Mission Update: Surprise, Surprise, Surprise. With three days of surgery under our belts, the World Surgical Foundation and Uplift Internationale teams have smoothed out the usual first day jitters and worked late into Tuesday and Wednesday. Monday’s start was a little slower than expected because the hospital staff was not prepared for the increase in patients from UI joining WSF on this mission. But by the end of the the day we were still able to complete 29 procedures including 14 plastic surgery cases with the help of a local surgeon. Because of the backlog of cases and emergency surgeries taking precedence, WSF sometimes has to insert patients into the schedule when the need arises. Tuesday brought two amputations, one above and one below the knee, along with a “mission surprise”. A baby being born via Caesarean section was diagnosed with gastroschisis, a type of hernia where an infant’s intestines are outside the body because of a hole in the abdominal wall. Last year, Dr. Alvear had a patient with a similar defect called an omphalocele, and he used a “silo” to slowly press the internal organs into the abdomen over a few days. Because the hole was small, Dr. Alvear did not need a silo and was able to put the organs back closing the hole with a hernia patch. Including the emergencies, Tuesday’s case count was 28 patients for a two day total of 57, Wednesday brought more emergencies including a gunshot wound to the leg. Surgical resident Allison Tompeck assisted Dr. Arguetta, a local vascular surgeon, with a revascularization of the lower left extremity replacing a segment of the artery using a saphenous vein interposition graft from the right leg. In the United States this procedure would be done endovascularly or with a synthetic graft for a bypass. Dr. Rovito, a WSF general surgeon, encountered two difficult emergency cases at the end of the day. The first was an emergency bowel obstruction caused by a pancreatic pseudocyst larger than 6 cm. The second case was originally diagnosed as a strangulated hernia with sepsis, but upon exploration with a midline incision and running the bowel, no holes were found. Rovito discovered the appendix had ruptured leaking into the hernia causing severe necrosis of the fascia and abdominal wall. He irrigated and cleaned the wound removing fluid and necrotic tissue. The patient was admitted and is recovering with antibiotics and fluids. As of Wednesday, the WSF and UI teams have completed 79 procedures with two days left in the week. We expect to finish more than 120 cases by Friday before the teams pack up and go home.
Posted on: Fri, 10 Oct 2014 21:34:39 +0000
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