Welcome back everyone to episode two of this series on surgeries, I'm your host Julian and
before we get into today's episode I want to say, if you haven't heard Episode One on the
history of surgeries and anesthesia, definitely go back and listen we're talking about holes
in skulls and how we don't know how general anesthesia works, which is a bit surprising
really fun stuff. On this episode, we're going to cover some specific surgeries, and we're able
to cover this topic on Seeker Plus because podcast you don't really have to show exactly what's
happening. And that's good if you're squeamish kind of like me, and well for the channel because
otherwise we could probably get flagged in a sense it would get taken down. And while we're at it,
don't forget to like share subscribe and know when to enjoy, enjoy this as we talk about how people
can open other people and either take things out of them, or put things into them. Now today,
we're going to get into some specific surgeries get more detailed on exactly what's happening,
because I feel like medicine has come so far actually note as you listen to the first episode.
And yet, we take for granted how amazing some of this stuff, truly is when you break it down.
So I'd like to talk about one of the most common surgeries,
One of the most advanced surgeries, and maybe one of the more complicated ones, and just for fun.
I'm gonna throw in a favorite of mine that I found along the way, like, one of the longest surgeries,
it took place in 1951, it lasted 96 hours and it removed an ovarian cyst, part of why
it took so long was because we had to drain 200 pounds of fluid from the system before removing
fun. Okay, so let's first start with one of the most common surgeries in the world but one that's
far from simple and actually it's kind of makes me squeamish when I talk about it because I'm really
glad we don't have to show these, I'm talking about cataract removal. Yeah, we're going to
talk about eyeballs and sticking needles in them. By some estimates there are more than 3 million
cataract surgeries per year in just the United States, and you're probably asking yourself,
what is a cataract, but you probably know what it is but not really what it is. So, I'll explain
one of the leading causes of blindness in the world. It happens when basically your eye gets
cloudy because some proteins start to clump together in the lens. The lens is part of the
eye that helps you to focus, so you can see. So as these proteins break down and clump together,
that obviously makes it so you can't see doctors compared to looking through a frosted window.
Now, I won't get too much into it because this is a series about surgery, not the eye
but we can do one on the eyes really cool how the eye works. Obviously, cataract surgery is
a way to remove that cataract, so you don't go blind. How is this done. Well, one of the most
popular ways to remove cataracts, is with a needle soundwaves in a vacuum. I'm not kidding, it sounds
so sci fi first the surgeons cut an opening in your eyes, one big enough for a needle to get it.
Now I say needle tool but it's not really a needle because folks, it is so much more than that,
once this tool is in your eye, it emits ultrasound waves inside your eyeball and these
ultrasound waves actually break up or emulsify the proteins, the same tool, then suctions all of them
out of your eye. After this they put in a new artificial lens, And it's done. So, to repeat,
they cut your eyeball, stick a probe into it. Blast some sound waves around inside and then
suck out the clouds. So cool. I just love the idea that surgery can be something like this,
not necessarily opening someone out, removing something and then sew them back together.
This is using sound waves to solve a problem. It's kind of like doing a surgery with lasers which of
course is a thing LASIK reshapes your cornea with the laser to make you see better, which
obviously much better than a doctor, it's doing it with their fingers like a potter with clay on
a pottery wheel. Okay, so, needles and eyeballs, tough to think about I'm gonna stop saying it.
Let's take it up a notch, let's talk about stopping your heart,
and then selling something taken out of your leg into it to make it healthier. This my friends is
coronary artery bypass surgery, it's an open heart surgery, meaning that surgeons have
to open the chest wall to get to the heart, as opposed to closed heart surgery where they can
go into a smaller incision with coronary artery bypass surgery, they also have to
stop the heart. Now I wanted to talk about the surgery because like cataract surgery,
it seems pretty common. I mean, heart disease is the leading cause of death in America, year after
year. I've heard the term bypass surgery and open heart surgery like whole life but I never really
understood exactly what they involved so I thought it'd be fun to get into all of the bloody details,
but like bloody with a good outcome in the end, you know, a positive blood. Okay. So briefly, why
would someone need the surgery. Well, when one of the arteries to your heart gets clogged or blocked
by socket, it decreases blood flow to your heart can lead to a heart attack and that can be fatal,
which, again, not good. So, we need a way to fix that. How do we do that, we bypass the clogged
arteries with a new healthy unclog from another part of your body. This surgery can also be used
for going around arteries afflicted with other issues. But before we can do any of that doctors
have to cut over your chest with a sternotomy. It's also called cracking the chest which is
just the grossest reward phrase I've ever heard. After surgeons wreck that chest, they go
harvesting for veins. Again, this whole thing is being done because of a blocked or clogged artery,
doctors need to find a new one. Add to that. Also important part of the main things used for this,
either arm, lake, or the current choice, the internal mammary artery in the chest.
