Cases of self-surgery#

First version: 2019-12-21
Last update: 2021-01-20
Persistent link to latest version: https://n2t.net/ark:21206/10028

Abstract

We present a compilation of case reports of self-surgeries. In each case only a very short description is presented. The reader is referred to the case reports for a more extensive description.

Inclusion criterion: We attempt to list only procedures that are remarkable in their good preparation, good technique or good results. Emergency surgeries done in the field without any proper equipment nor preparation like amputations of trapped limbs and similar are not considered. Cases of self-cutting without an intention to perform a well-defined surgical procedure are not considered.

1 Overview

Szabó, Brockington (2013) reviewed instances where a self-caesarean section was attempted.

Self-orchiectomy appears to be relatively common. We conjecture most cases go unnoticed by the medical establishment as it is a simple surgery unlikely to result in complications that would prompt the self-surgeon to seek help.

We recommend that professional and amateur surgeons document their experiences in the literature. To amateurs that do not want or can not pay for the publishing fee for open access we recommend to make use of e-print servers where papers can be published without cost to the author nor the reader.

2 List of reported cases

Individual cases self-surgery are listed below in chronological order. This is not an exhaustive list.

2.1 Removal of kidney stone of Maldigny, 1824

M. Clever Maldigny, miltary surgeon in the French Royal Guards had received 5 renal lithotomies (by other personnel) before he successfully performed the 6th himself (Nwaogbe et al., 2017).

2.2 Operation of inguinal hernia of Alexandre Fzaicou, 1909

In 1909 Alexandre Fzaicou operated his own left inguinal hernia using strychnine and amylocaine (a.k.a. stovaine) as an anesthethic (Nwaogbe et al., 2017).

2.3 Appendectomy of Evan O’Neil Kane, 1921

In 1921 Evan O’Neil Kane performed part of an appendectomy on himself in an hospital setting using local anesthetic. A stated motivation was to prove the suitability of local anesthetics for major surgery. Closing the wound was left to assistants (Rennie, 1987).

2.4 Cardiac cathetherization of Werner Theodor Otto Forßman, 1929

Forßman performed the first cardiac cathetherization on himself to prove its viability and safety. He presented the plan to the chief of surgery and was rejected. Without authorization he asked for the help of a nurse. The nurse accepted and offered herself as the subject. While keeping the guise of preparing to operate on the nurse, Forßman inserted the cathether in his own arm then revealed this to the nurse. They proceeded to the X-ray room to complete the procedure and take X-rays photographs. After contacting the chief of curgery about his success, Forßman was admonished and allowed to apply the procedure in patients (Nwaogbe et al., 2017).

2.5 Operation of inguinal hernia of Evan O’Neil Kane, 1932

In 1932 the previously mentioned Evan O’Neil Kane operated himself an inguinal hernia he acquired during horseback riding (Nwaogbe et al., 2017).

2.6 Appendectomy of Leonid Ivanovič Rogozov, 1961

The Soviet medic Leonid Ivanovič Rogozov performed appendectomy on himself in an improvised setting in an Antarctic research station. Members of his team without medical training served as assistants (Rogozov, Bermel, 2009). Depsite that Rogozov used a mirror, he chose to operate without gloves because given the sub-optimal visibility part of the operation had to be performed by tact.

2.7 Denervation of adrenal glands reported by Kalin (1979)

A 22-year old unnamed natal male attempted to denervate his adrenal glands. The surgeon had previously performed a removal of both of his own testicles and started taking MTF HRT. The motivation was to become asexual. In the case report he is quoted as saying “I’m no homosexual or transsexual. I still want a hugging and kissing relationship with a woman.”. We interpret this as that he had no intention to present as a woman. Note that since was taking cross-sex hormones he was transsex per the definition of “Pharmacology of transsexualism”.

The operation took place in the surgeon’s dormitory. He had previously cleaned it with spray disinfectant and covered an area (presumably of his bed) with sterilized sheets. He took barbiturates per oral for analgesia (the report is not more specific). He took cortisol and prepared a canister of aerosolizable adrenaline (case report says “vaporized” adrenaline) in preparation for a possible hypovolemic shock. A surgical mask, sterile gloves, scalpel and retractors were used. The outer incision was 14 cm incision from the end of the sternum to around the navel (case report does not specify if this was made in a single cut). Lidocaine was injected as he proceeded deepening the cut. For hermostatsis, sterile cotton thread for ligating blood vessels and gelatin powder was used. After 8 h there was no significant blood loss. The surgeon could not reach the target nerves. He closed the wound with bandages and went to a hospital. The personnel irrigated with antiseptic solution and closed the wound without terminating the surgery (Kalin, 1979).

