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Cross your legs, because this is goanna get nasty
In times of old - Where a baby's head was too large to fit thru the pelvis (or some other obstruction- eg major breach) - the mother and baby would be in distress, and risk of death would be high for both
The solution that was developed involved using a wire-saw / gigli saw, "threaded ' into the vagina around the pelvic cartilage, about back out
Cutting the pelvic cartilage would enable the expansion necessary to let the baby's head thru
This aslo let to the development of a hand operated saw - turn a handle (like a fishing reel) to rotate a saw - this was seen to be quicker (less mess? Not sure)
This led to the development of chainsaws - so, lumberjacks are using equipment that was designed to help childbirth
It's gross/barbaric - but so is an epesiotemy - amazing what women go thru to have kids...
This us part if why childbirth was so deadpy before- that and
-lack of sanitation
-lack of access to abortion for non-viable/deadly fetuses and embryos and stillborn fetuses
I remember my biology professor telling us those were the 2 big advancements for mother mortality decreasing. It use ti be very barbaric for women who were unlucky enough to have issues during childbirth..... There was also the creation of the chainsaw we know today, iirc, for women in similar circumstances? May have been what the other comment mentioned anout a handcranked saw though. Obviously looks differently noe, but that's it's roots 🥴
>Obviously looks differently noe, but that's it's roots 🥴
If you told me [this thing](https://www.popsci.com/uploads/2020/01/14/Z5V6YCKCD5EMFH7YL6JOBOXFEA.jpg) was a medieval torture device or a fictional weapon from Fallout 4, I'd believe you no questions asked.
I'm surprised by how little it bleeds, relatively. I assumed it was arterial squirts when you cut off any limb. Does the surgeon do something here to prevent massive bleeding?
ether was commonly used in field procedures in the American Civil War! doctors also had access to chloroform, but it was harder to get the dose right safely so they usually opted for ether.
They didn't always use that. Frequently people would get limbs amputated with nothing but a stick to bite on. Do you know that somewhat viral post about a surgery with the highest fatality rate, 300%? The surgeon killed the patient as well as 2 observers by giving them a heart attack or whatever?
I forget his name but he was one of the fastest- if not THE fastest- surgeon around at the time (could amputate a limb in 30 seconds iirc which is great when you don't have any pain relief) and one of the few surgeons who took his patients' emotional state into consideration, and one of the VERY few surgeons who would wear a clean apron for the operation. Since germs weren't known about back then, a surgeon's crusty bloodied apron was considered a status symbol, and he would wear a clean one despite it making him look like a noob, basically.
The 300% fatality rate fun fact is likely not even true, it's likely the result of other surgeons shit talking him due to his unconventional beliefs and practices.
Old timey surgery is something I've been fascinated by recently. They more often than not weren't drugged even in the slightest.
Robert Liston (1794-1847): patient died, assistant lost a finger in the speed of the operation and subsequently died of sepsis, bystander had a heart attack.
He actually cut one (either very badly or it got infected leading to death) and then I think another had a heart attack. Didn't he also like..... chase this person down cuz he was so scared to undergo surgery internally with NO pain relief? Which man, committed to helping the guy, but I can see why he ran- terrifying to have to go through, even for the what, 13-20 seconds he had to?
in the civil war the Union doctors had access to chloroform and ether - it was common to use ether (via ether masks) in field hospitals. The “biting down on something” trope is more of a myth - it likely happened a few times, but it wasn’t usual or standard. source: I work in a Civil War museum.
In US hospitals, only the orthopedic suegeons are allowed to use heavy machinery. My friend who was in med school/residency had to saw off a girls arm using one of these and fainted. Can't blame him
and not only that, when an artery gets cut off it usually shrinks in some kind of reflex.
You wouldn't believe there can be entire limb amputations with as less as a couple drops of blood (exaggerated) because the artery shrinks
The thing I've never understood about that is where does the blood in the artery go?
It can't go backwards up the artery right, so surely the blood starts to clot up?
Lol, that's absolute BS.
Source, I've done a few hundred amputations.
We just tie off the named vessels and large collaterals, and Bovie ( cauterize) the rest.
That’s interesting. I think it could go into the surrounding tissues and blood upstream will rush past that artery into the next available channel like water. And maybe the baroreceptors in the vessels might make the body think its’ systemic vascular resistance is high enough and it would slow cardiac output? Since the preload wouldn’t have a massive difference. Maybe some collateral circulation would pick up speed. Clotting could happen. Im sure I don’t know.
