Surgery Workshop

After visiting the wards, Dr. Kanyi guided us to the OR locker rooms. We changed into scrubs, and I was treated to size 10 surgical boots, which were fantastic on my size 14 feet. Then, the cases started. The week was dedicated to hypospadias repair. I'm going to briefly explain what this condition is, but if you're squeamish, you might want to skip to the beginning of the next paragraph. Hypospadias is basically when the urethra does not extend to the tip of the penis, but rather opens up somewhere on the underside. It varies case to case; in some boys, the opening is nearly at the proper position and it causes little problem, but in others, the opening can be in the area of the scrotum or even further back, leading to obvious problems with urination and having babies “the fun way”, as one doctor put it. The aim of hypospadias repair is to essentially make a new urethra that opens in the proper place. The difficulty varies depending upon the location.

Over the past few months, the pediatric surgeon has been “saving up” hypospadias cases for this workshop, so we had about 100 patients in-house to “choose from”. The residents decided on about 35 cases that were challenging in different ways, and those were the target to finish during the three days of surgery. About six cases per surgeon per day was a pretty aggressive goal, but the gauntlet was thrown down. Below is part of the team hard at work:



I'll spare the details, but the ensuing three days were very interesting and a great learning opportunity. Since the whole goal of the workshop was teaching, the surgeons basically talked throughout the cases, explaining each and every detail, their thought process, etc, which is awesome as a student. I got permission from the head of the hospital to participate, so I was also able to scrub on some of the surgeries when the Kenyans residents and students were otherwise occupied. I probably saw more hypospadias repairs than I'll see in the entire 5-6 years of my residency; I'm definitely fortunate that I had this opportunity. Here’s me deep in thought during a surgery:



I've been in the OR a fair bit since arriving in Kenya, but this was the first time in a developing world OR for the visiting surgeons. Though they were generally patient, I definitely heard more than once, "I need scissors that cut!". Not an unreasonable request, but sometimes more difficult to find than you'd think.