2.8 Removal of bone fixators reported by Moholkar et al. (2000)

A 27 year old male attempted to remove the fixation of his fractured fibula. At the time he performed the self-surgery he was awaiting for removal of the fixator. The fixators were causing pain. The fixation consisted of a metal plate and 6 screws. An alcoholic beaverage per oral was used for analgesia. He removed 5 screws, then he went to emergency room of an hospital where the removal was completed. The article where this case was reported states that the subject was a university student; it is not stated whether he was a student of a medical field. We suppose his field was not medicine becuase of the improvised instruments employed (Moholkar et al. 2000).

Henry David Nava Dimaano operated his carpal tunnel syndrome in the left arm. A video is available; unfortunately it does not show the suture.

Henry David Nava Dimaano performed a release of trigger finger affecting his ring finger of the left hand with heavy help of an assistant. A video is available; again it does not show the suture. The sutured wound of his previous carpal tunnel surgery is visible.

2.11 Lipectomy by de Freitas Sobrinho, 2012

Brazilian plastic surgeon Luiz Américo de Freitas Sobrinho performed a lipectomy on himself with the help of assistants. A self-archived recording is available. A translation of the text at the start of the video by the author of this article follows.

This film is about a self-surgery in the lower abdominal region performed by plastic surgeon Dr. Luis Américo de Feritas Sobrinho, whose challenge has as a main goal an improvement of his technique by feeling in his own body what his patients have felt over the course of 3 decades of his professional activity.

The video was published with the following description, again translated by the author of this article.

Self-surgery of my lower abdomen.

I pondered for around 2 years about the pros and cons of this self-surgery. Some colleagues supported me, other suggested me [psychological] therapy and fortunately some challenged me. I say “fortunately” because the latter contributed to my decision, taking into account that I like challenges very much.

When I read the story of Soviet medic Leonid Rogozov that extracted his appendix to save his own life during a mission to antarctica (in the article “The 10 most incredibles self-surgeries in the world” in HypeScience) I received the impulse I was missing to what on myself what that valiant collegue did on himself.

The surgery.

The surgery lasted around 2 hours. In the operating room as supporting team there was present a plastic surgeon, a general surgeon and a general practitioner. I used local anesthesia for the self-surgery, as I usually do in surgeries of minor and medium size in my clinic. Local anesthesia and muscular sedation are preferrable to general anesthesia or venous sedation because the risks are smaller.

With a mass of 92 kg and height of 1.70 m I performed the operation well above the ideal weight. It is important to note that when people are operated within the ideal mass future corrections to remove leftover tissue as a consequence of post-surgical shrinking can be avoided.

The surgical procedure included removal of skin and of fatty tissue in an ellipse shape, but in chunks (technique used normally by me) I removed several segments of around 10 cm each, cauterizing and suturing. I forgot to weight it, but I think I have not removed more than 1 kg of fat tissue because it weights little.

I feel happy for having accomplished another challenge, of the many that remain to heppen.

Luiz Américo de Freitas Sobrinho specialist in plastic surgery.

Web site: http://www.plasticlinicajundiai.com.br/.

The self-surgery of de Freitas Sobrinho was itself featured in HypeSpace, the web site from which an article inspired him to do a self-surgery.

2.12 Operation of umbilical hernia by Aytekin, 2013

Oygar Aytekin (web page) published a video (in YouTube) where he successfully operates his umbilical hernia with help of an assistant. Proper surgical instruments were used. The year given here is the year of publication of the video.

In an interview with newspaper Hürriyet (picture), Aytekin said (translation by Tsarina Effy):

The surgery was indicated. Regarding why I self-performed it, we can say that it was out of boredom. Imagine having to get off your butt and visit a colleague for it [...] I already had everything I needed there, so I just operated. Assistant nurse and I not only performed the surgery, but also had fun doing it.

I sat down reclined. I administered local anesthesia. Now that I have experienced it, I do not believe anyone saying ‘local anesthesia hurts’. I did not feel anything. I belive confidence comes from knowledge. You know that you cannot harm yourself. Because you know the layers, tissues, where everything is situated, and how exactly to operate. I told myself ‘I cannot be bothered to visit another doctor, I will do it myself.’ I do not find it extraordinary. Any surgeon can do it. The hard part of the operation is the position. In reclined position, it is harder to see the surgical site and to separate the layers. Also, the position applies pressure to the abdomen which pushes the fats outwards.

2.13 Excision of cosmetic defect in arm by Castelán Castro, 2020

In 2020 the author of this article removed a small cosmetic defect in the arm with one hand. A self-report with extensive details was written (Castelán Castro 2020).

3 Acknowledgements

Thanks to Tsarina Effy for bringing the self-surgery of Aytekin to my attention and translating the text and for bringing to my attention both surgeries of Nava Dimaano. Thanks to the persons who have performed self-surgery thus demonstrating in practice the right to self-determination over one’s body even when it goes against common orthodoxy. Thanks to the persons who have experimented with novel procedures of technical value (surgery or otherwise) on their own bodies thus leaving a technical contribution to humanity’s collective knowledge and an example of courage.

4 References

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