Julia Bellamy / Dr. Jason Spector - Week 6

This week was a mix of clinics, OR observation, and lab research. One of the OR cases I observed was a very complicated case with 4-5 surgeons taking the whole day. The patient had previously come in with a tumor mass on their mandible, and it was resected and a new left mandible constructed with the fibula. However, the tumor has since returned and the plan was to take a more aggressive approach. The ENT surgical team opened up the patients neck and lower jaw and began exposing the tumor. The plastic surgery team with Dr. Spector and Dr. Jacoby worked on dissecting a large flap from the thigh. When the ENTs finished with the opening of the mouth, the oral surgeons came in to remove the hardware on the jaw previously placed and cut the mandible with a bone saw. During this process, the plastic surgery team had detached the layers of skin and a small amount of muscle from the other tissue layers and have left the flap attached to the arteries and veins. The flap would remain attached until the tumor was completely resected. The oncological surgeons then came in to find all the tumor tissue and remove the mandible. This process was the longest part of the surgery. While I did not observe the rest of the case, the plan (similar to with the flap in the tongue reconstruction case we observed on the first week) would be to use the flap to make up the loss of skin on the neck and lower jaw, with the muscle not only filling in the bulk of the cheek for appearances, but also providing a blood supply to the transplanted tissue. This part of the surgery would be completed by Dr. Spector's team using microsurgery techniques to reconnect the vessels to the vessels in the neck.

In the clinic this week, we saw many patients. One patient was a post-op from a "mommy makeover" where they had a breast reduction and tummy tuck. There was another post-op appointment from a cervical spine fusion accessed through the back of the neck. Dr. Spector explained that plastic surgeons get involved in these spin cases by bringing in their expertise in separating and then bringing back together the muscles in the back of the neck, which would allow for better healing. There was another post-op following a scalp reconstruction from a carcinoma removal, where the skin graft had been placed. Another patient had a breast augmentation with implants 12 years ago following a breast cancer diagnosis. They recently had another surgery due to a recurrence, where the latissimus muscle was used as a flap to fill in the side of the breast. The patient was coming in for a post-op from the surgery and check in for the subsequent rounds of radiation to treat the recurrence. Another patient was here for a 3 month post-op following a very complex surgery to reconstruct the whole side of the jaw. It was interesting to note that the flap that was transplanted from the patients leg to the inside of the mouth was now growing hair, which indicates the health of the flap but provides the patient with discomfort. 

In the lab this week, I measured many donor blood samples. Faith, myself, and a researcher in Dr. Spector's lab donated blood to be used in my experiments of measuring human samples in the smart syringe. it was cool and funny at the same time to be running an experiment with my own biological sample. Usually when I give blood for lab tests, I am not the one that is performing the lab tests. This week I was also busy working on creating a presentation for the quarterly review meeting for the company that sponsers the Smart Syringe.

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