Week 3 – Garrett Beeghly

Clinical Immersion Week Three

Garrett Beeghly

It is hard to believe that three weeks have already passed of my clinical immersion term with Dr. Jason Spector in Plastic and Reconstructive Surgery at Weill Cornell Medicine. This week, Dr. Spector took us to an abdominal aorta aneurysm repair. An abdominal aorta aneurysm occurs when the lower portion of the aorta becomes enlarged. As the aorta expands, the tension in the vascular wall increases and creates a risk of rupture which can cause life-threatening blood loss. The method used for the repair was an endovascular aneurysm repair or EVAR. EVAR is a minimally invasive procedure conducted via two small incisions made in the groin. These incisions are used to place a synthetic stent within the aneurysm, providing an alternate path for blood flow, reducing the pressure exerted on the aortic wall, and thus minimizing the risk of rupture. Correct placement of the stent is confirmed during surgery with live X-ray imaging. In line with the purpose of the clinical immersion program, biomedical engineers helped develop both appropriate biomaterials to manufacture the stents and imaging equipment needed to assist with stent placement. The intersection of engineering and medicine turned a formerly open surgery, with a correspondingly high recovery time and mortality rate, into a minimally invasive procedure that only requires a one-night stay in the hospital.

In clinic, we followed up with the fasciotomy patient from the first week of immersion term. The DermaClose device had been removed after successfully pulling her incision together for suture. We examined the area around her wound for any signs of infection or healing complications, and gave her the go-ahead to resume normal use of her arm to begin rehabilitation. We also had an initial consultation with an oral cancer patient that will require jaw reconstruction after tumor excision. In the coming weeks, we will attend logistical meetings to coordinate the operation with the other surgeons on his team. The procedure will involve the head and neck, plastic, and oral surgery teams as well as ongoing consultation with his oncologist.

Outside of the hospital this week, we ventured to Up Thai on Second Ave for lunch and threw an impromptu viewing party for the first round of Democratic Debates. I am also looking forward to attending a music festival in Brooklyn this weekend. Hopefully the weather cooperates!

Getting all geared up for surgery!