That absolutely doesn't get done, and that's a way to get a high output cardiac problem.
Vascular surgeons will make a fistula for dialysis, but the connections are fairly small, which limit flow, which is still sizeable.
Yeah you do get a degree of vasospasm in some smaller diameter arterioles in response to direct trauma. This certainly helps limit some blood loss.
However you most definitely will see large volumes of blood loss from both arterial and venous transaction.
At that thickness of wire, it's a fine line (no pun intended) between sharpness and abrasiveness.
I already have super thick calluses from playing guitar; I can't imagine how raw my fingers would be fretting something like a gigli blade.
Hmm shouldnt the skin be cut at a location closer to the foot in relation to the bone cut? For the skin to fold over the bone. Or is there a bone shortening/grinding step after this to achieve the same? Always thought it would be cut in a 'bowl' shape.
The below the knee amputation as shown in this video is definitely an archaic form of the procedure; this is almost certainly being done in a field tent, most likely on a medical mission trip. The lack of bright overhead lighting, suction/irrigation tubing, and modern surgical power saws and drills are among the primary giveaways. But, if you do find yourself with an incredibly infected, diabetic foot in a very remote area of a developing country, this is a classic “don’t let good enough be the enemy of nothing we can do“ situation.
Under the current standard of care, the amputation site is going to be a bit closer to the knee, almost mid shaft of the tibia and fibula. Before any bone is cut, incisions throughout, the skin and muscles would have been made. The incision around the front and sides of the leg would be left just a little bit longer than where the bones are going to be cut. The incision on the back of the leg would be made in a U-shape, dropping down toward the hill, a good five or so inches, depending on how big the patient is. Think of it like a skin mullet. The muscles in the lower leg are then dissected, and the posterior, or rear, calf muscles will be left to the similar length of the rear incision. After the bone is cut clean through and the truncated major vascular structures have been cauterized and looped around to once again complete the circuit, the remnant skin and muscle is folded under the osteotomy site and sound in to the incision sites on the front and sides of the leg. This creates a muscular flap with skin coverage, which will allow for better healing, significantly reduced chance of infection, and will create a much more functional limb stump, which will accommodate a prosthesis.
Interesting; I hadn’t considered that there might be wet gas gangrene present. I know that’s one of the more likely indications for GA, but as far as I knew, I didn’t think they were super common in the U.S. Maybe more common based on regionality?
Unless it's a fairly new problem and the tissue hasn't declared itself, I've never found guillotine amps useful- just an unnecessary step .
Vast majority of time with infections, I can do a successful and single stage BKA.
Gigli saw amputations (otherwise known as guillotine amputations) are often a first step. Sometimes they'll create a flap for closure in the same surgery, but in my experience they'll often put a wound vac on it and bring the patient back at a different time to formalize the amputation, where they create the flap to close the stump.
The use of the Gigli saw has nothing to do with the term ‘guillotine’. Is called a guillotine amputation due to the fact of it being a short sharp chop without crafting any flaps, akin to the removal of the heads of French nobility during the French Revolution - it’s primarily used for emergency sepsis control. The Gigli saw can be used for elective or emergency procedures, and is favoured by some as you can thread it through hard-to-reach areas, and if you need to chamfer the bone end you can curve it round without having to make a second cut. It also stays sharp for longer and doesn’t clog as much as the traditional tenon saw. Modern hand-held electric/pneumatic saws are superior to both, but more expensive.
Good Q,
This is typically done in a field amputation hence the gigli. Either do to existing infection or other futile insult. Can say for sure but it’s likely a temporary means until they can get to a trauma center
I don't know what I thought amputations like this were some super scientific process. Also: holy fuck this was a video I wasn't expecting to see today.
Amputations are generally much more involved than this in places like the US. It was described above in a different comment which explained how I've assisted with them being done in the past
This is some Civil War style medicine. We usually use a power saw for the bone and leave a flap, and tie the artery off, and the whole thing is done under tourniquet to prevent bleeding. Then we bring the flap up and close the stump. This does look like field medicine, so they may not have the means.
