Heritage: The Story of St. Mary's Hospital, 1880-1980
By Leo G. Bryne and Sister Alberta Cammack, C.S.J
Chapter III Contemporary St. Mary's
Because of a need to cut down hospital costs, the Outpatient or Ambulatory Surgery Unit, a new development at St. Mary's, allows for admission, performance of surgery and discharge of the patient on a same-day basis. The schedule could read 6:30 a.m., arrival; 9:00 a.m., out of surgery; 11:30 a.m., out of recovery room; 12:30 p.m., discharged.
On the day of surgery, the patient arrives two hours ahead of the scheduled operation. After going through the Outpatient Admitting Office, the patient may go to the Laboratory where a complete blood count and urinalysis are done. In the pre-op room, a nurse takes the medical history, checks vital signs and prepares the patient for surgery. Patients having other than local anesthesia are seen by the anesthesiologist prior to surgery.
Procedures performed in the ambulatory setting are determined by the physician, taking into consideration the patient's medical condition and his ability to be cared for safely at home after the operation. As the anesthesia is light, patients recover quickly; however, they are kept in the Recovery Room until they can sit up or dangle their legs from the side of the bed followed by a final walk to the bathroom.
Often children admitted for surgery have eye muscle imbalance corrected or inner ear infections treated by myringotomy which involves the insertion of small tubes through the tympanic membrane to facilitate adequate drainage.
Among the procedures are face lifts and skin grafts, and the removal of moles, skin cancer or other growths which are done by plastic surgeons. Ptergium, a small growth on the eyeball, is removed by eye surgeons, and nasal polyps by ear, nose and throat specialists.
Other examinations and surgeries done by various specialists are tendon releases and repairs, the removal of small cystic tumors, dilation and curettage, cystoscopies, and bladder and kidney examinations, including pyelograms which examine the kidneys and ureters by means of dye and X-ray films.
Patients with knee joint problems are admitted for arthroscopic examinations and arthroscopic surgery, a new procedure done with a small scope and micro-instruments. Two or three small cuts about one-quarter inch in diameter are the only incisions necessary. Through these, the arthroscope, a seven- inch microscope with a light on the end, is inserted into the knee joint. The surgeon, peering through the eyepiece, is able to see the actual condition of the joint, thus eliminating the former need to lay the knee wide open with a five-inch slash in order to see and to repair traumatic or pathological damage.
While viewing the interior of the joint, the surgeon is able to insert micro-instruments and to guide them while cutting out small growths or cartilage and shaving away arthritic deposits. A small rubber hose flushes water into the knee extending it and making it easier to work inside. The flushed water also carries away loose fragments and blood. All action takes place inside the knee with only two or three small incisions which allow the insertion of instruments and the arthroscope. After the operation, the incisions are sewn up in a few seconds.
This procedure, new to Tucson, is done only in several hospitals that are equipped for it. It was developed in Japan and has been used in the United States for about four years. With the smaller incisions, there are fewer complications and with less pain, the convalescent time is greatly shortened. The new micro-surgery has transformed an operation for a knee injury from a three-week ordeal with a large scar to a much less traumatic procedure which allows the patient to be on his feet in a couple of hours.
Continue with Chapter III: Contemporary St. Mary's Burn Unit