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Dialysis Discussion => Dialysis: News Articles => Topic started by: okarol on March 18, 2009, 11:09:31 AM
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Transplant surgery by flashlight
By Mary Southall
Wednesday, March 11, 2009 2:05 PM PDT
Community Editor
Members of the Rotary Club of Novato just returned from their seventh mission in the Philippines, where Peter Bretan, M.D. in urology-vascular surgery, and his team performed laparoscopic kidney transplants under circumstances that would raise eyebrows — to say the least — here in the United States.
“While kidney transplants are semi-routine in the U.S., going to the other side of the world to perform them takes a lot more planning,” he understates. “You have to assume that conditions are going to be marginal.”
He’s more experienced now at dealing with the unexpected, but how well he remembers his first overseas transplant surgery: During a crucial procedure, the power went out.
It was a laparoscopic surgery, which means the doctor has not cut into the patient’s body to remove the kidney manually. Instead, the doctor views a video screen that displays body organs — images transmitted from a tiny camera inside a bubble of gas inside the body.
A handful of medicos, assisting Bretan for the purpose of learning the technique, apparently hadn’t quite made the connection between electricity and the videoscreen.
“We’ll get some flashlights,” they eagerly volunteered. “Then you’ll be able to see again.”
Knowing that a kidney will only survive outside the body for 40 minutes, Dr. Bretan made the decision to continue the surgery using only his sense of touch. He removed the kidney by hand, flushed it, and it was successfully transplanted into the recipient. Even though the power was off for only seven minutes, and the transplant was a success, Bretan remembers that day as both the worst and the best of his life. “After that first disaster, I never thought I’d have the energy to return,” Dr. Bretan remembers.
But return he has — every year, sometimes twice a year, to perform transplant surgeries all over the Philippines. The Novato-Philippines connection was started by Dr. Bretan in 2004. Rotary monies fund the costs of the hospital, but the costs of travel, food and lodging are personally paid by Bretan and his team. The next mission, in Davao in the southern Philippines, is in January 2010. Dr. Bretan usually travels with a second physician. Dr. Arthur Martinez accompanied him in January. One doctor removes the kidney from the donor, while the other doctor transplants it to the recipient. “Each transplant is really two surgeries,” Dr. Bretan explains.
Dr. Bretan performs these surgeries in the Philippines because that’s where his father and mother’s family are from. He did a surgery at one hospital where his grandmother was a nurse during World War II.
Dr. Bretan believes every one of his 14 kidney transplant patients is still alive because of Rotary’s Lifeplant International project. Formerly known as Rotaplant, the project’s purpose is twofold: to perform life-saving surgeries and to teach foreign medical personnel how to perform the surgeries themselves.
In addition to the kidney transplants, the Novato team (which also included an eye surgeon) performed five cataract surgeries, distributed dictionaries and other educational books, and initiated a scientific study to screen for tuberculosis (TB) in more than 500 patients.
The January trip was also made to support Dr. Malbar Ferrer, a pulmonologist and the director of TB screening in the surrounding areas of Iloilo City. He has been a long time Rotarian, and currently serves as Assistant District Governor in Rotary in Iloilo.
Photographer Lisa Fish, a member of the Novato Club, produced a grant, raised funds, designed the LifePlant Web site and took photos. She and her team delivered schoolbooks from local schools and Rotary District 5150 dictionaries to orphanages in Iloilo.
There are three Rotary Clubs in Novato; Dr. Bretan belongs to the original club. Information about the Rotary Club of Novato may be found by visiting online, www.novatorotary.org.
“By some stroke of luck, I was born here (in the U.S.) instead of there,” states Dr. Bretan. “The opportunity I had here was huge.
“Saving lives is what medicine is all about,” he concludes, “and I’m just glad to have the opportunity to do it.”
http://www.novatoadvance.com/articles/2009/03/18/news/doc49b8235c51d63048142438.txt