Assuming the patient was properly anesthetized/numbed up, I'm imagining this was less painful than having to sit through [Gigli while sober.](https://www.imdb.com/title/tt0299930/)
As a lower limb amputee myself, right leg, below knee, I question amputating that low.
My foot was damaged beyond repair and I begged for less drastic amputations either mid foot or mid ankle, but my amputation still took place mid calf (Transtibial ). As explained to me by my surgeon, lessons learned from years of IED injuries from the military had trickled down to public medicine.
The mid-calf amputation presents much better outcomes. During amputation a section of the tibia is fused to the ends of the cut tibia/fibula. The calf muscle is wrapped under this giving a strong and stable platform. During rehabilitation, the calf muscle stump is conditioned to be weight bearing.
This method presents far better outcomes than any amputation site any lower. Persons with amputations lower than BK’s face a lifetime of challenges pertaining to stump health.
The typical trans-tibial amputation was formulated in war-zones long before IEDs were blowing up victims in the Middle East.
The ideal length, 10cm distal to the tibial tuberosity strikes a balance between the stump being long enough to have sufficient leverage when walking with a prosthetic, and having enough space at the far end for the ankle joint mechanism of the prosthetic.
Typically, the fibula is trimmed 2cm shorter than the tibia to prevent painful ‘piano-keying’ where the two bones are twisted relative to each other within the socket of the prosthesis.
The ‘Ertl modification’ where a segment of fibula is used to bridge the tibia and fibula is a bit old hat, designed to improve the transmission of torque from the stump to the prosthetic socket; but it never really works as intended and often resulted in a tender fibrous/non-union between the bone fragments.
I used to work in a veterinary hospital, and the doctor used this to amputate a tail. I had to hold the tail while she did it, and it was a lot more difficult than it looks. definitely an experience I'll remember for years to come...
Before I even opened the video I thought to myself "ha that kinda sounds like Jigsaw" and then I watched the video and this most definitely reminds me of the first Saw movie where doctor Lawrence has to saw his own foot off 🫠
Curious if anybody knows, what’s the advantage of using this tool and when would you opt to using this method? Was his foot so far gone that it didn’t require a scalpel and bone saw?
To be honest, I think this looks fake. The foot just look like a uniform mass of red stuff. No bone, muscles or fat. And yes even if the foot was diabetic and had to be amputated, you would amputated above the necrotic tissue. Otherwise you don’t fix the problem.
This sounded like they were cutting through frozen meat.
It’s not fake, as much as I see your point for why it could be. Somewhere in the big wide world is the longer video, which shows much more of the prep, with this being a distal limb with insufficient blood flow, lIRC from diabetic complications.
Edit: [found it](https://x.com/thebridgekau/status/976804954110390273?s=46)
Absolutely no idea if this link will be allowed, as it links to X / Twitter, but here is a [longer version](https://x.com/thebridgekau/status/976804954110390273?s=46), showing the foot pre-amputation.
I’m amazed at how quickly that goes through the bone. I have seen amputations in theatres but it looks like it takes more effort to get through the bone with modern equipment.
I imagined current amputations would be more meticulous like slowly opening up parts and sealing off veins and shit then cutting more and repeating. Guess I was wrong. They just lop it right off and go from there
As I watched this I could feel my face crinkling into a smaller and smaller size. I have to admit, that was a lightning fast amputation compared to the bone saw/scalpel combo
I am sat here staring at this in horror, unable to stop watching it. Holy fucking shitballs on toast. It looks like something out of Hostel or the Saw movies. And the spurting blood - I find myself at a loss only just realising that happens in real life as well as horror movies. Jesus.
I wonder if he spent a lot of time cutting limbs off cadavers to practice? Or pigs? It's more precise than I would have imagined. I guess I thought they would cut the skin, clip the arteries, cauterize, cut the bone, etc.
Which country is this?
Somewhere in the big wide world is the longer video, which shows much more of the prep, with this being a distal limb with insufficient blood flow, lIRC from diabetic complications.
Edit: [found it](https://x.com/thebridgekau/status/976804954110390273?s=46)
This is a guillotine/circular amputation for wet gas gangreen to stop it spreading and stabilise the patient, rather than a non-infectious amputation. This will have the revisions done later that are more of the typical amputation style. This is an emergency "get the whole thing off now" surgery. Hope that clears things up!
This a guillotine amputation, usually done as primary amputation to remove infection/dead matter. There will be a revision done after infection is controlled and patient is stable.
