Office Visit Back Cyst

This is a good one 🙂
That thing is huge!!!!

PART 2 – Thanks to Zitworshipper for that!!

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  • That sac had it’s own zip code. Boy, what I wouldn’t do for a cyst like that… preferably on the top, front side of my thigh so I could have all that fun MYSELF.

  • I have honestly forgotten how many times I have watched this. Man, I wish my husband would grow one of these for me to pop. It could be like a Christmas gift or something.

    • You have forgotten how many times You have watched this.

      And I have forgotten how many times I logged on to this site to check whether this is in my favorites. 😉

  • I always find it interesting when a physician is so tentative in making the initial incision. Had the operator incised more widely, the cyst would probably have s**ZIT**ed out in one piece. This cyst had a tough outer s**ZIT**, almost certainly trichilemmal. Not only was the initial incision inadequate, but the use of sharp technique was excessive. Once the lesion is opened, blunt technique is called for. Takes time to learn, but superior results both medically and popologically.
    Notice how the materials oozes out, then stops Then there’s a small burst and it stops again. This is the hallmark of a loculated lesion, though the sheer SIZE of this lesion screams loculations! Loculations are septa that develop inside the cyst. If you rupture the cyst, then you insert a small, closed haemostat into the incision, stand back, and open the haemostat, then plunge it in several times, closing to insert and opening to break up the membranes. This would have enabled the evacuation of the keratinaceous material (it’s not pus, people) much more readily, with less trauma to the surrounding tissue. Trying to dig material out with a scalpel makes me wonder where could this person have been trained; then I remember what a bunch of hacks the non-surgical students are during their ER and surgical rotations.
    I wonder how bad the post-op infection was. The vid ends before the procedure so I don’t know if he closed the incision,left it open, or packed it. Given the fact that he’s still trying to extract material as the vid ends, I don’t think he packed it with iodoform gauze, and this one looks like the Pt may have had to come back or go elsewhere to deal with the post-op infection or rampant inflammation.

    • Thank you for this write up. It makes a lot of sense, particularly the portion about the small bursts of “keratinaceous material”. The loculations would likely explain the different consistencies of the drainage, as well, correct? Despite the bad technique and the added tissue trauma to the patient, as a layman, I found it fascinating. Now I feel a little guilty. 🙁 The only thing that I might disagree with you about, (you obviously appear to be in the medical field, so I do this with caution) is the extent of infection. The procedure seemed sterile enough, and if packed/bandaged properly, along with topical and oral antibiotics, what makes you so certain that the patient will develop an infection? I do not ask this question rhetorically, I am sincerely interested in your response.

    • After watching countless cyst removals on this site, I was also surprised by the doctor’s initial incision. I’m not a doctor, so I **ZIT**umed maybe I was missing something. I’m glad you cleared it up. Also, should the patient have been on his side like that? Would it have been more advantageous for him to lie on his stomach? Finally, why did the doctor keep reusing the same gauze?

    • YES! To all of the above.
      My doctor mother removed a cyst from my back (unfortunately I have no video to prove this).
      She used the blunt technique with a hemostat and managed to pull the cyst out complete without bursting it at all!
      And it was packed and s**ZIT**ched open so it could heal properly. No post op infection at all.
      Cyst done right.

    • And also,in the first vid (you were talking abt),not only the DR was “tentative” to make his incision….but when he tried to make it bigger,he missed his mark and made one more little hole….
      And instead of “joining” these 2 incisions,he “popped” this HUGE cyst with these 2 small holes…

      So,during the whole procedure,he try to p**ZIT** this ultra thick keratinaceous material (tnx for the correct appellation cybersharque) through these holes.
      And at the “end” (cuz it wasnt the end at all),he said;”Heres the sac!”.
      That wasnt the sac AT ALL.Maybe,just maybe,it was a little tiny part of it!!!Plus he said it like the procedure was done…
      That cyst was still full of it…it was obvious!

      Tnx for that good comment cybersharque!

    • I agree…..I”m not nearly as knowledgeable, but definitely makes sense! My thoughts thru the whole thing is this doc was enjoying himself a little too much and selfishly did the minimum to open so that he could watch the flow of material as it was….not to mention all the times he was playing with all the “gak” and so called sac. Don’t get me wrong, I would’ve love to get my GLOVED hands in all that but as a physician, he wasn’t very professional or caring for the after effects.
      Thanks for sharing nonetheless.

  • What I saw was very nice… I just kept saying “Go Wide Doc, Go Wide”. This comment is based on the first 3.32 mins. of the 1st vid, then the vid stopped & I couldn’t get it to play the remainder. Nice one anyway…

  • Why do they always have a gauze that is WAY too small? Or why do they continue to use the same nasty gauze over and over again?

