The idea to organize a surgical mission had been in the works for several years. When Matthews first arrived at Washington University and Barnes-Jewish Hospital in 2004, he and MIS Lab Administrator Peggy Frisella, RN, talked frequently of their own unique experiences volunteering in developing countries. From these discussions arose a mutual desire to make the surgical mission trip a reality.

A team of 11 surgeons, residents, anesthetists and others who work closely with the Section of Minimally Invasive Surgery (MIS) at Washington University School of Medicine traveled to the Dominican Republic on Jan. 24-31 to participate in a surgical mission. While serving at the Institute for Latin American Concern (ILAC) Clinic outside Santiago, they performed 61 procedures — mostly hernia repairs — on 53 patients. Team members were (l-r) General Surgery Resident Eric Jenkins, M.D.; General Surgery Resident Lora Melman, M.D.; medical secretary Susana Rodriguez-Ferrer, anesthetist Ross Thomas, CRNA; (kneeling with dog) research coordinator Katie Miller; clinical lab manager Peggy Frisella, RN; Washington University alum Wes Vega; anesthetist Gosia Borschardt: MIS Section Chief Brent Matthews, M.D.; MIS Fellow Steve Hodgett, M.D; and vet tech Kathryn Cook, RVT.

“The intent was to do something that we do clinically, in an outpatient setting, for which there was a great need,” says Matthews. “Hernias are quite common as manual labor and an agrarian lifestyle predominates for most Dominicans in rural areas.”

Matthews and his team — all of whom work closely with the MIS Section — traveled to the north central Dominican Republic, just outside of Santiago, from Jan. 24-31, 2009. They worked in conjunction with the Institute for Latin American Concern (ILAC), a faith-based group that has a free-standing clinic with three operating rooms and five exam rooms.

ILAC has a system of health-care workers, called cooperadores, who live in remote villages and perform health screenings. The cooperadores brought surgical candidates to the clinic, where the Washington University team examined them. Four members of the team spoke Spanish and were strategically placed in the exam room, preoperative and postoperative areas.

Along with Matthews and Hodgett, general surgery residents Eric Jenkins, M.D., and Lora Melman, M.D., who are currently in their research years in the MIS Lab, assisted with the surgeries. Anesthesia was provided by anesthetists Ross Thomas, CRNA, and Gosia Borchardt, CRNA. Altogether, the team performed 61 surgeries on 53 patients with inguinal hernias, umbilical hernias, epigastric hernias and other surgical conditions.

“Normal health maintenance is a significant issue with this population,” says Matthews. “There were several patients screened who could not have surgery due to uncontrolled hypertension or diabetes. We had to initially treat these medical problems and asked the patients to come back when the next surgical group comes through.”

The mission trip was planned with the help of Frisella, who scouted various locations and learned about mission partner ILAC through Creighton University. Other members of the team were research coordinator Kathleen Miller and veterinary technician Kathryn Cook, RVT, who sterilized equipment in the OR; medical secretary Susana Rodriguez-Ferrer, who had worked as a hospital Spanish interpreter and coordinated care for patients in the preoperative area; and Wes Vega, a Washington University alum, who also is bilingual and coordinated care in the postoperative area. The local Dominican health-care staff was critical in handling the flow of patients through the preoperative and postoperative areas.

The mission was made possible through grants from both the Barnes-Jewish Foundation and Christian World Relief, a philanthropic group interested in supporting just such mission work. The team also solicited donations of surgical equipment and supplies from private companies.

“Despite the rural setting, the care that we provided was similar to what we would do daily at the Center for Advanced Medicine in the same-day surgery center,” says Matthews.  “I think the patients received the best care we could deliver.”

Members of the team report the experience was extremely gratifying, in part, because the patients were so grateful. In addition, family members and others in the community were very supportive, singing and clapping as patients were taken into the OR.

For residents Jenkins and Melman, both of whom are leaning toward specializing in minimally invasive and abdominal surgery, the surgical mission also was an opportunity to gain greater exposure to hernia surgery.

“At the end of my second year of general surgery residency, I had done a number of open inguinal hernia repairs with other attendings,” says Melman. “But doing one after another every day was just unparalleled. We didn’t have all the bells and whistles, but you don’t need that many sophisticated instruments to do a hernia repair.”

Jenkins also contributed to the mission by speaking fluent Spanish with patients in the OR, which he found especially rewarding with children. “We weren’t just a bunch of strange faces with masks on,” he says.

According to Matthews, all of the participants worked outside of their accustomed environment. “Out of this arose a totally new level of respect for the members of our mission team,” he says.

The team is planning another mission at the ILAC Clinic from Jan. 30-Feb. 5 in 2010.