Violet’s Journey – Part three: Inside the Operating Room | Boston Children’s Hospital

[MUSIC PLAYING] We’re here in the
operating room with Violet. And today, we’re
going to be performing a facial bipartition. And you can see the
model of the skull. You can see the
defect here in front. And we’ll be making some
cuts along here where I’ve marked in pencil. And removing this segment
first so that we have access to the orbits. And then, you can see,
we’ve made some cuts here in the orbits. They’re fairly far apart now. We’re going to be moving
them towards the middle, and moving the eyes together. So these pieces come together. So instead of what you see here
with this large nasal opening here, and you see how
far apart the orbits are, we’re hoping to get
closer to the image that I have in my left hand. And the whole procedure will
probably take most of the day. So we have the
otolaryngology team involved, neurosurgery, plastic surgery,
ophthalmology, anesthesia, and also the nursing team. So when you factor
in all the things that are being done
by all the teams, it would be most of the day. It’s quite a big move. If you look right
at the side here. I also need to elevate
the nostril floor and the palatal gingiva so
I can split the palette. OK, are we ready? Everybody ready? OK, so Violet Pietrok. We’re going to be doing a
facial bipartition, nasal reconstruction. Alexa Elliott is coming
in a little while. She’s going to do
an EUA of the eyes. This will be a standard
coronal incision. And Mark will come in, take
the frontal segment off. Do we have antibiotics in? Antibiotics are in. Decadron is in. Cortisol is in. Good, good. Move the table
down a bit, please? In terms of any of her skin
that we have to deal with. Can I have another
Tessier, please? Let me go a little bit smaller. Yeah. OK. Let’s do the other medial orbit. There we go. OK. That helped. What is holding us? Yeah, it’s the back
of the maxillary sinus and the pterygoids. Yup. Okay, then we need a
piece of bone over here. Now, this is it. Looks really good. Is that good? All right. We just finished
up the case file, and things went very well today. We came into the
room around 7:30. And then now, Dr. Procter and
I began the procedure at 9:00. And so it’s been
about six hours now, and we probably have
another hour of operating, and then the anesthesia
team will allow her to wake up slowly. We’ll go to the ICU
for a night or two, and then out to
the regular floor. And I’m very hopeful for Violet. I think she’ll do
extremely well. And at this point,
it’ll just be a matter of refining some of the
things that we started today.

5 thoughts on “Violet’s Journey – Part three: Inside the Operating Room | Boston Children’s Hospital

  1. Will her eyes learn to track correctly in their new proximity to each other? She's young enough, I think.

  2. Just ran across Violets story, how is she doing? Could see from the videos what a bright and happy child she is. So glad for the surgeons and the whole medical team.

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