A Brazilian Surgeon Saved a Man's Hand by Sewing It Into His Stomach
BY Kirstin Fawcett
April 6, 2016
Thanks to a creative surgeon, a Brazilian factory worker will get to keep his hand after suffering a terrible work accident that ripped nearly all of the skin off his left appendage.
Instead of amputating the limb, The Independent reports that surgeons at Santa Otilia hospital in southern Brazil sewed 42-year-old Carlos Mariotti’s hand into his stomach, and covered it with a flap of protective skin. There it will stay for about six weeks until it develops new tissue and tendons that can receive a skin graft.
Mariotti served as a machine production operator at the Zettapack Plastic factory, close to his home in Orleans in southern Brazil. While operating a machine that makes coils, his hand was dragged into the machine. The de-gloving injury exposed Mariotti’s bones and tendons; doctors feared that the hand would become infected, and that the tissue and tendons would rot away. The flesh needed to heal—and the only place in the body doctors could fit Mariotti’s whole hand, they say, was his belly.
Luckily, the unconventional surgery was a success. ‘When I woke up from the operation I didn’t know whether it was still there,” Mariotti told The Independent. “I couldn’t believe it when they said they had tucked my hand inside me.”
Mariotti is still recovering at Santa Otília Hospital. To keep his hand from becoming stiff, he has been instructed to move it gently around inside his abdomen. “It’s a really weird feeling trying to wiggle my fingers inside my body and creepy seeing my tummy protrude slightly as I prod around,” Mariotti said.
Mariotti lost his index and middle fingers in the accident, and doctors say he’ll never regain full movement of his left hand, Inside Edition reports. Still, Mariotti is grateful that surgeons were able to preserve the limb, so he can hold utensils, drive, and dress himself without any help.
While Mariotti’s operation sounds bizarre, it’s been successfully performed before. In 2015, surgeons in China grafted a man’s hand to his lower right calf after it was amputated in a factory accident. After its tendons and nerves healed, they reattached it to his arm.
In the 1970s, archaeologists discovered a site in France containing hundreds of cow skeletons dating back 5000 to 5400 years. The sheer number wasn't surprising—human agriculture in that part of the world was booming by 3000 BCE. What perplexed scientists was something uncovered there a few decades later: a cow skull bearing a thoughtfully drilled hole. Now, a team of researchers has released evidence that suggests the hole is an early example of animal brain surgery.
Fernando Ramírez Rozzi, a paleontologist with the French National Center for Scientific Research, and Alain Froment, an anthropologist at the Museum of Mankind in Paris, published their findings in the journal Nature Scientific Reports. After comparing the opening to the holes chiseled into the skulls of humans from the same era, they found the bones bore some striking similarities. They didn't show any signs of fracturing from blunt force trauma; rather, the hole in the cow skull, like those in the human skulls, seemed to have been carved out carefully using a tool made for exactly that purpose. That suggests that the hole is evidence of the earliest known veterinary surgery performed by humans.
Trepanation, or the practice of boring holes into human skulls, is one of the oldest forms of surgery. Experts are still unsure why ancient humans did this, but the level of care that went into the procedures suggests that the surgery was likely used to treat sick patients while they were still alive. Why a person would perform this same surgery on a cow, however, is harder to explain.
The authors present a few theories, the first being that these ancient brain surgeons were treating a sick cow the same way they might treat a sick human. If a cow was suffering from a neural disease like epilepsy, perhaps they though that cutting a hole in its head would relieve whatever was agitating the brain. The cow would have needed to be pretty special to warrant such an effort when there were hundreds of healthy cows living on the same plot of land, as evidenced by the skeletons it was found with.
Another possible explanation was that whoever operated on the cow did so as practice to prepare them for drilling into the heads of live humans one day. "Cranial surgery requires great manual dexterity and a complete knowledge of the anatomy of the brain and vessel distribution," the authors write in the study. "It is possible that the mastery of techniques in cranial surgery shown in the Mesolithic and Neolithic periods was acquired through experimentation on animals."
Either way, the bovine patient didn't live to see the results of the procedure: The bone around the hole hadn't healed at all, which suggests the cow either died during surgery or wasn't alive to begin with.
In medicine, magnetic resonance imaging (MRI) uses powerful magnetic fields and radio waves to show what's happening inside the body, producing dynamic images of our internal organs. Using similar technology that tracks blood flow, functional magnetic resonance imaging (fMRI) scans can show neuroscientists neural activity, indicating what parts of the brain light up when, for instance, a person thinks of an upsetting memory or starts craving cocaine. Both require staying within a massive MRI machine for the length of the scan.
There's some controversy over how scientists interpret fMRI data in particular—fMRI studies are based on the idea that an increase of blood flow to a region of the brain means more cellular activity there, but that might not be a completely accurate measure, and a 2016 report found that fMRI studies may have stunning rates of false positives.
But we're not here to talk about results. We're here to talk about all the weird, weird things scientists have asked people to do in MRI machines so that they could look at their brains and bodies. From getting naked to going to the bathroom, people have been willing to do some unexpected activities in the name of science. Here are just a few of the oddest things that people have done in scanners at the behest of curious researchers.
