Thomas Manning, 64, is recovering after receiving the first penis transplant in the United States. Manning had his penis amputated in 2012 due to penile cancer. It took 15 hours for surgeons at Massachusetts General Hospital to complete the transplant, medically known as a "gentitourinary vascularized composite allograft." The surgery involved "grafting the complex microscopic vascular and neural structures of a donor organ onto the comparable structures of the recipient." According to the surgeons, the procedure could someday be used for gender reconstruction. From CNN:
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Dr. Dicken Ko, director of the hospital's Regional Urology Program, said the objectives of the surgery were primarily to reconstruct the genitalia so that it appeared natural, followed by urinary function and hopefully sexual function. However, Ko added that while sexual function is a goal, reproduction is not, because of a concern surrounding the ethical issues of who the potential father may be.
In 2001, the roof of a flaming building fell on volunteer firefighter Patrick Hardison, burning his firefighting mask onto his head. As a result, Hardison, now 41, has spent more than a decade without a face. Now, Hardison has the face of David Rodebaugh, a 26-year-old who died in a bicycling accident and donated much of his body for transplant. Surgeon Eduardo Rodriguez and a team at the New York University Langone Medical Center performed the facial transplant, "the most extensive" in history according to the hospital.
Hardison also received a new scalp, ears, ear canals, chin and cheek bones, and Rodebaugh's nose. Previously unable to close his eyes totally, he now has eyelids and also muscles for blinking.
New York University paid for the transplant, totaling $850,000 to one million dollars.
"Biography of a Face"
(New York Magazine via CNN)
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For more than a century, physicians have used music to make patients feel better before, during, and after surgery. A new scientific meta-study looks at the evidence and confirms that yes, listening to music has measurable pain-killing properties and reduces anxiety around surgery. Read the rest
Professional singer Ambroz Bajec-Lapajne sang opera during neurosurgery for a brain tumor, at his physicians' request so they could monitor his singing ability and "avoid deficits after the procedure," he writes. Read the rest
In America, chicken has better health care than you.
found a beautiful cecropia moth being attacked by a robin, then used online instructions to repair the moth's damaged wing
before releasing it. Read the rest
In December, Stellenbosch University Dr. Andre van der Merwe performed a penis transplant on a man whose own was amputated after a (majorly) botched circumcision led to gangrene. Van der Merwe says that his patient just informed him his girlfriend is four months pregnant. Read the rest
The South African man who successfully received a donor penis last year after losing his own from a botched circumcision three years is expecting a baby with his 21-year-old girlfriend.
From an earlier article about the patient:
Primitive conditions in the South African bush frequently lead to infection and other complications during routine, common procedures like a circumcision. The unnamed patient lost his own penis after it became gangrenous, Van der Merwe said. Some 250 men a year have their penises amputated in South Africa each year.
"This is a very serious situation. For a young man of 18 or 19 years, the loss of his penis can be deeply traumatic. He doesn't necessarily have the psychological capability to process this,” Van der Merwe said. “There are even reports of suicide among these young men.”
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For many years, Stanford University surgeon James Chang has been fascinated by Rodin's hands, sculptures made by the French artist in the 19th century. Chang uses Rodin's hands in what sounds to be a marvelous undergraduate seminar titled "Surgical Anatomy of the Hand: From Rodin to Reconstruction" in which he combines 3D scans of the sculptures, a process seen above, with medical imaging of human bones, nerves, and blood vessels.
Now, Chang has collaborated on an exhibition at Satnford that lies at the intersection of science and art. “Inside Rodin’s Hands: Art, Technology, and Surgery” opens next week at Sanford's Cantor Arts Center. Read the rest
Changsha, China resident Xio Wei's hand was severed in an accident so physicians attached it to his ankle. That kept the hand alive for a month until it was reattached to his arm. Read the rest
Researchers at Imperial College London have invented an electric surgical knife that comes equipped with a built-in mass spectrometer
. Electric knives cauterize wounds as they cut, which produces smoke. The iKnife will be able to analyze the chemistry of that smoke to determine, for instance, whether the tissue that was just cut was cancerous or not — allowing doctors to make decisions in the OR that would, today, require them to take samples, send those samples to a lab, and maybe schedule a second surgery. Read the rest
From Retraction Watch
: The Indian Journal of Surgery has retracted a 2011 paper entitled "Penile Strangulation by Metallic Rings". The reason: The authors apparently self-plagiarized the report from an earlier 2005 paper. Please insert your own jokes here. Read the rest
The Journal of the American Medical Association Internal Medicine has a really interesting essay they've published in full online. It's written by Anna Petroni, a 77-year-old California woman who recently decided against undergoing surgery on her ankles and knees to correct recurrent foot abscesses and arthritis. It's a short, simple piece — just Petroni recounting the story about why she made the decision she made — but serves as a jumping-off point, I think, for several different important discussions about the way we do medicine and the way we make medical decisions.