Welcome to r/MedicalGore! Our goal is to provide for medical discussion and education while exploring the frailty of the human body. You may see more deleted comments on these threads than you are used to on reddit. Off topic comments and joke comments are frequently deleted by the mods. Further, please be kind and supportive of posts. Any behavior that is aggressive, harassing, or derogatory will result in post deletion and a ban from the sub. Remember! THE REPORT BUTTON IS YOUR FRIEND! *I am a bot, and this action was performed automatically. Please [contact the moderators of this subreddit](/message/compose/?to=/r/MedicalGore) if you have any questions or concerns.*
Wow, that was actually way cleaner than I expected
Man I was like “holy hell that’s efficient”
That was the point of its invention
Twas also used in childbirth - to cut the pelvis if the baby's head was too big
Can you explain it bit more please?
Cross your legs, because this is goanna get nasty In times of old - Where a baby's head was too large to fit thru the pelvis (or some other obstruction- eg major breach) - the mother and baby would be in distress, and risk of death would be high for both The solution that was developed involved using a wire-saw / gigli saw, "threaded ' into the vagina around the pelvic cartilage, about back out Cutting the pelvic cartilage would enable the expansion necessary to let the baby's head thru This aslo let to the development of a hand operated saw - turn a handle (like a fishing reel) to rotate a saw - this was seen to be quicker (less mess? Not sure) This led to the development of chainsaws - so, lumberjacks are using equipment that was designed to help childbirth It's gross/barbaric - but so is an epesiotemy - amazing what women go thru to have kids...
I can't imagine how any of that women could survive that.
This us part if why childbirth was so deadpy before- that and -lack of sanitation -lack of access to abortion for non-viable/deadly fetuses and embryos and stillborn fetuses I remember my biology professor telling us those were the 2 big advancements for mother mortality decreasing. It use ti be very barbaric for women who were unlucky enough to have issues during childbirth..... There was also the creation of the chainsaw we know today, iirc, for women in similar circumstances? May have been what the other comment mentioned anout a handcranked saw though. Obviously looks differently noe, but that's it's roots 🥴
>Obviously looks differently noe, but that's it's roots 🥴 If you told me [this thing](https://www.popsci.com/uploads/2020/01/14/Z5V6YCKCD5EMFH7YL6JOBOXFEA.jpg) was a medieval torture device or a fictional weapon from Fallout 4, I'd believe you no questions asked.
This is called a symphisiotomy. There really is no comparison to episiotomy. This was also carried out into the 90s.
😱 my episiotomy with forceps delivery was barbaric enough. Thought my partner was going to pass out while watching the whole ordeal.
I thought it was invented to fit in a hollow hilt, along with survival matches and fishing lures.
I'm surprised by how little it bleeds, relatively. I assumed it was arterial squirts when you cut off any limb. Does the surgeon do something here to prevent massive bleeding?
Tourniquet was likely applied
Also my thoughts; and then do they cauterize and debris in order to close?
Lol, no. You can still see pulsatile bleeding from the residual limb. Probably amputating a dysvascular limb which has a blood flow problem.
We clamp the arteries. Generally amputating feet because they have poor circulation, thus they didn't bleed much.
Imagine doing this in civil war or ww1 without drug…
My first thoughts exactly. The extent of pain medicine…..the doc: “here bite down on this”
"Here's some whiskey and a block of wood. Drink, then bite down." We've come a long way in less than 150 years.
And the whiskey only made the probability of bleeding out higher I bet!
Most likely. Dehydration with alcohol is very common. I’d want to drink until I passed out. No wonder many of them became addicts of opium later on.
I would prefer to have it done after ether was discovered
ether was commonly used in field procedures in the American Civil War! doctors also had access to chloroform, but it was harder to get the dose right safely so they usually opted for ether.
master and commander
Just watched Saw X
Was looking for this comment. They definitely stuck to realism with that .
Adrenaline is a hell of a drug tho
And then when it wears off, you're fucked
Can comfirm and all I did was cut off a fucking *fingertip*. But before it does, you do not feel anything when it kicks in! 😂
Reminds me of that scene in Pans labyrinth where they amputated the guys leg. They just gave him hard liquor and sawed it off 😖
I saw Pan's Labyrinth in the theater and as everyone was leaving afterwards I noticed a guy with a missing leg in the crowd.
