First Dropped Stump

The surgical emergency every new grad fears.

For the non-vets, a "dropped stump" is when a particular artery isn't well tied off when you let go of it (usually accidentally), so uh, blood starts pouring out of it into the abdomen. Pretty much every vet student's nightmare, and inevitable at some point in your career. I've spent years dreading it, being extra super paranoid in every surgery, and it finally happened in August.

Naturally, it was on a day when I was the only surgeon in. And naturally, they had booked a large, deep-chested dog spey for me. It was like looking down into the grand canyon and trying to work with a grappling hook attached to a helicopter. I managed to get my ligatures on, half-blind and up to my elbows in dog abdomen, and, ironically, I wasn't quite confident in them so I wanted to add a third. Just as I lifted the pedicle up to tie another knot, poof, the pedicle was gone. In my hand, securely in the clamp, were the two original ligatures, nice and secure... And attached to nothing.

Sometimes in these situations, blood starts welling up in the abdomen like someone turned on the tap. Fortunately mine didn't bleed all that much, really. I still had to stand there for ten minutes with a fistfull of swabs pressed into the general area, while one of the other vets drove in to help.

At the discharge, I had to figure out how to explain to the client that surgery wasn't exactly routine, but the problem was resolved. I went with "there was more bleeding than usual." At the recheck a week or so later, she mentioned she'd heard a "sloshing sound" the first night. :S

Considering in the very next surgery I did, a cat spey, the clamp cut clean through the uterus and I had to go fishing for the severed end, I was put off surgery for a little while...