Hernia International – mission report
International Hebron Hospital – Phnom Penh, Cambodia, 9 to 13 Jan 2017
Team members:
Dr. med. Jürgen Meyer
Prof. Markus Heiss
Dr. med. Andreas Hohn
Dr. med. Simone Seefeld
Nicole Daams (nurse)
Our German team (3 surgeons, 1 anaesthesiologist, and 1 scrub nurse) arrived at Phnom Penh on Saturday 7 Jan 2017, and the next day we were warmly welcomed by the hospital’s vice director Dr Chul Lee and his team. He gave us a brief introduction to Cambodia’s history and the story of the Hebron missionary hospital which is funded and operated by Korean Christian missionaries.
The Hebron hospital has three well equipped operating rooms available, all with AC, full monitoring, and anaesthesia machines. As cardiac surgery and ENT surgery is regularily performed by different international teams, most common drugs and standard airway management equipment is available at the Hebron.
On Monday we started on one table, but temporarily, we were able to run two tables concurrently, depending on the personnel resources and the particular complexity. Our Team was supported by a local surgical resident, several scrub nurses, and two anaesthetic nurses. During this week, we managed to do 28 hernia repairs. Among these twelve children were between 2-12 years old with inguinal hernia to a varying degree. All children were operated by using the technique of Ferguson.
Most of the adult patients showed large inguinal hernia, three-times on both sides and in five patients chronic incarcerated hernia were met and operated under spinal anaesthesia. Only one patient with an altered coagulation due to liver cirrhosis and one woman with a large abdominal incisional hernia needed general anaesthesia. All children received general anaesthesia and an additional caudal block for postoperative pain control.
In adult patients, the Lichtenstein technique with polypropylene mesh implantation was used. The abdominal incisional hernias were operated with sublay mesh implantation.The patients were clinically investigated by our team. Sonography was available and used occasionally. All patients came with a preoperative checklist and were all well prepared by the local team. Patients had received perioperative antibiotic prophylaxis. Laboratory tests and chest x-ray were done according to the local standards and further lab tests as HIV, HBV, and HCV were available on the very same day.
Patients were visited by the Hernia International team twice a day and no major postoperative problems, especially no signs of infection were found. Only one young patient with a large incarcerated scrotal hernia had a prolonged hospital stay due to a postoperative bowel dysfunction and abdominal distensions The ward nurses did an excellent and dedicated job and took care for the patients. The ward nurses were supported by two local GP residents.At our last day, a great celebration in the hospital´s main hall was performed with a warm acknowledgement for the performance of our team.
As accommodation we choose the Dragon hotel in Phnom Penh, which is a little hotel nearby the hospital with friendly service and clean rooms. In dependence of traffic it takes 10- 15 minutes with the tuk-tuk to the hospital and 15-20 minutes to the city center. After our mission we traveled for two days to Ankor wat und Siam Reap. The tour was well organized by the people from the hospital, so we had the opportunity to visit the temples from Ankor wat.At last we had a great time in Cambodia, we met a lot of nice people, which helps us a lot and finally we could help some patient…..
