Haoyang Du - Dr. Theodore Schwartz - Week5

I went in to the OR on Monday this week to shadow Dr. Schwartz for surgeries. The first surgery is a right endoscopic third ventriculostomy to treat the patient who has a cyst in the brain. The surgeon opens up a small incision on the skull and cut opened part of the dura to provided access to the brain. The endoscope was then put in to the cortex. The surgeon kept advancing the endoscope till it reached the ventricular space of the brain. Once located the cyst, the surgeon made an incision on the site of the cyst to open it up to the ventricular space. In this case, the fluid built up in the cyst will drain in to the ventricular space with the CSF and the cyst will be resolved. However, the opening created by a single cut on the brain would easy fuse back together and close up. To prevent this from happening, after the primary incision, the surgeon will insert a needle with a "balloon" at the tip and a syringe connecting the balloon. The needle will be placed in to the incision and the surgeon will push on to the syringe to pump water into the balloon. The balloon then will then expand and further opens up the incision to create a larger opening that will not close up by itself. Since the balloon simply pushed on to the surrounding tissue, everything stayed intact with no further tissue removed. There were two more surgeries later on Monday, one right parietal stereotactic biopsy and another endoscopic skull base pituitary tumor remover. 

I shadowed Dr. Schwartz for his clinic day for the first time this Tuesday. This is a really different experience comparing to the OR and to the lab. We've seen 14 patients coming to see Dr. Schwartz for both imaging consulting and for surgery follow up. Most of the patients are older people. 

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