, to treat humans, but Dr's can't treat animals.

I have attended human dissections of the abdomen, am good at 3d crafts and have good reading comprehension for the provided books, so suspect that in ideal conditions I could cut someone (who wasn't fighting back) open and locate part of the digestive system that was likely to be the appendix - especially if it looked inflamed but the gallbladder, pancreas etc did not. However, if doing this triggered them to go into shock, they'd die.
I suspect sewing living bowel is not the same as sewing cotton (I don't know surgical knots but could learn that in the prep time), but I do have superglue in my house, so if adding that would hold sufficiently to begin healing up the gap that would be OK. I'd also like to look in the books to see if something slightly less invasive to the bowel like tying a elastic band around it incredibly tight would allow it to drop off rather than needing to be cut (like with balls) - I'm assuming this isn't done as the dead tissue would then rot inside the body?
The thing that would definitely kill the patient is if the appendix was stuck to loads of other nearby things and I damaged them whilst looking for it, or (extremely likely) raging peritonitis from spillage and general contamination during the procedure. If the trauma interrupted the bowel function they'd also be on their own. And I hope they didn't need functional abdominal muscles - sewing up the outer shell afterwards in a way that left them sealed up and also still able to bend etc would be awful too.

Well if it was truly life or death, and there was absolutely no other means of getting help, and I had a book to study, and no choice - yes, I think i’d stand a slightly better chance than Joe Bloggs the milkman or Sheila the hairdresser.

I’m a nurse, I’ve been in an operating theatre for an appendectomy, I know enough about interpreting vital signs, keeping someone haemodynamically stable, pre-loading with fluids to optimise for theatre, aseptic technique, where i’d expect to find the appendix, what structures I’d be expecting to cut through to gain access to the peritoneal cavity, avoiding touching bowel as much as possible, selecting an appropriate antibiotic if they’re available in the scenario, etc.

If your patient had unknown situs invertus, you’d probably not be including appendicitis on your list of differential diagnoses in the first place, never mind getting as far as making any cuts on the right side, as they’d be presenting with left sided abdo pain.

100% no. I'd probably yank out the small intestine by mistake, and then want to do a pretty embroidery stitch to sew it all up again.

Surgeon here.

So some of you might be able to 'pull it off' but the ratio of luck to judgement would be significantly higher than a trained surgeon doing it.

The trick is not doing it once, it's doing it 1000 times, with variations in anatomy, perforated vs u perforated, body habitus etc, and being able to do it reliably.

I've watched Greys (all seasons) way to many times. I could do it! 😂 even learnt through poor George not to cut the bloody purse strings!!

I don’t think there was a surgeon available in the OP’s scenario unless they were the patient, because I’d have happily stood aside and passed them tools 🤣