On this day in medical history: Self-surgery in Antarctica

On the morning of April 29, 1961, Dr. Leonid Rogozov was more than 9,000 miles from home, and he was running out of options.

The Soviet general practitioner had weakness, fever, malaise, nausea, and pain over the right side of his abdomen; he quickly identified the hallmark signs of appendicitis.¹

He was the only physician on the Soviet Antarctic Expedition, and his country’s nearest research station was 1,000 miles away. No other countries with research stations had access to an aircraft, and the current blizzard conditions would have made a flight impossible.

Dr. Rogozov, who had only partial training in surgery, first attempted conservative measures to resolve the inflammation, but the treatments had no effect. He developed signs of possible perforation of the appendix and localized peritonitis, so he had to act.

“The only solution was to operate on myself,” he wrote.

After “training” a meteorologist and a driver to be his surgical assistants, the makeshift operating room was prepared. The surgical equipment had been stored outside in the extreme cold, so re-sterilization was not difficult. If Dr. Rogozov lost consciousness, the two assistants were instructed to administer a prepared injection of drugs and perform artificial respiration.

Dr. Rogozov assumed a semi-reclined position designed to allow him to perform the operation with minimal use of a mirror.

After all parties scrubbed in, the equipment was brought close to the bed and the abdomen was prepared. Novocaine 0.5% was used for anesthetization of the abdominal wall, and then Dr. Rogozov made a 10-12 cm incision. 

“It was frequently necessary to raise my head in order to see better, and sometimes I had to work entirely by feel,” Dr. Rogozov wrote. “General weakness became severe after 30 to 40 minutes, and vertigo developed, so that short pauses for rest were necessary.”

Toward the end of the operation, Dr. Rogozov nearly lost consciousness and he feared he would not survive.

“Finally here it is, the cursed appendage!” he wrote in his diary. “With horror I notice the dark stain at its base. That means just a day longer and it would have burst…My heart seized up and noticeably slowed, my hands felt like rubber. Well, I thought, it’s going to end badly and all that was left was removing the appendix.”²

It did not end badly. After resection of the severely diseased vermiform appendix (including a 2 × 2 cm perforation at the base), antibiotics were introduced into the peritoneal cavity, and he closed the wound. By midnight on April 30, it was done.¹

Understandably, he described his postoperative condition as “moderately poor,” although signs of peritonitis resolved during the next 4 days. At 5 days post-surgery, his fever diminished, and the sutures were removed by day 7. After 2 weeks, he was back to work.

Interestingly, Dr. Rogozov performed his self-surgery just 18 days after Russian cosmonaut Yuri Gagarin became the first man in space.² Both men were welcomed as national heroes, yet Dr. Rogozov shunned the publicity and resumed medical practice one day after returning home.

He died at the age of 66 from lung cancer in 2000.

References:

1. Rogozov LI. Self-operation. Soviet Antarctic Expedition Information Bulletin. 1964;223–224.
2. Lentati S. The man who cut out his own appendix. BBC News website. www.bbc.com/news/magazine-32481442. Accessed April 24, 2018.