Surgery with condoms

A condom is inserted into a patient’s abdomen during surgery.

Ethiopian doctors have much to teach their counterparts in the West about being resourceful and efficient. They often don’t have the fancy, high-tech equipment common in the U.S., so they improvise, using everyday items like condoms in the operating room.

A good example of this is how they perform laparoscopy. It’s a common procedure in which the surgeon makes a small incision to remove some type of mass – such as a cyst, tumor or tissue – from a patient’s body.

In the U.S., physicians use a relatively expensive device designed for the procedure. The surgeon makes a small incision and pushes a plastic tube called a “port” through the opening. A hollow rod is inserted through the tube and into the body. Inside the rod is a bag that can be deployed inside the patient. Using grasping instruments, the surgeon can maneuver the mass into the bag, which eventually gets pulled out of the body. If the mass ruptures during the procedure, the bag contains any fluid (or other nasty stuff) and keeps it from spreading in the body. After the surgery, the instrument gets tossed in the trash.

In Ethiopia, doctors also insert the tube or port into the patient’s body. But they don’t use the fancy hollow rod with the bag inside. Instead, they use a stick along with a condom – or a surgical glove for a large mass – which is pushed through the port and used to round up the offending object. The condom costs just pennies, and the rod and tube are sterilized and reused.

Beth Skinner, who specializes in minimally invasive gynecologic surgery at the University of Michigan, has spent the week operating with Ethiopian colleagues at St. Paul’s Hospital Millennium College. This is her third trip to the country. Each visit motivates her to rethink her own views and processes.

“They do a lot of resourceful things here,” she said. “In the U.S., we can be very wasteful, using so much equipment.”

The U-M physician also has been impressed with the efficiency of Ethiopian surgeons. “They are very expeditious in the operating room,” she said. “They are very ‘start, stop, done.’”

The Ethiopians have to work this way because of their huge caseload. It’s also costly to keep people under anesthesia for hours.

To be sure, the U.S. has higher standards of sterilization and multiple safety checks in the operating room. This can slow things down and increase costs.

Still, Skinner said, “We have a lot to learn from each other in Ethiopia.”

 

 

 

 

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