Participants: Dr. James Marcum (Host), David A King
Series Code: BRX
Program Code: BRX00004A
00:01 Are you confused by the conflicting health reports
00:03 in the news today?
00:04 In this well marketed world is hard to know who or
00:08 even what to believe, but there are answers
00:10 you can depend on.
00:11 Hi, I'm Dr. James Markham.
00:14 Join me for Bible RX, a program exploring the
00:18 healthcare world.
00:19 Looking at all aspects of healing, using the Bible
00:23 and biblical prescriptions as the ultimate
00:26 source of truth.
00:48 Our program today is going to be on General Surgery.
00:51 Specifically focusing on when to use and
00:54 how to use the scalpel.
00:55 With this today is Dr. David King, a General Surgeon.
00:59 And he's going to answer questions on when
01:02 to use a scalpel.
01:05 Many people have questions regarding general surgery.
01:09 It is very frequent topic
01:11 and we have collected
01:12 questions generally from
01:14 all over the United States
01:16 and all over the world regarding general surgery.
01:19 We are fortunate to have a special guest who answers
01:21 these questions on a daily basis in the office and
01:24 at the hospital, Dr. David King.
01:27 David we want to welcome you specially to Bible RX.
01:31 Bible RX stands for biblical prescriptions.
01:34 Tell us what got you interested in surgery.
01:36 I know you have done some different things before,
01:39 how did you get interested in working on people
01:41 and taking care of their physical needs?
01:44 Well first of all Jim thanks
01:45 for the opportunity to be here.
01:49 Yeah, I sort of took the scenic
01:51 route towards my profession.
01:54 My first love I guess, when I made a decision for
01:58 a career in engineering, in high school actually.
02:02 I went straight through college and then through about
02:07 5 years of experience doing engineering before
02:11 I went to medical school.
02:13 From medical school on, at first I thought maybe
02:17 I would like to be an Orthopedic Surgeon.
02:18 It seemed like a natural fit.
02:20 Are orthopedics working with bones and joints?
02:21 Working with bones.
02:22 That natural fit with engineering.
02:24 It wasn't quite right?
02:25 But as I did my clinical rotations,
02:27 which you do in your third year of medical school,
02:29 I fell in love with general surgery.
02:32 I've gone that direction and did not look back.
02:36 I take it you are still in love with general surgery?
02:38 I still love what I do.
02:39 I guess you enjoy working with people?
02:42 I do I love working with people and I love the
02:44 technical aspect and working with my hands.
02:46 I love to see that gratification of seeing a person
02:49 who has been sick, now who is well.
02:51 I hope that you also like to answer some questions too!
02:55 Because a lot of people have questions
02:57 regarding general surgery.
02:59 And we are going to answer some of these.
03:01 Our first one comes from Doris in Nebraska,
03:03 and Doris writes:
03:16 Now first we are going to have to talk about
03:18 what adhesions are?
03:19 Sure, to start from the beginning.
03:22 Adhesions are essentially scar tissue that forms as a
03:26 result of inflammation or the healing process.
03:30 Things get sticky in there.
03:32 They do, and it is a natural process of your body
03:35 to form these as part of the healing process.
03:37 In other words, it has to happen for our bodies to
03:40 respond to surgery, and heal appropriately.
03:42 Every surgery you are going to have at least some!
03:44 Every surgery generates some scar tissue.
03:48 So there is almost no way to prevent that from
03:51 occurring because it is a natural response and
03:55 essentially required if you do a surgery on
03:58 somebody that they heal with a scar.
04:00 Now, are there some things that we can do to try and
04:03 prevent those scars from becoming
04:05 a problem after surgery?
04:07 There are several things we can do.
04:08 There has been a tremendous amount
04:10 of research put into this.
04:12 With limited results, but some positive results with
04:16 Films that can be used to try to eliminate adhesions.
04:21 What are Films?
04:22 It is like an absorbable, hard to describe the type of
04:28 material it is, it almost feels like a plastic in your hands.
04:31 It basically prevents the body from having a response
04:38 to that inside.
04:40 You use it when you operate?
04:41 You use that when you operate and you put in after
04:43 we are done to try to prevent scar tissue
04:45 from forming in that particular location.
04:48 It only works in its own local area where you put it.
04:51 Which is why it is not been 100 percent effective at
04:55 limiting adhesions to the point where people
04:58 will not have problems afterwards.
04:59 It can only prevent adhesions in the location it is.
05:02 So this is a real tough, really there is nothing
05:05 that you can keep it from forming then?
