Cayla Dietz

Surgery Observation

10/22/2021
 While observing surgery, I got to witness a bilateral hernia repair with mesh placement,

as well as spacers being placed in the lumbar back region of a patient. I will be discussing the

back-surgery observation as that was my favorite surgery I watched. The patient had spinal

stenosis which resulted in the surgery. Spinal stenosis is due to the narrowing of the

passageways, causing compression of the nerves. The spacers used in the surgery were

“hammered” into the patient’s back which will correct the spine to its normal alignment. Dr.

Ugokwe performed the surgery in the lumbar region of the patient. The patient was lying face

down on a table, and her arms were secured above her head. There was a sheet covering her

upper portion of her body from the neck upward. The circulating nurse explained that the

patient was obese which caused a larger incision to be made. During the insertion of the

spacers, Dr. Ugokwe had radiology scans taken of each placement to ensure they were in the

correct areas. Staff wore x-ray vests to prevent radiation exposure.

Prior to undergoing an extensive surgery such as this, the patient had to have lab work

and other tests to ensure she was healthy enough to go through with the surgery. She also had

a COVID test prior to surgery. At midnight prior to surgery, the patient should not have eaten or

drank anything to avoid surgery complications. Post-surgery care was also set up so it would be

ready for the patient after hospital discharge. Back surgery is a serious event, so it is important

the patient does not lift anything heavy or bend over to lift objects. Rehabilitation was set up

before hospital discharge to ensure proper strength and healing.

During the operation, Dr. Ugokwe along with another surgeon stood at the patient’s

sides performing the procedure. There was an incision approximately 4-6 inches wide in the

lumbar region of her back. There was another nurse who stood at the bedside next to Dr.
Ugokwe and handed him tools and whatever he asked. Dr. Ugokwe used a small hammer to

insert the spacers into the back. There were two or three spacers inserted. In between

hammers, he had a radiology tech snap pictures of the patient’s vertebra to ensure proper

placement of the spacers. There was also a medical rep for the surgical equipment there in the

OR room. The CRNA stood at the head of the bed controlling the anesthesia and watching

patient vitals. The circulating nurse was walking around the OR and was getting instruments for

the surgeon. Communication was smooth and everyone was very friendly. The surgical team

seemed to all be close and Dr. Ugokwe was cracking jokes with them. Music was playing

overhead and there was a calming demeaner in the room. Watching Dr. Ugokwe hammer into

the spine made my jaw drop. Another treatment that shocked me was watching them pour a

pitcher of antibiotic solution into the incision. It was a large pitcher, and it was surprising

watching that much liquid go into the patient’s back. They also used antibiotic beads in various

layers of the incision, and they explained to me that these dissolve over the next few weeks to

block infection. I had never seen either antibiotic technique used so it was really interesting to

watch these two ways. After the initial layer of the incision was closed, Dr. Ugokwe stepped out

and the other surgeon finished closing the layers. It took a long time to finally close the area,

and they finished by stapling the incision. They also sutured around the drain that was coming

from the patient’s back, and she was transferred onto another bed, straight on her back. This

looked super painful since the patient just had back surgery, and she woke up shortly after.

After the patient was moved to a new bed, she was transferred to PACU. The OR team began

cleaning and preparing the OR for another back surgery scheduled.

 The nurse ensured that everything remained sterile during the procedure to reduce risk

of infection. The patient remained covered to protect privacy, and there was a warmer on her

during surgery to maintain body heat. Once the patient started waking up, the nurse got her a

warm blanket and got her to PACU immediately. The nurse made sure the patient was

comfortable while being transferred and made sue the PACU nurse knew pertinent information

prior to leaving the patient there.

It was a great day in surgery and I really enjoyed my experience. I feel like I learned a lot

and could potentially see myself as an OR nurse in the future.