Sao Paulo, Brazil September 2014

Sao Paulo Brazil September 2014

Background:

        Brazil is massive country with excellent surgeons and modern medical facilities.  Mesh repairs for inguinal hernia repair are commonly performed in urban areas and mesh is provided by the government for all patients rich or poor.  However, in rural areas the Lichtenstein mesh repair is less popular with the overall rate of mesh repair adaptation being 40% despite the availability of mesh.  To improve the incidence of mesh repair Dr. Sergio Roll, immediate past president of the Americas Hernia Society and board member of Hernia Repair of the Underserved (HRFU) organized a hernia training seminar.

                                   Mission Report – Sao Paulo, Brazil

The seminar organizing committee chaired by Dr. Roll included; Dr. Rodrigo Altenfelder at Santa Casa Hospital, Dr. Hamilton Brasil and Dr. Maurivce Youssef Franciss at Grarulhos Hospital and Dr. Armando Anelo Casaroli at Sao Luiz Gonzaga Hospital.

The teaching collaboration had the dual purpose of providing care to the underserved and fostering sustainability through training and collaboration with local Brazilian surgeons.  Eighteen in practice surgeons were trained on September 18th to the 23rd 2014.     Dr. Colleen M. Fitzpatrick a Pediatric surgeon, Dr. Dwijen C. Misra Jr, and Dr. David Chen all of the United States and Dr. Wolfgang Reinpold of Germany came to train surgeons and Dr. Tommy Lee observed to better understand the training process.  

                

Dr. Fitzpatrick on the left then Dr. Roll next to her, Dr. Pedro, Dr. Reinpold, next to him Dr. Chen and Dr Marcelo.

Participating Hospitals included Hospital Central da Irmandade da Santa Casa de Sao  Paulo (Hospital Central) see below

                   

          Hospital Geral de Guarulhos (HCG) and Hospital Sao Luiz Gonzaga.

 

Training:

The Lichtenstein mesh hernia repair was taught to 18 surgeons using the HRFU training protocol.  A standard rating form was utilized and all surgeons passed and will have a follow up video of a Lichtenstein repair sent to a panel of experts for review to determine if the training was effective.

All 75 patients were out patients and of those, 1 developed a seroma that was treated conservatively and 4 had a hematoma one of which required outpatient drainage.

Surgeons trained were Marcelo Furtado, Maurice Y. Franciss,  Hamilton Brasil, Otavio Schimidt, Daniel P Palma,  Henrique Abrahão, Victor Bruscagin, Henrique Cunha Mateus, Enarco Grigolli Filho, Ronald Reverdito, Wilson de Freitas, João Carracedo, Ricardo Tadashi, Carlos Henrique Arruda Salles, Thiago Ijichi, Roberto Gonçalves, Luiz Fernando R. Alves de Moura and Marcelo Francez.  

Thanks:

Providing mesh to our affiliated surgeons is helpful and allows them to continue operating and teaching with optimal materials. All 18 surgeons practice in systems that care for the poor and after further review of their operative abilities may be encouraged to teach others. Thus the impact of the trip increases exponentially.  Covidien, Ethicon, B Braun, BioMedical-Atrium, Orcimed, Cristalia and Bard provided much needed supplies and we thank them for their important contribution.

        We greatly appreciate the team’s willingness to give back and provide the highest quality of care. This was an outstanding team with high quality people. Thank you Dr. Roll for organizing this landmark educational event and to his chairman Professor Dr. Antonio Jose Gonçalves who encouraged and provided the program support to make the seminar possible.