Now, this is a preferred choice because, unlike the veins in arm, leg the mammary arteries,
an artery, it means it'll hold up better once grafted onto the heart. The other thing is,
right there, right near the heart, you don't have to take it out of the limb and put it in the chest
you just move over a little bit. Oh, what a surprise there it is. Special thanks, by the
way to our editor Max dad for this information. It was really difficult sifting through complicated
medical papers to research this. So we reached out to Seeker Plus's official cardiologist
Matt can you put a picture of your, your dad up here and thanks Matt's Dad. Thank you.
I've never met Matt's dad so I actually I don't know if this is really a picture of
him or not but we're going to trust that on that. Okay, moving on. Once we've got that
replacement vein it's time to stop the heart. Doctors will inject the heart with a chemical
agent called cardioplegia and it'll put the heart into arrest and stop beating, which
makes it much easier to work on you wouldn't want to work on your car engine while it's running.
The solution is also cooled it cools down the heart, helps protect the tissue during surgery.
But if the heart is stopped, won't that kill the patient and you're kind of achieve the opposite
of what we're going for. Not if you're using a handy dandy heart lung machine that will help
keep blood circulating, and oxygenated. Why is it called the heart lung machine,
thanks for asking. In a normal health person oxygenated blood is pumped out of the heart
goes throughout their body, dropping up oxygen and oxygen and blood goes back into the heart
directly into the lungs and get oxygen back, and the process repeats. So, in order to ensure
that oxygenated blood is still keeping the body alive, doctors, hook up to to the heart, one takes
deoxygenated blood out, it's fed into the machine, and oxygen and then it's fed into the second tube,
and put back into the heart and pump the body really fascinating stuff. Okay, so now the
patient is knocked out they're cut open, and their heart is still empty and cold, just like my exits.
This is what surgeons can finally so on a new artery to bypass the clog, they so one end of the
new vein or artery right below the block section, and the other end into the aorta. So now the blood
will literally just bypass that section and deliver that sweet, sweet blood, uninterrupted,
once that's all set, doctors will get the blood flowing condition off the blood pumping machine,
some backup. I will say, I love taking deep dives into this because even the simple version of this
surgery is impressive, open heart surgery, but then you get into the details about cool liquids,
stealing veins and blood pumping machines just makes you appreciate it that much more.
Okay. I wanted to end with a surgery that always makes the list of longest surgeries for
most complicated surgeons and that is separating conjoined twins. The problem is we can't really
break down step by step how this procedure happens like your previous surgeries because
it really is a case by case thing depends on how twins are connected. That all comes down to if
they share important organs or veins, for instance if twins share to heart, there's no way to
separate them. The process of becoming a conjoined twin happens in the womb, when a fertilized egg
starts to split make identical twins, but it's what happens too late, doesn't happen all the way,
some also think that eggs can come back together at some point during pregnancy. Doctors can see
this on ultrasounds, they can start making plans for surgery even before the twins are born,
a lot of separation surgeries are done on babies and toddlers depending on what's safe, which brings
us to the first step in separation, making sure that survival is possible if doctors are confident
that they can start with expanding skin at the point of separation to make the separation, easy.
This involves surgically putting balloons under the skin, and slowly filling them up so
the body creates more skin. Then for surgery doctors can the balloons out and have more stuff to work with.
After the procedure, and because these procedures are so complicated. It usually takes a huge team
to ensure success. In one example from a pair of twins were connected at the head and doctors were worried about one twin
having too few veins in the head after separation. So they did 3d modeling and computer animation to
test out the scenarios, then a team of 15 doctors and surgeons worked on a series
operations to separate them, including expanding the skin and bone in head with those balloons we mentioned.
The longest surgery in the world was separating twins joined at the head. It took doctors 103 hours to do the
job. You see that in a lot of these surgeries 12 hours to separate twins in Israel with 50 doctors,
and of course, 3d modeling and months of planning, 24 hours and 30 surgeons to separate twins at UC
Davis and California, again with all hands on deck to separate connect things do blood transfusions,
reconstruct skulls and tissue, there are so many of these stories and each of them involves
months and months of planning, well before the babies are even born. Using high tech equipment,
some of the most skilled surgeons in the world working 90 days on end is quite remarkable and
probably one of the most challenging things to do in operating rooms. So those are a few surgery
explainers and I wish we had time for more there are so many things we didn't get to talk about like
times surgeons had to operate on themselves or theories on head transplants, or how we put animal
parts inside humans, face transplants, there's so much stuff, but alas, we'll have to leave it
there, thank you for tuning into Seeker Plus, I'm your host Julian. If you like this series,
make sure you like, comment share and of course subscribe, we'll be making a lot more of these
going forward. So, please let us know what topics you want us to cover, we can really talk about
anything, just drop it in the comments. Thanks so much for watching and we'll see you next time.