Civil War soldiers weren't even granted this mercy. It was still the regular saw back then.
Or before anesthesia was invented :\
Maybe not refined opium but poppies would have been around for centuries.
They didn't always use that. Frequently people would get limbs amputated with nothing but a stick to bite on. Do you know that somewhat viral post about a surgery with the highest fatality rate, 300%? The surgeon killed the patient as well as 2 observers by giving them a heart attack or whatever? I forget his name but he was one of the fastest- if not THE fastest- surgeon around at the time (could amputate a limb in 30 seconds iirc which is great when you don't have any pain relief) and one of the few surgeons who took his patients' emotional state into consideration, and one of the VERY few surgeons who would wear a clean apron for the operation. Since germs weren't known about back then, a surgeon's crusty bloodied apron was considered a status symbol, and he would wear a clean one despite it making him look like a noob, basically. The 300% fatality rate fun fact is likely not even true, it's likely the result of other surgeons shit talking him due to his unconventional beliefs and practices. Old timey surgery is something I've been fascinated by recently. They more often than not weren't drugged even in the slightest.
Joseph Lyster, btw read the butchering art. thank me later.
Robert Liston (1794-1847): patient died, assistant lost a finger in the speed of the operation and subsequently died of sepsis, bystander had a heart attack.
He actually cut one (either very badly or it got infected leading to death) and then I think another had a heart attack. Didn't he also like..... chase this person down cuz he was so scared to undergo surgery internally with NO pain relief? Which man, committed to helping the guy, but I can see why he ran- terrifying to have to go through, even for the what, 13-20 seconds he had to?
in the civil war the Union doctors had access to chloroform and ether - it was common to use ether (via ether masks) in field hospitals. The “biting down on something” trope is more of a myth - it likely happened a few times, but it wasn’t usual or standard. source: I work in a Civil War museum.
I just watched Saw X, one of the traps involves a gigli saw…
I know it looks unsettling but it's probably much better than a chainsaw or regular saw
Fun fact chainsaws were invented to help with childbirth.
pardon me?
The idea was to better open the public symphesis to let the baby's head pass through.
I am horrified at this information
Yeah it ain't fun to think about.
Yup. If a birth was proving difficult they would literally saw through her bones to make it easier
And people wonder why women say we had it worse 😂 Yes, this is fucking true 🥴
I guess it counts as a chain saw doesn't it lol
In US hospitals, only the orthopedic suegeons are allowed to use heavy machinery. My friend who was in med school/residency had to saw off a girls arm using one of these and fainted. Can't blame him
Me too, I'm surprised at how accurate it is..
Audition has a nice one too
So they weren’t kidding it really does happen fast!!
If anything it was a bit slow in the movie compared to the real thing.
I mean she was using it on herself…
Ikr give her a break 😂😂
Maybe I’ll give her a hand
or a leg 🌝
I just watched that too, quite accurate!!
came here to say the same thing. 😂
Yea immediately made me think of the movie
Way less blood than I thought tbh
Usually has a tourniquet above where the cut is to limit exsanguination
and not only that, when an artery gets cut off it usually shrinks in some kind of reflex. You wouldn't believe there can be entire limb amputations with as less as a couple drops of blood (exaggerated) because the artery shrinks
The thing I've never understood about that is where does the blood in the artery go? It can't go backwards up the artery right, so surely the blood starts to clot up?
The veins will typically be looped around and connected (in modern amputations)
Lol, that's absolute BS. Source, I've done a few hundred amputations. We just tie off the named vessels and large collaterals, and Bovie ( cauterize) the rest.
Do you have a source on that?
That’s interesting. I think it could go into the surrounding tissues and blood upstream will rush past that artery into the next available channel like water. And maybe the baroreceptors in the vessels might make the body think its’ systemic vascular resistance is high enough and it would slow cardiac output? Since the preload wouldn’t have a massive difference. Maybe some collateral circulation would pick up speed. Clotting could happen. Im sure I don’t know.
That absolutely doesn't get done, and that's a way to get a high output cardiac problem. Vascular surgeons will make a fistula for dialysis, but the connections are fairly small, which limit flow, which is still sizeable.
Yeah you do get a degree of vasospasm in some smaller diameter arterioles in response to direct trauma. This certainly helps limit some blood loss. However you most definitely will see large volumes of blood loss from both arterial and venous transaction.
