Carotid Endarterectomy

Ah. My first educational post.

It'll detail the surgery that I observed the other day, a carotid endarterectomy. Sounds really complicated? Well, sort of.

Like many surgeries, simple errors can have tremendous consequences - particularly because the body is packed more tightly than sardines. Nerves, vessels, lymphatics, muscles, etc. One slip of the scalpel and that's it.

In actual fact though, the term just means cutting open the carotid artery (Internal) in the neck; scraping out all the plaque that has formed; then stitching it all back up. Yeah, Yeah. I know you're all saying "Chey", but that procedure took 2 hours.

Anyway, we are operating on the carotid triangle on the anterior cervical region.

WARNING! The following images may not be suitable for some viewers. Discretion is advised.


Hehe. Let you take a look at this little teaser picture first. That's me in the middle. How? Look like a surgeon or not?



Here you can see the constriction in the Internal Carotid Artery. Now as I have noted earlier, this surgery is actually pretty risky and you would not elect to have it most of the time. However, the patient had suffered a stroke and this is being done to prevent additional incidences of that.


Nothing much here. This picture just shows the initial cut. Note that all the equipment you see here are sterile - in other words, free of bacteria and viruses.


In this picture, you can observe the anatomy of the carotid artery. It's the one that they always like to show in movies - the evil guy severs it and blood spews out like crazy. In actual fact, it's not as dramatic.

The surgeon has tied down the arteries so that they don't move about too much.

The first horizontal red line above the carotid arteries is the Hypoglossal Nerve (CN XII).

A more detailed picture. Note the Vagus Nerve (CN X). That one controls nearly all of the parasympathetic nervous system in the body - including your heart. Cutting or damaging it is NOT recommended.

The cartoid arteries, the internal jugular vein, and the Vagus Nerve (CN X) also make up what is known as the carotid sheath.

The atheroma is what you get in return for too much Cha Kway Teow, KFC, or Kway Chap with lotsa fatty pork. You can see how the presence of it makes the diameter of the blood vessel smaller - hence allowing less blood through.

Just below the middle blue tie is where the atheroma has been partially dissociated from the artery wall. Gives you an idea of its thickness eh?

That's it when removed from the artery.

Here we have the artery all stitched up and we're now ready to close off the skin.

"Sterile Strips included."

Another picture of Tat Woon, Ker Fern and Me! Jonathan's taking the photo.

Okie. A picture just for Jonathan. Dang. I think I look better when I don't bare my teeth while smiling. Haha.

Cake!

Anyway, that's all for the surgery that I attended! I actually went to observe a kidney transplant too, but we forgot to bring a camera for that.

Hope it has been interesting! Note that I haven't studied Head & Neck anatomy yet, so there might be mistakes. Don't take this to be the Bible!

P.S. Gabriel. Don't you have anything nice to say ever! hAz. Give you my blog address just to have you giving mean comments.