Surgeons Often Find More Issues During Surgery Than Expected

Hi Gang,

My surgeon told me they had me open for over 6 hours, dealing with lots of adhesions and fistulized bowel that formed a huge mess. They tried to save as much bowel as they could, and I'm grateful for their efforts. But they could have known what to expect before they cut me open... I even suggested how they could do it. And now I keep reading on here people saying the same thing... they found it much worse once inside and I ended up with a _____ instead of a _____. So here's what I don't understand. My surgeon had me get a full abdominal CT scan prior to the operation. A radiologist read it and gave my surgeon his interpretations. And interpretations are all they are, as reading CT images is an art unto itself. This was back in 2014, and 3-D printing with thermoplastics was still sort of in its infancy. But I checked into it and found out the file format that both CT scans and MRIs output is the same file type that 3-D printers use to make exact full-size three-dimensional models. So I checked around. Cleveland Clinic was toying with it, as was Hopkins. I called a few places that did 3-D printing and got quotes. I then went back to my surgeon and asked him if he wanted me to have a 3-D image of my torso internals made for him so he could see what's where, what's sticking to what, and give him a heads-up on what he was getting himself into. He wasn't the least bit intrigued and told me not to waste the $1500 it would cost, because as he put it... "we have to go in and deal with it no matter what we find in there, so no thanks." At the time I figured okay, this guy is supposedly as good as it gets in colorectal surgeons around here, so I guess we'll do it his way. But when he told me post-op how much work he had to do when they got me opened up I felt like telling him he would have known that if he let me make the 3-D model of myself... but I kept quiet.

I keep reading on here that someone went into the OR expecting to get X and came out with a Y because things were much worse inside them than the surgeon thought. So why aren't surgeons having your guts 3-D printed using the data from your CT or MRI? Today it doesn't cost much to have your full torso printed up. It was about $1500 back in 2014, so how much could it be today? Heck, I could do it for free at work now that we have a full 3-D modeling lab at the base I'm on. And there are commercial 3-D printing facilities everywhere nowadays. I would think major hospitals would all have that capability in-house by now as well. Or maybe they do? Has anyone had their gut reproduced in plastic for your surgeon to look at prior to surgery???

Regards,

bob

This sounds very interesting. Hope u get yur answer buddy. 

Fascinating!

 Hi Bob. I went in expecting to have an colostomy, woke up to find they had formed an ileo instead.. Before I went in, over a few months, I had virtual colonoscopy, ct, MRI and various other tests..adhesions unless they restrict bowel movement don't often show up on CTS etc. I had 3 previous surgeries all through same scar and 2 lapors. Everything was stuck to everything else, and I too was in theatre roughly 6 hours. I was shocked when they told me also that things were worse than they initially thought..amazing really with all the tests I had done. Know how you feel. They couldn't give me any straight answers either.

But, the pain I have had daily for the last 6/7 years has gone ( have it somewhere else now, they said they think new pain is scar tissue) had they gone ahead with original plan I would still be in horrendous pain.. Gonna take some getting used too but I hope its going to give me my life back.

Hope you get some answers and would be interested as in a similar boat.

All the best.

I think part of it is that the picture they get is of the inside of the bowel and to some degree the thickness of the lining.  Adhesions and external ulcerations don't really show up.  My GE was really pleased with how my colon looked for years but she had no clue about all the scar material gluing the pipe to the contiguous pipe.

I do find it disconcerting the frequency we read about it on hear.  This reminds of what you'd hear back in the 70's when a proctoscope was a rigid aluminum pipe and anesthetics were never used.  Getting a good surgeion back in those days was a real crap shoot.  My second surgery they told me after that if I'd had the problem 10 years earlier I'd have been dead.  You think so much has changed since then but then you read these comments and you're not so sure!  Perhaps I'm hyper-sensitive because I have a stoma revision in January and I'm not getting the warm and fuzzies between what my surgeon said and what their surgeons have said....

 

Dave

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