Sunday, April 18, 2010

Surgeon Removes His Own Appendix



You gotta love the British Medical Journal for their report of a surgeon in a remote area of the Antarctic who did emergency surgery on himself. Russian Leonid Ivanovich Rogozov was the only doctor on an expedition ship whose mission was to build a new Antarctic polar base island in 1961. The sea had frozen over and the 12 explorers were alone at the base when the 27 year old team doctor developed fever, chills and symptoms of acute appendicitis. Transportation was impossible and there was no way to get any help.

As his condition worsened and he grew weaker, he knew he would need to operate on himself. The other guys on his team helped by sterilizing the bedding and getting instruments ready. In the event Rogozov lost consciousness, he instructed his team how to inject him with drugs using syringes he had prepared and how to provide artificial ventilation.

Rogozov chose a semi-reclining position and elevated the lower half of his body at a 30 degree angle. He disinfected his skin and used procaine as a local anesthetic. He then make a 10-12 cm incision as his team mate held a mirror for him to see. After 30-40 minutes he needed to take short breaks because of general weakness and dizzyness. Finally he removed the severely infected appendix. He then applied antibiotics directly into the wound.

His teammates were close to fainting and wanted to leave but they stayed. Rogozov himself was calm and focused on his work, but sweat was running down his face and he requested his forehead to be wiped. Afterward he reflected that "after I gave myself the first injection, somehow I automatically switched into operating mode, and from that point on I didn't notice anything else."

The surgery took 1 hour and 45 minutes.

The day after the operation his temperature was 38.1 and he described his condition as "moderately poor." He continued taking antibiotics and after 5 days his temp was normal. Within two weeks he was able to return to his normal duties.

A year later the team left Antarctica and Rogozov returned to his work at the clinic. He never returned to the Antarctic and he died 39 years later.

The British Medical Journal says Rogozov's self operation was probably the first one undertaken in the wilderness, out of hospital settings, with no possibility of outside help.

21 comments:

Kellie said...

WOW, absolutely ASTOUNDING, especially that long ago. I wonder what kind of pain meds. he used?

CountryMidwife said...

Amazing indeed. Doc, how well can local anesthetic work for this? He couldn't keep numbing all layers could he?

Karen said...

Very courageous - it well could have been his last surgical procedure!

john said...

Nice blog.

I recall a story about a Japanese doc who took out his own appendix aboard ship during WWII. I t may be just a folk tale of course. He used procaine also, a disfavored local now. Also, to sit on a suspect appendicitis until it ruptures is not considered poor practice today, although perhaps a bit of an embarrassment. By contrast during WWII it was a much feared complication, so that early aggressive appendectomy was the rule, and a 25% finding of normal appendix was acceptable.

To Country Midwife; In my opinion local anesthesia is generally very safe and effective. When i was a surgery resident in 1957 an older surgeon taught me how to do many procedures under local: Gallbladders, hernias, appendectomies, hemorrhoids etc. He even used whiskey ( a 'whiskey tit') for anesthesia in a one month old infant with pyloric stenosis. He gave the whiskey, i did the surgery, and the baby did beautifully.

pilgrim said...

and i thought i was such a stud for starting an IV on myself to run in a liter at home one night in the middle of horrible n & v. he even got PHOTOGRAPHS !

Heather said...

This one tops the bizarre stories I've heard all year. The morale of the story is....surgeons, don't travel alone!

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