A couple of things particularly stood out to me. First is the relationships we have with doctors, especially specialists whom we see once or twice and who don't know us very well. Petroni's story suggests that bedside manner is about more than just making somebody feel nice — it can also affect their overall health if the doctor makes decisions related only to their specialty without taking into account the patient's whole story. The second thing I think is really important here is the idea of there often not really being one right answer when it comes to medical decisions. Doctors can say, "we can do this" or "we can fix that", but there's a responsibility on the patient (one we're not usually prepared for or coached through) to decide whether the trade-offs of intervention outweigh the side-effects. And those decisions can vary widely from patient to patient.
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I guess I was so shocked when the orthopedist told me I needed to have 4 surgical procedures, I didn't even think about the fact that he did not ask about my cardiac history.
Turkish plastic surgeon Selahattin Tulunay is performing 50-60 mustache implants every month, helping Middle Eastern men achieve thick, full mustaches. The procedure costs about $7,000.
Pierre Bouhanna is a Paris-based surgeon who, for the past five years, has been performing increasing numbers of mustache implants. He says the majority of his patients come from the United Arab Emirates, Iran, Lebanon and Turkey, with men traveling to France to have the surgery performed.
"My impression is more and more they want to establish their male aspect," he said. "They want a strong mustache."
Mustache Transplants on the Rise in the Middle East [KTLA]
(Image: James and Matthew, with fake moustaches, a Creative Commons Attribution (2.0) image from jonevans's photostream)
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Today, he's known as "Wound Man", but once upon a time this illustration was just one part of a standard medical or surgical text book. You'd get your basic illustrations of anatomy. Then you'd get your Wound Man, to show you all the different, awful things that could happen to that anatomy. A 2009 blog post from the Wellcome Library explains:
Captions beside the stoic figure describe the injuries and sometimes give prognoses: often precise distinctions are drawn between types of injuries, such as whether an arrow has embedded itself in a muscle or shot right through. (The latter is better – the arrowhead can be cut away and the shaft withdrawn smoothly, whilst the embedded arrow will tear the muscle with its barbs when pulled out.)
The other interesting thing about this illustration: It's also an example of how the early printing industry worked. According to the Bernard Becker Medical Library at Washington University, there were several different versions of the Wound Man, but the same version would show up in multiple books — a result of surgeons and printmakers literally carrying the same wood blocks from one printing press to another.
Read more about surgery and medicine during this time period by visiting the excellent history of science blog: The Chirurgeon's Apprentice
Wound Man via David Ng Read the rest
This is absolutely wonderful, and absolutely not for the squeamish.
Defective Heart Girl Problems is a blog where physicist Summer Ash has blogged her experience with finding out that she has a defective heart valve and getting treatment to deal with that defect. The image above shows her scar from her recent surgery.
Ash went through surgery to repair her heart on July 18th. Here's how she explains the problem:
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I recently discovered that I was born with a congenital heart defect known as bicuspid aortic valve disease (BAVD). It’s not a disease, per se, so much as a defect. Most people (roughly 99% of them) are born with a tricuspid aortic valve. I am the lucky 1% born with a bicuspid valve. (I am the 1%!)
As a bonus, being born with this genetic mutation also means the lower part of my aorta, the part that connects to the aortic valve and helps channel the flow of oxygenated blood into the arteries, has less fibrillin-1 – a protein that helps to maintain the structural integrity of the aortic wall. This means that my aorta is prone to “stretching out” and even the normal stress of blood flow coming out of the heart and being channelled to the rest of the body is enough to cause it to start ballooning outward.
The nominal course of BAVD usually entails the aortic valve calcifying and stiffening later in life (60s – 70s), ending in valve replacement surgery. Some people will also need the root of their aortas replaced at this time, some may not.
Sometimes, it's a little mind blowing when you remember just how recently medicine passed from the world of art/magic/tradition and into the realm of science. There's plenty of reason to argue that the transformation still isn't complete today, but I'm really mesmerized by stories from the 19th century, when every surgery was something of an experiment and the same, cutting-edge doctor could vacillate between modern techniques and medieval bio-alchemy in his treatment of the same patient.
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Until that time, the prevalent method of cataract treatment was “couching,” a procedure that involved inserting a curved needle into the orbit and using it to push the clouded lens back and out of the line of sight. Warren's patient had undergone six such attempts without lasting success and was now blind. Warren undertook a more radical and invasive procedure—actual removal of the left cataract. He described the operation, performed before the students of Harvard Medical School, as follows:
"The eye-lids were separated by the thumb and finger of the left hand, and then, a broad cornea knife was pushed through the cornea at the outer angle of the eye, till its point approached the opposite side of the cornea. The knife was then withdrawn, and the aqueous humour being discharged, was immediately followed by a protrusion of the iris."
Into the collapsed orbit of this unanesthetized man, Warren inserted forceps he had made especially for the event. However, he encountered difficulties that necessitated improvisation:
"The opaque body eluding the grasp of the forceps, a fine hook was passed through the pupil, and fixed in the thickened capsule, which was immediately drawn out entire.