Saturday March 8

Saturday March 9

     After breakfast at the dorm we went to JFK to do some surgery. We had 2 cases planned, but Sano( one of the scrub techs) brought his brother in who has a recurrent hernia. We discussed doing it as a One Day Surgery, and Sano said that would be fine and he would take care of him. Then Percillar came in, and thought that was crazy because it was too big of a case to do as a one day; she and Sano had a discussion, and then she relented. So while Santiago and Rakesh decommissioned an ileostomy in a 12 year old boy who had had a typhoid perforation, Yuk and I repaired the recurrent hernia. It was a big mess, and difficult to sort out what was what, but eventually I was happy with our repair. We used a piece of Ultrapro mesh, and that made the job of the repair much easier I think. As always sterility was a concern : we soaked the mesh in Betadine until just prior to implantation, but we has the windows open in the OR because there was no air conditioning. I think it will all work out.
      The other case we did was rather interesting. He is a 55 year old man with an abdominal mass for a year which was getting bigger, though it doesn't seem like it was particularly painful. He had an ultrasound which showed a cystic mass extending from his liver to his bladder, and the diagnosis given was a mesenteric cyst. Santiago and I like to do a case together on each of these trips, to remind us of the old days when he was a resident, so we did this operation together.  After the patient was asleep I felt this large, volleyball sized mass in his abdomen; after a Foley catheter was placed with ease into his bladder, the urine started coming out and the mass shrunk considerably ! Eventually, after draining about 6000ml, the mass was gone! We decided we would take a look to see what was going on, and we found just a huge bladder with no obvious obstruction. We decided to reduce his bladder volume with a partial cystectomy, which went smoothly.
       Later in the afternoon we went for an excursion around Monrovia, taking Dewalt with us,  to the carving shop as well as Mamba Point and the Hotel Ducor. Then back to the apartment for a short nap prior to going to The Great Wall for Chinese food. Wilfred joined us, and then he took some of the younger ones out for drinks. Santiago, Kenna, and I decided to call it an evening and went back to the apartments.