This was only the second DAISI trip to National Referral Hospital (NRH). It was a one week trip from 24-30th April 2017  and included two DAISI volunteers including one hepatobiliary surgeon (a/Prof Charbel Sandroussi) and one anaesthetist (Dr Kate Smyth).  The aim of the trip was to build on very basic laparoscopic skills taught two months earlier at NRH, with a particular emphasis on safe open Hasson technique for entry into the abdomen in order to achieve pneumoperitoneum. The week was action packed with early starts and late finishes every day. The all day laparoscopic workshop was attended by all general surgeons and registrars with significant advancements made in laparoscopic technique in this one week trip to Honiara, compared to the earlier much shorter 3 day trip in February.

A protocol based approach was given for various laparoscopic procedures (eg Hasson technique for entry into the abdomen, laparoscopic appendicectomy, diagnostic laparoscopy) with this same protocol method taught and re-taught. For donated supplies to be useful they need to be needed, and appropriately packed/catalogued. Attempts were made to methodically categorised or discard previously useful or not useful donated medical supplies found to have been donated in a state of disarray.

douglas pikacha with charbel sandroussiPictured above is Dr Douglas Pikacha, who performed the first laparoscopic cholecystectomy at National Referral Hospital (NRH) in February 2017.

Sterile technique was taught to nursing staff, with emphasis on using re-usable stainless steel laparoscopic trochars (unfortunately not found and used until the last day).

Overall the trip was very productive and constructive. In order for laparoscopic skills to not diminish frequent visits to National Referral Hospital are required, where most of the surgeons and registrars are placed and the need for teaching the greatest. There is a desperate need for reusable laparoscopic graspers, diathermy hooks and gowns, which are often the rate-limiting factors for surgical lists.

Professor Charbel is keen to to return to NRH and supervise a systematic teaching program for NRH building on the laparoscopic skills already taught so far. DAISI is keen to put more emphasis on teaching at NRH for all future trips, as this is where the need is the greatest. Ideally one trip every month will ensure that laparoscopic skills are maintained and improved in a safe and systematic manner.

Nurse education on the maintenance, sterilisation and systematic storage of laparoscopic needs to be part of this program.

VIDEO COLLAGE TRIP # 6: 24th -30th April 2017 (Laparoscopic cholecystectomy workshop) to National Referral  Hospital (NRH)

4 minors (laparoscopic)
8  majors (laparoscopic)
12 Total Cases