Dominican Republic, November 2014

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HRFU Dominican Republic Trip Summary

The most recent HRFU Dominican Republic was a huge success!  A team of 50 US volunteers plus 7 Institute of Latin American Concerns health care providers (cooperadores) and 2 Peace Corp volunteers provided care for over 250 patients and two potential HRFU team leaders, Dr. Mark Reiner and Dr. Antoine Lofti were trained – see below about team leader training.  One hundred three hernia operations were performed without complication and numerous other patients were examined and treated medically. As always the team members were grateful for the experience.  The patients and their families touch your heart in ways unanticipated.

Pictures below show Dr. Guy Giroux of Anesthesia and our Pediatric surgeon Dr. Robert Cusick on the right, a child patient in her mothers’ arms – another beautiful child patient, and Dr. Jim Manion our chief of Anesthesia sitting with one of his adult patients.

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HRFU Team Leader Training:  We use a team leading manual and Dr. Reiner and Dr. Lofti were given a copy by e-mail prior to their arrival with the understanding that they were coming to learn about but not necessarily volunteer to be a team leader.   The manual includes the HRFU mission statement and goals, our code of conduct, the way HRFU supports teams, our surgical policies, team leader qualifications, how to plan a trip, assemble a team, fund raise, the expected OR routine, surgical complication local physician backup, in kind donation procurement, a description of our surgeon training model, the responsibilities of specific team members, information about liability and sterility practices, a sample equipment and medication list for a  80 patient trip, information about the Peace Corp and attachments of a variety of HRFU policies and chart forms.

After reviewing the manual materials with the surgeons they performed hernia operations and Dr. Filipi assisted/observed and explained the Lichtenstein repair as we train it.  Dr. Lofti and Reiner will then decide about their further involvement.  Yearly team leader training will continue to build the reach of our program.

Mao, Dominican Republic, November 2014

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2014 HRFU Dominican Republic Mao Trip Summary

The trip to Mao as a new site for HRFU in the Dominican Republic trip was truly a success.  From November 17th-21st; 66 hernia operations were performed and numerous other patients were examined and referred for additional medical and cardiac workups pre-operatively. As always the team members were grateful for the experience. We had team members from Centrastate , Jersey Shore , Lankenau and CHOP Hospitals.

Drs. Jarrod Kaufman, Giampero Campanelli, Robert Fitzgibbons were the surgeons. Dr. Kaufman led the team and brought many new first time physicians. Dr. Sandra Abramson a Cardiologist facilitated the pre-op and post op evaluations. The anesthesia team consisted of Drs. Charles Farrell, Anthony Fugaro, and Nancy Moyer CRNA.  There were no operative complications during the mission and none reported postoperatively to date.

The entire team performed well under less than predictable conditions, as this was our first time at the site.  There is continued enthusiasm on the part of the team members and local hospital staff members to continue our work at the Mao hospital. The Timmy Foundation and Banelino and HRFU Local staff truly helped round out the team for a successful mission.

There were many good moments and below are but a few.

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                              Below two of our post operative patients are ready to go home.

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 Surgeon Training:  One fully trained local surgeon, Dr. Fausto Rodriguez-Perez, a Mao surgeon was trained by Drs. Campanelli and Fitgibbons on the Lichtenstein repair.  Dr. Fausto did very well and was awarded pieces of donated mesh for future Lichtenstein repairs on poor patients.  Below are pictures showing the beginning of training with Drs. Campanelli and Fitzgibbons . After operating and after completion of 5 other groin hernia operations performed by Dr. Fausto  with Drs. Campanelli  and  Fitzbibbons first assisting him.  After each of the 5 operations a written rating form was used to assess surgical performance by Dr. Fausto.

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Training has become an important part of the HRFU mission.  Many hernia repairs need to be performed but surgeon training and eventually if protocols are followed, training of those surgeons to be trainers will occur.

Dominican Republic, November 2013

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2013 Dominican Republic ILAC Trip Summary

The most recent Dominican Republic trip was a success.  One hundred and eight hernia operations were performed and numerous other patients were examined and treated medically. As always the team members were grateful for the experience.

Dr. Robert Cusick and Dr. Lao were the Pediatric surgeons, Dr. Campanelli and Dr. Fitzgibbons plus Dr. Ed Buckley, Dr. Steve Kerns and Dr. Jarrod Kaufman were the adult surgeons.  The later three were there for Hernia Repair for the Underserved (HRFU) team leader training.  Dr. Manion led the anesthesia team followed by Dr. Guy Giroux, Theresa Keefe CRNA and Dr. Carl Heine.

The entire team performed well under Barb Elliott’s leadership.  Welcome back Barb.  There is continued enthusiasm on the part of the team members and ILAC staff members to continue our work at the ILAC surgical center.

There were many good moments and below are but a

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Below one of our post operative patients going into her home.

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Surgeon Training:  One fully trained surgeon, Dr. Jean Fritz Jacques from Port au Prince Haiti was trained by Dr. Cusick on pediatric hernia repair and Dr. Campanelli on the Lichtenstein repair.  Dr. Jacque did well and was awarded 20 pieces of donated mesh for future Lichtenstein repairs on poor patients.  Below are pictures showing the beginning of training with Dr. Campanelli operating and the two surgeons after completion of 5 other groin hernia operations performed by Dr. Jacque with Dr. Campanelli first assisting.  After each of the 5 operations a written rating form was used to assess surgical performance by Dr. Jacques.

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Training has become an important part of the HRFU mission.  Many hernia repairs need to be performed but surgeon training and eventually if protocols are followed, training of those surgeons to be trainers will occur.

Dominican Republic, November 2012

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The most recent HRFU Dominican Republic trip was a huge success! Forty two US volunteers and many Institute of Latin American Concerns health care providers (cooperadores) and 4 Peace Corp volunteers cared for more than 200 patients. Two Dominican surgeons were trained as described below. One hundred and fourteen hernia operations and 18 lumpectomies were performed without complication and numerous other patients were examined and treated medically.

Surgeon Training

Two fully trained Dominican Republic surgeons were chosen–a Pediatric surgeon for Pediatric hernia training, and a general surgeon for Lichtenstein hernia repair training. Dr. Robert Cusick trained the Pediatric surgeon and Dr. Wolfgang Reinpold trained the adult surgeon. Both trainers used a validated surgical technique rating form designed by the University of Southern Illinois surgical department education division (with input from Dr. Filipi, Dr. Cusick, and Dr. David Chen of the UCLA department of surgery). The rating form is now being implemented in the U.S. for surgical residency training. The hernia rating forms are available upon request.

The rating form was reviewed and then the trainer performed the first operation and the trainee assisted. The trainee and trainer reversed their roles with following operations. The trainer then filled out the rating form in privacy then immediately reviewed it with the trainee giving him a numerical score and explanation for all of the step ratings. This was repeated immediately for four subsequent operation. Both surgeons passed with flying colors and Dr. Ramirez was given free mesh on condition that he would use it only on poor patients and that he would monthly fill out a spreadsheet on the patients receiving the mesh and send the spreadsheet electronically to Dr Filipi. Photographs below show the process.