05:07 There really is nothing we can do.
05:09 Except not have surgery.
05:10 That is one option.
05:11 But I have heard of people who have had adhesions
05:14 and they go back in and try to work on them.
05:16 What is that all about?
05:18 You've heard about when things are hurting them and
05:20 they go back again, what do they do to limit that?
05:24 That is an operation that we call a Lysis of adhesions
05:27 which actually means that we go in and cut any adhesions
05:31 that we find, particularly these are adhesions that
05:33 happen in the abdominal cavity.
05:34 They pull on things right?
05:37 And that your intestines, the shape that they are
05:40 in when you are born and throughout life,
05:42 before you ever have surgery,
05:43 they are free-floating in your abdominal
05:46 cavities essentially.
05:47 When you have surgery and scar tissue forms,
05:50 some scar tissue will form so that it tethers to
05:52 that bowel and certain areas in your abdomen,
05:55 so it can no longer be free-floating,
05:57 move and sometimes that causes no problem at all.
06:00 In fact most of the time it causes no problem at all.
06:03 We will just have to pray that Doris doesn't get any.
06:06 So hopefully Doris doesn't get any.
06:08 That would be good!
06:09 The next one actually comes from Georgia,
06:11 Melvin in Georgia is writing and says:
06:13 well this is coming from Melvin Georgia, the town.
06:35 I guess we need to talk about a Laparoscopic.
06:37 What is that?
06:38 A laparoscopic many people refer to it as laser surgery.
06:42 That has been a popular term for many years.
06:45 In fact when laparoscopic surgery for the gallbladder
06:49 was originally designed, they did use a laser.
06:52 They actually cut the gallbladder
06:53 free from its attachments.
06:55 That hasn't been done for many years in most locations.
06:59 However, it just simply means that we use a
07:01 video camera and 3 or 4 small ports,
07:05 where we can do the operation under
07:08 video camera guidance.
07:09 And then we take the gallbladder out through a small
07:12 incision, usually no bigger than about half inch.
07:14 What are the advantages to that?
07:16 The big advantage is the amount of pain
07:19 people have afterwards.
07:20 The recovery period is shortened by that significantly.
07:23 The old surgery that we used to do for gallbladder,
07:25 we would make a big incision under the rib cage,
07:28 more up and down in the middle.
07:29 It would take sometimes a week in the hospital and
07:32 up to 6 weeks to recover from.
07:34 The laparoscopic surgery typically is done now
07:38 as an outpatient.
07:39 Most people go home the same day and the recovery,
07:42 period to where people can do a full-time job,
07:45 is usually about 2 weeks.
07:47 She is also asking about the risk of this type of
07:50 laparoscopic surgery?
07:52 The main risk is gallbladder surgery,
07:55 or bleeding and infection, which are fairly common
07:58 to all abdominal surgeries.
08:00 In particular with gallbladder surgery, injury to
08:02 something that is around the gallbladder is one that,
08:05 though it does not happen often, can be
08:07 very devastating if it does.
08:09 There is liver, small intestines, stomach, the colon,
08:13 or large intestine, the main bile duct,
08:15 which the gallbladder is attached to that bile duct
08:20 and acts as a storage reservoir for bile.
08:23 If that main bile duct gets injured, it certainly can
08:26 be a major complication that requires additional surgery
08:29 possibly even multiple additional surgeries
08:33 in order to correct the problem.
08:35 Now can everyone had this type of laparoscopic surgery?
08:38 No not everyone, though as time has past and we have
08:41 become more proficient at laparoscopic surgeries,
08:44 we have almost gotten to the point where we will try
08:48 it on almost anybody.
08:50 The type of people who have the most trouble with doing
08:53 laparoscopic surgery are those that have had previous
08:55 upper abdominal surgery.
08:57 Where there might be scar tissue that has formed,
09:00 like we talked about with the first question.
09:02 That scar tissue can prohibit us from being able to
09:05 see properly, it can make it more difficult for us to
09:08 use a video camera and a special instruments and find
09:11 a free space in the abdomen to be able to put those
09:13 ports we talked about.
09:15 Well I am just amazed that they can get it out one day,
09:17 that is amazing because I can remember when everyone
09:20 used to stay in nearly a week with that procedure.
09:22 Very true and even over the past 5 years it has gone
09:25 from where most people would stay overnight to where
09:28 most people now go home the same day.
09:30 What we are going to continue with your general
09:33 surgery questions right after a short break.