THE WORKSHOP DAY ZERO

Today was what I would describe as day zero of the colorectal workshop because it was not official, professor Penia and and dr Bishoff came around today for team briefing, prepare the patients, use the equipment and make sure everything is working well.

They recieved a warm welcome by our hospital director Rania Hegazy, cardithoracic director dr. Tarek Salah and ofcourse head of pediatric surgery department professor Gamal el Tagy and our pediatric surgery professors, my colleagues and ofcourse me.

Professor Penia had a brief chat with everyone and a particular interesting chat with dr. Tarek Hegazy the cardio thorathic surgeon telling him that he was privileged to work with professor Robert Gross the eminent pediatric surgeon who first ligated the patent ductus arteriosus, the story of the first ligation is interesting as Robert Gross did it while he was an intern and his Boss was away for a holiday, therefore if it had failed this procedure, it would have meant the end of his career as a surgeon. Those kind of surgeons are like diamonds you specially bred, it needs certain type of not only skill but personality and grit to be one of those, the kind of surgeon that a lot of surgeons secretly and openly strive to be, yet it is dangerous to act like one because it takes a special furnace to be forged in to be one.

He asked us if we remember when did the first case of tracheo-esophageal fistula survive, we couldn't answer this question.

dr. Rania Hegazy proceeded to speak about abou el rish hospital how many beds(about 500) and ICU bed (about 350 ) I guess this was the number she stated and how a great great service that we provide. Indeed it is a great service if we weigh the flow rate with the resources that we have, that should be OK.

at the hospital main enterance

at the directors office

After every one said their words, professor Gamal asked me if I would like to add something and how come I knew dr Bischoff that well and why is she greeting me with familiarity, simply because I read about her work and professor Penia, was very familiar with the subject given my MD thesis back ground, surprisingly professor penia thinks one of his team's greatest achievment is the nonsurgical treatment of fecal incontience rather that the PSARP, the thourough protocol for complex cloaca management and many other innovations and achievement.

I was frank enough to say that professor penia and dr Andrea Biscoff are treated like a royal couple wherever they go and I also stated that what they are famous for is not only their surgical technique and experience(they treated over 3000 patients with anorectal malformation) but also their fine manners when they treat their patients. probably that's why they are treated like royals, one might not be like them but they represent certain values that people want to hold on.

They were keen on seeing the patients files first and meeting the patients whom they decided are good candidates for the workhsop, they did that to avoid parents frustration if they are not picked up for the operation.

our morning ward round before arrival of prof Penia and dr Bischoff

dr penia and dr bischoff reviewing patient files

I have learned that we really need to have proper chat with the radiology department regarding the distal loopogram, the contrast needs to be injected under pressure until it fills the bladder and urethra and the coccyx tip need to be visible. an MRI was done covering whole of the patients body stopping short of the pelvis. whom do you blame the surgeon who did not communicate the information well or the radiologist.

in theaters, professor Penia made it clear he want only the working team in theaters and everyone else up in the conference room watching the broad cast. he was keen on meeting up with the camera man the scrub nurse and didnt want them changed for the next few days.

prof penia meeting up with the camera man

The trial case recto- vestibular fistula in a female, typical case, as that is what they are keen on doing operating on typical case for educational purposes, dr Bischoff did it lovely steps there was a long channel though, perineal body thoroughly and nicely repaired as this is the part that usually suffer dehiscence.

2 cystoscopies were carried out in females to look for fistulae the first one was a pure imperforate anus no fistula the patient didnt have any associated anomalies no down syndrome.

the second cystoscopy was the surprise one it was a VAGINAL FISTULA and professor penia and dr Bischoff mentioned in their book that it is rarely seen or rather a possibility which he didn't encounter but he did see eventually today in our center so i guess. I personally whispered it did look like the female hypospadias that he described in his book but i heard no response so I didnt repeat the statement.

finally but not last we finished. Prof Penia and dr Bischoff had a Jet lag and really needed some rest but everyone gathered around them just to be there.

trivia: I promised I won't get star struck and act like a groupie and go for selfies but couldn't resist the temptation.

hopefully will continue update for the rest of the workshop

group photos and othe happy moments