UCSF MC Gastrointestinal Surgery | Surgical Excellence, Innovative Research, Compassionate Care

“Sorry I can’t describe every step I take right now. I need to concentrate” Dr. Jon Carter says as he pokes tools and his fingers into the surgical opening of the abdomen of the patient. BIE members stand off to the side in the operating room (OR), some slightly unsettled by the sight of blood, but the majority completely fascinated.

Dr. Carter (Center) getting ready to insert the mesh for the hernia with his assistants.

These past two weeks in four teams of three, members of BIE visited UCSF Medical Center’s Gastrointestinal Surgery department to observe Dr. Jon Carter, a bariatric and gastrointestinal surgeon. The visits all started off like a scavenger hunt, as we looked for security to sign ourselves in, locker rooms to change into scrubs, PPE that was required for each section of the floor, and finally Dr. Carter in front of the OR, all the while ensuring that we did not get in the way of other hospital proceedings.

Left: BIE members Nikki and Hannah intently observe the surgery through screen as Dr. Carter delicately works the Da Vinci. Right: Operating room where the surgeries were held.

With the patient anesthetized and the surgical area sterilized, BIE entered the OR with the doctor, and after introducing us to the rest of the surgical team, Dr. Carter immediately began the surgery. During the first team’s visit, they observed a laparoscopic conversion of a sleeve gastrectomy to gastric bypass in the morning and then an inguinal hernia open surgery in the afternoon. Team Two observed laparoscopic procedures conducted to fix an inguinal hernia and a ventral hernia. Both of the procedures that day were done using the Da Vinci, produced by Intuitive Surgical, whose headquarters BIE had visited earlier in the program. Team Three observed a laparoscopic gallbladder removal, as well as a esophagogastrectomy. The second surgery involved multiple mini surgeries, including one that used the Da Vinci to disconnect the stomach and intestines and an open surgery for connecting the esophagus to the intestine. Team Four observed two laparoscopic gastric bypasses which included the removal of the gallbladder.

For most of us, this was our first opportunity to observe a surgery from inside the OR. BIE made sure to identify the unmet medical needs that were presented, and identified each of the stakeholder’s thoughts on the current methods of the procedure. Some groups were lucky enough to be able to observe surgeries that went smoothly, but others ran into complications which meant that the team needed to be sure that they adequately covered the unmet needs.

As the surgeries ended, we were sure that our visits to the UCSF Gastrointestinal Surgery department would be a highlight of the BIE experience, and one that most others would never experience. Some of us managed to grab a picture with Dr. Carter, and we ended our day, knowing that our host had successfully improved the quality of life for the patients we encountered during our visit.

Members of BIE Team 2 (Hannah Tang, Jeffrey Feng, and Nikki TJahjono) with Dr. Jon Carter at the end of the visit.