1. SING OPERA
Researchers once invited world-famous opera singer Michael Volle to sing inside an MRI at the University of Freiburg in Germany. The baritone sang a piece from Richard Wagner's opera Tannhäuser as part of a 2016 study on how the vocal tract moves during singing at different pitches and while changing volume. The study asked 11 other professional singers with different voice types to participate as well. They found that the larynx rose with a singer's pitch, but got lower as the song got louder, and that certain factors, like how open their lips were, correlated more with how loud the singer was than how high they were singing. The scientists concluded that future research on the larynx and the physical aspects of singing should take loudness into consideration.
That study wasn't the first to take MRI images of singers. In 2015, researchers at the University of Illinois demonstrated their technique for recording dynamic MRI imaging of speech using video of U of I speech specialist Aaron Johnson singing "If I Only Had a Brain" from The Wizard of Oz.
2. REACT TO ROBOT-DINOSAUR ABUSE
Stills from the videos participants watched of robot dinosaurs being treated kindly or unkindly.
To test whether or not humans can feel empathy with robots for a 2013 study, researchers put participants into an fMRI machine and made them watch videos of humans and robotic dinosaurs. The videos either included footage of the human or robot being stroked or tickled, or the subject being beaten and choked. The brain scans showed similar activity for people viewing both videos, suggesting that people might be able to feel similar empathy for robots as for people.
To see whether the brain responds to emotional pain in similar ways to physical pain, researchers asked participants in a 2003 study to experience social rejection within an fMRI machine. During the scans, participants played a virtual ball-tossing game against two other players—whom they believed to be other study participants in other scanners—by watching a screen through goggles and pressing one of two keys to toss the ball to one of the other players. They were actually playing against a computer that was programmed to eventually exclude the human player. At some point during the game, the computer-controlled players stopped throwing the human player the ball, causing them to feel excluded and ignored. The researchers found that the excluded study subjects showed brain activation in regions similar to the ones seen in studies of physical pain.
Watching people poop through MRI imaging is a surprisingly common medical technique. It's called magnetic resonance defecography. Doctors use it to diagnose issues with rectal function, analyzing how the muscles of the pelvis are working and the cause of bowel issues. The scan involves having ultrasound jelly and a catheter inserted into your butt, donning a diaper, and crawling inside an MRI scanner. Then, on command, you clench your pelvic muscles in various ways as ordered by the doctor, eventually resulting in pooping out the ultrasound jelly and whatever else you might need to evacuate. No pressure.
5. HAVE SEX …
MRI images of a woman at rest, in a pre-orgasmic phase, and 20 minutes after orgasm (L–R)
Schultz et al. in BMJ, 1999
Scientists have also recorded MRI body scans of couples having sex. In the late '90s, Dutch researcher Pek Van Andel and his colleagues at the University Hospital Groningen asked eight couples to come into their lab on a Saturday and have sex in the tube of an MRI scanner in order to analyze how genitals fit together during heterosexual intercourse. Despite the surroundings, they apparently had a fine time. "The subjective level of sexual arousal of the participants, men and women, during the experiment was described afterwards as average," the study noted.
Meanwhile, other researchers are trying to capture scientific images of sex in different, sometimes even more awkward ways. For her 2008 bookBonk: The Curious Coupling Of Sex And Science, science writer Mary Roach and her husband had sex in a lab at University College London while a researcher stood next to them and held an ultrasound wand to her abdomen.
Scientists still don't know all that much about how orgasms work, so various studies have asked participants to come into the lab, lay down in an fMRI scanner, and stimulate themselves to orgasm. (A reporter at Inside Jersey went to Rutgers to take part in the university's orgasm research herself in 2010. She brought her own sex toy, but the lab was kind enough to provide the lube.)
Over the course of their work, Rutgers researchers have found that when people bring themselves to orgasm within an fMRI machine, it activates more than 30 brain systems, including ones that you wouldn't think would be involved in getting off, like the prefrontal cortex, which is associated with problem solving and judgment.
Singers aren't the only music professionals to get inside an fMRI machine for science. For a study published in 2015, 17 young composers were asked to create a piece of music while Chinese researchers examined their brain activity. While all of them played the piano, they were asked to compose a piece for an instrument none of them know how to play—the zheng, a traditional Chinese string instrument. They were given a musical staff with just a few introductory notes already written as inspiration and asked to come up with something from there. As soon as they exited the scanner, they wrote down the notes they had imagined during the imaging process. The researchers found that the composers' visual and motor cortex showed less activity than usual, the opposite of what researchers have seen in studies of musical improvisation.
8. HAVE AN OUT-OF-BODY EXPERIENCE
Activated portions of the brain during an out-of-body experience
In a 2014 study, psychologists at the University of Ottawa recruited an undergraduate student who reported that she could have out-of-body experiences at will to do so within the confines of an fMRI scanner.
"She was able to see herself rotating in the air above her body, lying flat, and rolling along with the horizontal plane," the researchers wrote. "She reported sometimes watching herself move from above but remained aware of her unmoving 'real' body."
She entered the scanner six times, reporting out-of-body experiences that included feeling as if she were above her body and spinning or rocking side-to-side. The researchers found that the experience activated regions of her brain associated with kinesthetic imagery, the feeling of visualizing movement (as athletes often do during training and competitions, for instance), and a deactivated the visual cortex.