Wednesday April 13

 This was a long and busy day for us. I worked with Becca on a man with a recurrent inguinal hernia which had been repaired twice previously. Reoperative surgery is always a challenge because the anatomy has been distorted by the previous interventions, and because normal tissue plans have been obliterated. In this setting a further challenge is the good chance that a previous repair was unconventional and wasn’t a standard textbook repair. All of that was true for this man, but with time and patience we were able to give him a good mesh repair. We then operated on a 3 year old boy with a large protruding umbilical hernia we thought. The overlying skin changes made us think he had been born with an incompletely formed abdominal wall, and appears to have had surgery to close it. His mother was unable to give us the details. Going into the surgery I was concerned that it would be quite complicated, and as surgeons do in those circumstances, I had thought thru a number of scenarios trying to figure out what I would do in each. Fortunately it turned out to be not as complex as I had expected, and the repair was relatively straight forward. Other cases included drainage of a tuberculous abscess associated with Pott’s disease , endoscopies, and Yuk did dressing changes on 3 kids with burns. One of them is an 11 year old boy who was caught in a house fire and has greater than 50% of his body burned. It breaks my heart to see him.