I had been working at my first long term locum for several weeks, I was well settled in, and starting to relax a bit among the chaos and rush of an extremely busy vet hospital. In those days I had a yen to be a surgeon, and on this particular day I was out in the surgery, working my way through a long list. The next one up was a dog with only one testicle on the outside. The second one hadn\’t dropped, and was hidden away somewhere inside the abdominal cavity. It\’s important to have surgery and remove these, as they have a high chance of becoming cancerous later in life.
\”Are we all ready to go?\” I asked my nurse for the day.
\”Yes, we are all set up, everything\’s here, we just need the dog.\”
I went out and got him from the cage, a small, fluffy, friendly fellow, tail thumping against my side as I carried him into the unique scent of the surgery – antiseptics, a hint of alcohol, the scrubbed clean, efficient smells I was so familiar with. The nurse took him in a firm, business like hold, and held up the vein for me. I eased just enough anaesthetic in to take him deep enough to intubate, then we connected him to the gas, and jiggled with the levels until he was nice and deep, and stable. I scrubbed up my hands while the nurses clipped up and prepped his tummy, chattering away to each other about what they had been up to on the weekend, with lots of smiles and laughter.
By the time I had carefully scrubbed every nook and cranny of both hands at least ten times with the soapy antiseptic scrub, and turned back to the table, hands raised, careful not to touch anything, the surgical kit was laid out on the tray, and the dog was all ready, tummy nude and glistening. I opened the kit, and dried my hands on the sterile towel inside. The nurse offered me the corner of the sterile packet of gloves, carefully peeled back. I grabbed it, and gloved up. Then I untangled and neatly laid out the shining array of surgical tools, collected the sterile blades and suture materials form the nurse, and draped up the dog, so only a neat rectangle was exposed. Now the rest of him was hidden under the green expanse of cloth, only his head sticking out for the nurse to monitor his anaesthetic.
\”How\’s he going?\” I checked in with the nurse, before I began.
\”Fine, nice and deep, steady and strong pulse,\” she replied.
I made a nice long incision along the midline, swabbing up the ooze of blood, and clamping off any small veins with mosquito forceps. I blunt dissected through the subcutaneous fat, down to the midline, made a careful puncture, and then cut along the white band of connective tissue with my scissors. I was confident, I\’d done one of these before, so I started to guddle about gently inside, searching for the missing testicle. I eased the glistening loops of intestines to one side, then the other, feeling about deep inside. I searched and searched, with increasing desperation. Where was the damn thing??? I gently pulled out all the intestines I could and laid them on saline soaked swabs, covering them up as well to keep them moist, and looked, and looked, and looked. Nuthin!
\”Could you go and see if any of the other vets are free?\” I asked the nurse.
She scurried out, and in a minute one of the other bets walked in. She gloved up, put a mask on, and soon both our heads were bent over the little dog, both hands gently seeking.
\”I think we need to extend the incision,\” She said.
\”Ok, then,\” I replied, and did so.
Eventually, after another good fifteen minutes, her eyes lit up.
\”I think I can feel it, way up in the pelvis,\” She said.
Sure enough, I could just, just get my fingers around it. We spent another 20 minutes then trying to find a way to get the damn thing out. We\’d run out of room to extend the incision, and there was no way to safely exteriorise and ligate the blood vessels without cracking the poor little dogs pelvis open at the front. It just couldn\’t be done.
Eventually, we looked at each other, shrugged, and conceded defeat. I had to stitch the little fella back together, feeling deeply dissatisfied!