Hola from San Juan de la Manguana- what's up in the OR

Operating Room update for the week of 1/31-2/3....Brian Watkins, MD, MS, general and laparoscopic surgeon here from Rochester, NY with Ed Bosch, CRNA from Mobile, AL.  We had a great week in the operating room!  Busy and productive.  I did not bring staff with me from NY and the RNs and staff that came from Peoria were great and helpful.  We did 16 cases including a lot of hernias and hydroceles (adult and infant), a tonsillar bleed, lumps and bumps, thyroid lobectomy, revision of an AKA, and a lap chole. 

There are many supplies here, and we tried to organize them as they were somewhat disorganized at the start.  Helping to continue the organizational efforts would be greatly appreciated.  Nicole, visiting RN (here until April) is helpful, awesome and willing to do whatever it takes to make things work.  As for laparoscopy, they have plenty of trocars and some working instruments.  The limiting factor will be the availability of CO2.  I had to use parts of 2 towers but had a picture almost as good as in the U.S.  There are plenty of bovies, bovie tips of all sorts, TONS of suture of all varieties.  The instruments are adequate but if there is a specific instrument you MUST have, bring it.  The lighting is poor.  I would recommend bringing a headlight if you think you will need it.  There is mesh of all varieties, both standard hernia mesh as well as composite mesh.  As there are many children I would recommend bringing loupes if you have them. 

There is an 11 month old with possible anal stenosis and small anal dilators would be helpful.  There is a 77 yo gentleman who I saw and is coming back next week for a L inguinal hernia and it may be recurrent. He was getting labs and an ECG today (2/3).  In addition there is a 75 yo with thyromegaly but he is entirely asymptomatic and he is euthyroid. I didn't think he needed surgery.  As of now, these are the only remaining general surgery cases.  As I got through the entire list and some emergencies as well this week.

This was my first experience operating outside of the U.S., it reminded me of the reasons for which I went into surgery.  The patients are gracious and thankful, the hard part is sending them back to less than ideal situations in the post-op period and not seeing them in follow up. 

Feel free to contact me with any questions via email or phone:  watty1@rochester.rr.com  (585) 831-7656

Brian Watkins