Today is Thursday, Day 6. Mission Days 3, 4 and 5 have already come and gone. Approximately 110 surgeries have been performed successfully to date with 2 days left on the mission.
Business as usual for the World Surgical Foundation is not always smooth sailing. Even though WSF has been going on missions for over 15 years, each one has it's own set of difficulties that need to be solved as they arise.
The first major problem on this mission was that WSF failed to bring two portable anesthesia machines for backup because there were not enough general anesthesia machines. We were expecting 4 general anesthesia machines but upon arrival it turned out there were 3 available and only 2 were in full working order with the 3rd one missing its vaporizer.
But this became a "blessing in disguise" because we had to perform pediatric procedures using spinal anesthesia instead of general which we have never done before. And as a result our patient output increased thanks to a shorter turnover time. Pediatric patients under general take approximately 25-30 minutes to wake up before the next case can be started. Spinal on the other hand takes only 10 minutes or less to go into PACU. This discovery will help future missions because now we can use spinal anesthesia in place of general allowing WSF to take care of more pediatric patients whether or not there are enough general anesthesia machines.
Another problem we face is our equipment breaking. Since WSF relies on donations, each machine is precious. But sometimes machines will stop working unexpectedly. On the first day of surgery we lost two machines. The first one to go was our SurgiStat portable electro-surgical generator. More than likely somebody plugged it directly into a local power source but since this machine only operates at 110V, it didn't stand a chance smoking itself at the first opportunity. Better labeling and having a step-down transformer packed with the machine will be our saving grace next mission. But the biggest loss this trip has been the Ultracision harmonic scalpel, a very costly unit. Dr. Alvear was able to perform 3 cases with the harmonic before it could no longer do its job. Why it stopped working is still a mystery that can only be solved when we bring the unit back to the United States.
The loss of both of these machines does not mean we cannot continuing working. Thankfully hospitals in the US throw away battery operated pencil tip cautery instruments after one use which is a huge waste. WSF accepts and resterilizes these once-used instruments for missions as they last a long time past the first use. We were able to use these instruments in place of the larger machines and there were also two local electro-surgical generators available to go along with the one remaining unit we brought. The local surgeons now want WSF to leave whatever pencil tip cautery instruments are still usable and we promised to send them more in the near future along with another electro-surgical generator.
There are 40 or so cases left to do by Friday unless more come out of the woodwork. Today looks like it's going to be the busiest day of the week since we are finishing up early tomorrow to pack.