After coming across some articles involving surgery on different parts of the body, we couldn’t get the children’s song “Heads, Shoulders, Knees and Toes” out of our heads. It inspired this month’s surgical topic. If we’ve now passed the song on to you as an earworm, our apologies.
Head
The Awake Craniotomy
One amazing advance in modern neurosurgery is the awake craniotomy, in which the patient remain conscious during parts of brain surgery so surgeons can monitor speech, movement, and other critical functions in real time. This technique helps doctors safely remove tumors located near certain parts of the brain while reducing the risk of long-term neurological damage. During surgery, patients may be asked to speak, count, identify objects, or move parts of their body so surgeons can map brain activity as they operate. Although the idea sounds frightening, awake craniotomy has been found to be generally safe and effective; many patients report the experience was far less painful or traumatic than they expected.
Shoulders
Novel Shoulder Replacement Surgery Spares the Rotator Cuff
UCLA Health orthopedic surgeon Ed Cheung, MD, is among just a handful of surgeons in the U.S. and Europe pioneering shoulder replacement procedures approached from the back rather than the front. This eliminates the need to cut rotator cuff tendons, thereby reducing patient pain and shortening recovery time.
Knees
Rotationplasty: Turning an Ankle into a Knee
Rotationplasty is a limb salvage procedure that preserves the lower part of the leg. Although not a new procedure, it is a fascinating one. The surgeon amputates the diseased or injured upper part of the leg, including the knee, then rotates the lower part (shin, ankle and foot) by 180 degrees before reattaching it. The ankle then bends backward and can work as a knee in conjunction with a prosthetic device.
Toes
Bioabsorbable Implants in Forefoot Surgery
Instead of leaving permanent titanium screws or plates in place, surgeons can now use materials such as polylactides or magnesium-based screws that gradually dissolve in the body as the bone heals. This approach is especially useful in procedures like bunion correction, hammer toe repair, and other small toe deformity surgeries, where it can reduce the need for a second operation to remove hardware and may better mimic natural bone loading during healing. However, these materials are still evolving, with trade-offs such as lower mechanical strength and the potential for inflammatory reactions in some patients.
News
Hospital Surgical Escape Room Puts Nurses to the Test
From Calvary Adelaide Hospital, in Australia: “This patient simulation puts experienced nurses to the test as they solve complex scenarios and respond to perioperative emergencies. Working together, participants must adeptly and efficiently manage whatever challenges are put before them before they can successfully ‘escape.’” Read more . . .
Videos
Awake Brain Surgery at UCSF Health
Watch as neurosurgeon Dr. Shawn Hervey-Jumper performs awake brain surgery on a 31-year-old woman with a brain tumor at UCSF Health.
Watch video. . .
Reverse Total Shoulder Replacement
Guest surgeon Dr. John Haverstock discusses reverse total shoulder replacements. He reviews a radiograph and the actual implant.
Watch video. . .
Another Perspective on Perioperative Leadership
In the May issue of ORToday.com, James Stobinski takes a look at the topic of skills obsolescence among perioperative nurse leadership.
He considers the lack of standardized education and career paths for perioperative nurse leaders, the lack of consensus on the core curriculum required to lead an operating room; the importance of leadership succession planning; and much more.
James X. Stobinski, PhD, RN, CNOR, CSSM(E), CNAMB(E), is a faculty member at Central Michigan University and NIFA’s Director of Hospital / ASC Surgical Education Relationships. Read more . . .
In The Spotlight: Stephanie Pedersen
Credentials
BSN, RN, CNOR, RNFA
City & State
Tampa, FL
Current Position
RNFA at St Joseph’s Women’s Hospital
What made you choose nursing in the first place?
My career as a nurse came about a little bit later in life for me. For as long as I can remember, I have always had an interest in healthcare. Initially I thought I was going to become a doctor, more specifically, a pediatric surgeon. The cards didn’t fall that way and I graduated from college with my first degree in accounting. I realized early on in my career that accounting really wasn’t for me. After doing some research, I found out that the university I graduated from offered a nontraditional accelerated nursing program for people with degrees in other fields. The decision was easy. I made the leap and headed back to school. It was a grueling program but well worth it in the end. I am much happier as a nurse and don’t regret my decision to change careers.
On a side note, some years ago I was cleaning out some old papers my mom had and I came across one of those “What do you want to be when you grow up?” assignments from kindergarten. Much to my surprise I had written “Nurse.” I don’t ever remember saying I was going to be a nurse when I grew up. It was always a doctor. I guess I must have known all those years ago better than I did when I entered college the first time around!
How did you come to choose perioperative nursing?
I have always been fascinated by surgery. I was quite certain that the operating room was where I wanted to be. I was lucky enough to be able to do my final semester nursing school preceptorship in the OR. My time spent there solidified my desire to obtain a position in the OR and ultimately pursue my RNFA.
When did you first get involved with NIFA?
I graduated from the NIFA program in March 2022. Dean reached out to me with the opportunity to join the SutureStarTM workshop team the following year and the rest is history!
What do you enjoy about teaching the SutureStarTM workshops?
I really enjoy being a part of developing our students and future RNFAs in their skills. It is a lot of fun to see those “lightbulb” moments in real time and witness the students’ progress from the start to finish of the workshop.
What is one interest or ability you have outside of surgical skills that might surprise people?
I am a ballroom dancer in my free time. Back in 2019 I had the distinct pleasure of participating in Tampa Bay’s Dancing with the Stars, a large fundraising gala for local charities and community needs in the Tampa area. It was a major highlight in my lifelong hobby as a dancer. And here’s a picture from my recent trip to Patagonia. Traveling is another passion of mine. I want to see the world!
NIFA – Office Hours
Monday-Thursday, 8:00am – 4:00pm
Friday, 8:00am – 3:00pm
Practice Resources
Here are several of the most-in-demand sites for our students, prospective students and grads:
Disclaimer: The views expressed in this newsletter are strictly those of their respective authors and do not necessarily represent the views of NIFA. NIFA does not give any express or implied warranty as to the accuracy of statements made by our contributors and does not accept any liability for error or omission. It is the responsibility of all perioperative personnel to work within and adhere to their facility bylaws and individual scope of practice.