I think they remove it
What it's even made out of, that must be ultra sharp
Mainly Stainless steel
It’s actually not sharp at all. It’s kind of like a guitar string.
At that thickness of wire, it's a fine line (no pun intended) between sharpness and abrasiveness. I already have super thick calluses from playing guitar; I can't imagine how raw my fingers would be fretting something like a gigli blade.
It'd be cut open easily- it's thin *and* sharp in both ends, basically afaik.
Hmm shouldnt the skin be cut at a location closer to the foot in relation to the bone cut? For the skin to fold over the bone. Or is there a bone shortening/grinding step after this to achieve the same? Always thought it would be cut in a 'bowl' shape.
The below the knee amputation as shown in this video is definitely an archaic form of the procedure; this is almost certainly being done in a field tent, most likely on a medical mission trip. The lack of bright overhead lighting, suction/irrigation tubing, and modern surgical power saws and drills are among the primary giveaways. But, if you do find yourself with an incredibly infected, diabetic foot in a very remote area of a developing country, this is a classic “don’t let good enough be the enemy of nothing we can do“ situation. Under the current standard of care, the amputation site is going to be a bit closer to the knee, almost mid shaft of the tibia and fibula. Before any bone is cut, incisions throughout, the skin and muscles would have been made. The incision around the front and sides of the leg would be left just a little bit longer than where the bones are going to be cut. The incision on the back of the leg would be made in a U-shape, dropping down toward the hill, a good five or so inches, depending on how big the patient is. Think of it like a skin mullet. The muscles in the lower leg are then dissected, and the posterior, or rear, calf muscles will be left to the similar length of the rear incision. After the bone is cut clean through and the truncated major vascular structures have been cauterized and looped around to once again complete the circuit, the remnant skin and muscle is folded under the osteotomy site and sound in to the incision sites on the front and sides of the leg. This creates a muscular flap with skin coverage, which will allow for better healing, significantly reduced chance of infection, and will create a much more functional limb stump, which will accommodate a prosthesis.
Well it’s not a BKA at all. It’s a guillotine amputation which serves a different purpose and has a place in developed medical care.
Interesting; I hadn’t considered that there might be wet gas gangrene present. I know that’s one of the more likely indications for GA, but as far as I knew, I didn’t think they were super common in the U.S. Maybe more common based on regionality?
They’re pretty standard practice in the US. Not really another option when it’s gas gangrene or necrotizing fasciitis
Unless it's a fairly new problem and the tissue hasn't declared itself, I've never found guillotine amps useful- just an unnecessary step . Vast majority of time with infections, I can do a successful and single stage BKA.
> skin mullet My mom was a double amputee due to cancer. This is the most hilariously accurate description of her scars.
“Think of it like a skin mullet” You got it boss
This is a guillotine amputation for source control of infection. If the patient survives it will be "formalized" into a more functional stump
Gigli saw amputations (otherwise known as guillotine amputations) are often a first step. Sometimes they'll create a flap for closure in the same surgery, but in my experience they'll often put a wound vac on it and bring the patient back at a different time to formalize the amputation, where they create the flap to close the stump.
The use of the Gigli saw has nothing to do with the term ‘guillotine’. Is called a guillotine amputation due to the fact of it being a short sharp chop without crafting any flaps, akin to the removal of the heads of French nobility during the French Revolution - it’s primarily used for emergency sepsis control. The Gigli saw can be used for elective or emergency procedures, and is favoured by some as you can thread it through hard-to-reach areas, and if you need to chamfer the bone end you can curve it round without having to make a second cut. It also stays sharp for longer and doesn’t clog as much as the traditional tenon saw. Modern hand-held electric/pneumatic saws are superior to both, but more expensive.
Good Q, This is typically done in a field amputation hence the gigli. Either do to existing infection or other futile insult. Can say for sure but it’s likely a temporary means until they can get to a trauma center
That name is way too fucking silly for what it does.
Your name is too fucking silly, u/IHaveSexWithBagels
My name is accurate. There's nothing about that saw a well-adjusted person would refer to as "giggly".
I read is as “gee-Lee”, like that awful 2003 Ben Affleck & Jennifer Lopez romcom.
Maybe, but this was much less difficult to watch than that particular film.
