Every person has the right to live. However, there’s a limit to how much help a layperson can give to someone who is seriously injured. Helping someone who needs immediate attention, whether that’s making a tourniquet, a splint or cauterizing a wound is one thing, and performing surgery in the field with no experience and no proper equipment is another.
This article will lay out some ideas of why surgery shouldn’t be practiced, unless absolutely necessary.
First off, surgery is harder than it looks and there is often blood, lots of it.
Consider the following example: Your buddy has been shot in the belly and is bleeding internally. Pressure cannot stop the bleeding. Is it possible to perform surgery to stop it?
Sure, anyone can cut open an abdomen, but that’s just the first step in a long process.
When you cut through muscles and fat, they too contain blood vessels, causing additional bleeding in the skin and the tissues and fat. If you hit a larger blood vessel, there will be even more bleeding.
Let’s assume you knew it would happen and prepared for it: You got someone to apply direct pressure to the bleeding area and clamped or sutured the vessels bleeding the most. Excellent.
However, you are likely to find one big pool of blood in the abdominal cavity, with many feet of intestines crammed inside.
It’s not easy to keep the abdominal wall open, especially one that is filled with blood and without proper instruments, you will be fighting an uphill battle.
2. Cutting & Closing
If, rather than an internal bleed, you were concerned about something like an appendix or a gallbladder—both of which people often wonder about—you would still need to open the abdomen and wade through those intestines to cut out the problem.
Surprisingly, even if you know anatomy, an appendix or gallbladder can hide in a place not in the textbooks.
If you remove too much or too little of the problematic organ, you may induce an intestinal leak. Alternatively, you might nick a blood vessel.
It’s not unusual for even surgeons to believe one thing is causing the problem, only to discover during surgery that the issue is something else.
But, for the sake of argument, let’s suppose your diagnosis was correct. You’ve dealt with the situation. The next step is to stitch things up. However:
- You must close the incision from where you removed the organ; you’ll need to suture the thin bowel wall and not pierce all the way through it.
- You must also close the hole in the abdominal wall and for the body to heal properly, you’d have to suture the wall layer by layer: first the thin membrane (known as the peritoneal wall), next the muscle, then fat and skin.
It’s likely that any type of serious surgical operation would likely not be sterile but would likely be filthy. Internal infection in conditions like this is almost a certainty.
IV antibiotics would be a must if you were hoping to survive such an experience, something that most everyone would not have on them at the time of their accident.
Survival Surgery: Outcome
Performing an abdominal operation in the field with basic instruments in a non-sterile environment and you are not looking at very good odds. Throw in the fact that someone with minimal to no experience is handling the surgery, and your chances of survival are reduced to practically nothing.
Chest or abdominal surgery is the worst type of surgery due to the number of things that can go wrong. Chest surgery can cause a host of problems, the collapse of a lung or the rupture of an artery are just two of them.
Other than limb amputation, there is not much need for life-saving surgery on arms and legs. When it comes to amputations, the question is when to perform one, and that answer is debatable.
It also may be that a limb could be saved instead of being amputated, which would result in a needless operation and a possible lifetime of dealing with the repercussions.
What Happens if You Do Not Get Surgery?
Doctors spend four years in medical school and another five years in specialized training. They do numerous operations under the eye of an experienced surgeon who’s there to assist if something goes wrong.
Even a skilled surgeon may elect not to operate in a survival situation. The surgeon and the location would play a role in the decision. They’d want a clean environment with at least some local anesthetic or ether for the pain.
The chance of surviving an appendix burst or significant internal bleeding in an emergency disaster scenario is not great, but it’s preferable to being butchered by a guy with a knife.
With bleeding, there is always a hope that the vessel will clot, though, for someone who has never attempted surgery before, the chances of stopping the blood flow and surviving the ordeal are slim.
There is a little better chance of surviving appendicitis if the infection is localized, confined, and has not spread. Or the diagnosis might be incorrect and could be nothing more than a bad stomachache.
If it’s impossible to get expert help right away, it’s better to watch and wait to see what happens and try and get medical treatment and antibiotics if accessible, rather than having a complete amateur perform major surgery.
What About Those Surgery Survival Stories?
There are many stories out there, some of them true, others not so much, where people survive harrowing ordeals while conducting field operations.
Take Dr. Leonid Rogozov, this guy was stranded at camp in Antarctica and performed an appendectomy on himself. But he still had basic medical equipment and help when he needed it. According to BBC News, he was also in a reasonably clean environment, had done the surgery before, and was a doctor. Still, he must have had a remarkable pain threshold to be able to withstand such a self-operation.
One of the most common mistakes made by patients is that they forget to consider the possibility of complications when deciding whether or not to have surgery. A nick in an artery, a cut in the intestine, anatomy in the incorrect location, and other unforeseen problems are all possible. So not only do you need extensive anatomical knowledge and how to conduct surgery, but you must also be aware of what to do if something goes wrong.
Instead of second-guessing yourself about whether or not you’d be able to perform surgery in a survival scenario, it’s better to learn what you can about the basics and leave the rest to the doctors. There’s so much to study and learn that we needn’t be proficient in everything under the sun.