    This doc actually plays with the stuff, but I have to say, this is one of the best all around vids I have seen. The camera person was spot on, the spot was spot on and the doc got squirted and he didn’t even jump! : )

  • This has the best sequel since. . . I can’t think of any better sequels, film or otherwise. The suspense, the drama, the cinematography– both films should have swept the Oscar’s. “The story of a doctor and his long, sometimes difficult, relationship with his patient’s cyst– The loving birth of the sac, and the sensual m**ZIT**age of its content. . . .epic”

  • This is a good one! The doc creeps me out just a tad at the end. That playing around with the sac and displaying it. I know it was filmed for learning. Good one lovett!! Cl**ZIT**is yuckiness…

  • Stellar post!! I hope no one gets an infection and all that good stuff but I loved every ‘pus’ filled moment….except when the dr. played in that and the sac….a tad disturbing……definitely needs to get an award!!! The director and producers worked well together making sure the camera man was right on!! Awesome awesome movie….I hope there are many more from these people….a different patient would be fine as long as the finished product was the same!!

  • Usually, these end with just removing the sac, but this one seemed to still have loads of goo coming out along with pieces of sac. Kept me guessing right up to the lights going out!

  • I felt the same way “Gilbert2” I commented on this oldie seems like two years ago, this doctor just got way to much pleasure during the proceedure even when family is present, the way he smeared the cheese all over his fingers and directed his camerman to get a shot of it.
    his technique was terrible also, he injected the pain block like a first year med student and he was terrible when cutting out the cyst wall, he could have removed so much more..

  • Also, thanks for posting part two. I had never seen it. My only problem is that this female doctor doesn’t know EXACTLY what she’s doing. Also, there is no need for spreading the cheese between her fingers. We get it.

  • Needs lessons from Doc J on a proper field block. I hate huge wounds but this slice was too wimpy. Agree with most posters that he did not use hemostat to break loculations, and his playing with the gunk was just WRONG. Very unprofessional and marginally weird. Displaying sac pieces a bit more understandable. Still, this cyst will always be a cl**ZIT**ic!

  • This doctor is a jerk. This cyst was completely intact – as we could see prior to the local anasthesia being given. There was no reason to rupture the sac and squeeze. This should have been removed with a slightly larger incision and it could have been removed with the capsule intact, reducing the risk of infection. It seems that the doc wanted to play with the cystic contents – perhaps this doc needs to take up a hobby that deals with clay. I almost lost it when she said “I am just delivering the placenta”. Then she proceded to play with it. If it were a placenta she would have to examine it just like that to determine if it were a Duncan or a Schultz presentation – but it wads NOT a placenta. Poor woman is confused. It is likely that she is a family doc and most female family docs do a lot of obstetrics. She should have referred this patient to either a general or plastic surgeon or a dermatologist for a proper cyst removal. Many of the videos that we see of home cyst removals are done better than this one. The only difference is that with a home removal, it is doubtful that so much of the capsule would have been removed. It is unfortunate that some doctors don’t know their own limitations or don’t want to give up any “contol” of their own patients. When I see something like this, I am so greatful for my own family doc – he definitely would have referred me to a surgeon for a cyst like this – and he has removed smaller ones from me in the past. He knows what he does best and refers the rest. I sometimes refer to him as Dr. Triage.

  • ahhhh yes playing with the pus and the sac – guy after my own heart! Better than scooping up a bucket full of diamonds! I used to have a dream where I was walking down a road and looked to the side and saw a ditch full of dimes, quarters and half-dollars shining in the sun, and it was so big I just jumped in and wallowed around in it, throwing it up in the air, in pure joyful fun! That’s what came to mind when I saw this beauty. The joy of it all! You GO doc!!!

  • I’ve been on PTZ for several years now. This and the one where the lady squeezes m**ZIT**ive amounts of pus out of the older man’s back are my faves.
    Loved it! Thanks for the post on PTZ.

  • I’m no doc but it seems like you should change gloves and gauze after all of that pus got on them before you start messing with the hole. I could be wrong, mind you, but it just seems a bit unsanitary to me.

  • This is the first time I have observed this ‘extended’ version of the sebaceous sac removal. The one I watched quit when the Dr. got the sac out and started playing with it. It always seemed not quite finished to me. And I was proved right. He does get more material out. Seeing how big the sac was, I would hope he packed it and left it open to drain. I wonder if there is an extended-extended version kicking around somewhere. The stuff dreams are mad of. Signed ‘The eternal optimist’. Thanks for this one LOVEIT. I really like it. ja ja ja
    Caio Prunesquallor

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