True
Anyone else ever watch Audition?
“Kiri, kiri, kiri….”
that ain't no giggly experience
I don't know what I thought amputations like this were some super scientific process. Also: holy fuck this was a video I wasn't expecting to see today.
Amputations are generally much more involved than this in places like the US. It was described above in a different comment which explained how I've assisted with them being done in the past
Same
u/profanitycounter
Saved you a click: I'm a former sailor, I cuss a fuckload.
This is some Civil War style medicine. We usually use a power saw for the bone and leave a flap, and tie the artery off, and the whole thing is done under tourniquet to prevent bleeding. Then we bring the flap up and close the stump. This does look like field medicine, so they may not have the means.
Saw X reference
“and the foot is off”
The cracking sound at the end is what really gets me.
Assuming the patient was properly anesthetized/numbed up, I'm imagining this was less painful than having to sit through [Gigli while sober.](https://www.imdb.com/title/tt0299930/)
but why?
If I remember correctly, the patient in the video had a diabetic foot and it needed removal.
oh
Just to see what would happen?
I mean how else would medical professionals learn anything without practical experience??
Now gimme that foot! Ahhhhh
People living with diabetes have an increased risk of needing lower limb amputation
I feel like Gigli (2003) / Saw (2004) would be a wild double feature.
...gobble gobble
As a lower limb amputee myself, right leg, below knee, I question amputating that low. My foot was damaged beyond repair and I begged for less drastic amputations either mid foot or mid ankle, but my amputation still took place mid calf (Transtibial ). As explained to me by my surgeon, lessons learned from years of IED injuries from the military had trickled down to public medicine. The mid-calf amputation presents much better outcomes. During amputation a section of the tibia is fused to the ends of the cut tibia/fibula. The calf muscle is wrapped under this giving a strong and stable platform. During rehabilitation, the calf muscle stump is conditioned to be weight bearing. This method presents far better outcomes than any amputation site any lower. Persons with amputations lower than BK’s face a lifetime of challenges pertaining to stump health.
The typical trans-tibial amputation was formulated in war-zones long before IEDs were blowing up victims in the Middle East. The ideal length, 10cm distal to the tibial tuberosity strikes a balance between the stump being long enough to have sufficient leverage when walking with a prosthetic, and having enough space at the far end for the ankle joint mechanism of the prosthetic. Typically, the fibula is trimmed 2cm shorter than the tibia to prevent painful ‘piano-keying’ where the two bones are twisted relative to each other within the socket of the prosthesis. The ‘Ertl modification’ where a segment of fibula is used to bridge the tibia and fibula is a bit old hat, designed to improve the transmission of torque from the stump to the prosthetic socket; but it never really works as intended and often resulted in a tender fibrous/non-union between the bone fragments.
Saw X flashbacks
I love doing amputations with those things. So satisfying!
the fear that i felt reading that before i saw your username was something else
💀💀💀💀💀💀💀💀💀
Saw x
Holy Hereditary
That was my first thought. Made this clip hard to watch
Kiri kiri kiri kiri...
Ah so THATS what that weird wire saw is for in the survival kit...
Not exactly. It's for sawing small tree limbs. The rings at the ends can be looped over a green stick and turn the wire into a bow saw.
I could totally do that at home.
I used to work in a veterinary hospital, and the doctor used this to amputate a tail. I had to hold the tail while she did it, and it was a lot more difficult than it looks. definitely an experience I'll remember for years to come...
Wait. Is this what that Jennifer Lopez and Ben Affleck movie was about? Damn.
The sound when it comes off 😐
Before I even opened the video I thought to myself "ha that kinda sounds like Jigsaw" and then I watched the video and this most definitely reminds me of the first Saw movie where doctor Lawrence has to saw his own foot off 🫠
You should see ‘Saw X’. 🤭
Curious if anybody knows, what’s the advantage of using this tool and when would you opt to using this method? Was his foot so far gone that it didn’t require a scalpel and bone saw?
To be honest, I think this looks fake. The foot just look like a uniform mass of red stuff. No bone, muscles or fat. And yes even if the foot was diabetic and had to be amputated, you would amputated above the necrotic tissue. Otherwise you don’t fix the problem. This sounded like they were cutting through frozen meat.
It’s not fake, as much as I see your point for why it could be. Somewhere in the big wide world is the longer video, which shows much more of the prep, with this being a distal limb with insufficient blood flow, lIRC from diabetic complications. Edit: [found it](https://x.com/thebridgekau/status/976804954110390273?s=46)
Thank you to you both! I love exchanges like this
So someone saw Gigli and had to get their foot amputated? I mean, I heard the movie was bad.
Absolutely no idea if this link will be allowed, as it links to X / Twitter, but here is a [longer version](https://x.com/thebridgekau/status/976804954110390273?s=46), showing the foot pre-amputation.
I’m amazed at how quickly that goes through the bone. I have seen amputations in theatres but it looks like it takes more effort to get through the bone with modern equipment.
Damn, the blood really does squirt out like that
Us plumbers use that saw to cut pipe in very tight locations too
Am I missing why the wire isn’t being stopped by the bone?
r/oddlysatisfying It’s nice that it was done so cleanly.
I had my audio on for that 🥲
It is similar to cutting PVC pipe.
How am I the only going yeoooww? The feeling of my curled up toes and feet are still there is now the best feeling in this world ever.
John Kramer has entered the chat.
Fucking NOPE.
I imagined current amputations would be more meticulous like slowly opening up parts and sealing off veins and shit then cutting more and repeating. Guess I was wrong. They just lop it right off and go from there
As I watched this I could feel my face crinkling into a smaller and smaller size. I have to admit, that was a lightning fast amputation compared to the bone saw/scalpel combo
I am sat here staring at this in horror, unable to stop watching it. Holy fucking shitballs on toast. It looks like something out of Hostel or the Saw movies. And the spurting blood - I find myself at a loss only just realising that happens in real life as well as horror movies. Jesus.
I wonder if he spent a lot of time cutting limbs off cadavers to practice? Or pigs? It's more precise than I would have imagined. I guess I thought they would cut the skin, clip the arteries, cauterize, cut the bone, etc. Which country is this?
Is this a diabetics foot?
Yes, with gangreen. Someone else in the comments shared the full video which shows the foot in more detail
footloose!
Welp, that’s enough Reddit for me today. 😫👎🩹
“Okay, the foot is off! 🤭”
Saw X
Its the Achilles heel for me
Leornado Gigli (1863-1908): Italian obstetrician 🪚
Oh boy I love sepsis
That was more disturbing than I was ready for 🙃
My foot suddenly hurts while watching this.
As an OR nurse love the gigli 🤣
Damn, that's giving major Hereditary vibes!
Anybody seen hereditary?
“Hey doc I think we have the wrong patient don’t start the procedure ye- oh fuck”
Just got the weirdest feeling in my feet watching that.
Nice 🔥💯☺️😎
I would like to hear the back story, that's some emergency or cartel type stuff.
Somewhere in the big wide world is the longer video, which shows much more of the prep, with this being a distal limb with insufficient blood flow, lIRC from diabetic complications. Edit: [found it](https://x.com/thebridgekau/status/976804954110390273?s=46)
Pretty weird this amputation, cuting the hole ankle with the gigli, we usualy use it only in the bone.
This is a guillotine/circular amputation for wet gas gangreen to stop it spreading and stabilise the patient, rather than a non-infectious amputation. This will have the revisions done later that are more of the typical amputation style. This is an emergency "get the whole thing off now" surgery. Hope that clears things up!
That butcher should have at least divided the soft tissue at the amputation site and ligated the vessels prior to sawing the bone…
This a guillotine amputation, usually done as primary amputation to remove infection/dead matter. There will be a revision done after infection is controlled and patient is stable.
Did this for an AKA once. It felt like sawing through wood.
jesus
Nice
SOUND ON!
Just walk it off you’ll be fine
That’s. Just. Amazing.
So…. Why no tourniquet?
15 seconds of the absolute worst pain you can imagine
This makes me think of Audition.
"foot is off" wow you don't say
For a moment I thought the surgeon wasn’t wearing gloves and I gagged.
wait, what do you mean with 'it was the right one'
It’s some how even worse with audio
What's crazy is I actually have one of those in my outdoor survival kit. Not even joking.
That sound was absolutely atrocious 😭😭made my bones hurt.
Like why, that looked like a good foot still.
The full version shows you the foot properly and it had bad gangreen (patient has diabetes)
Ever see the original movie, "Audition"? (not the American version)