|
 O S S A A
OVERSEAS SPECIALIST SURGICAL ASSOCIATION OF AUSTRALIA
TEAM VISIT
Halilulik, West Timor
June 20 – 28, 2009
TEAM LEADER’S REPORT
DR MARK MOORE AM
MB, ChB, FRACS
PLASTIC AND CRANIOFACIAL SURGEON
Implementation of Dr John Hargrave’s mission in East Timor and Eastern
Indonesia; providing a specialist surgical service to the disadvantaged
where the service is not available or affordable
AIMS AND GOALS
1.
To expand and maintain a regular Plastic & Reconstructive Surgical
Service to those patients with physical disability in the West Timor region
of Nusa Tenggara Timur (NTT), Indonesia
2.
To work with the local counterpart medical and nursing staff at the
Rumah Sakit Katolik Marianum to maximise the teaching and skills transfer of
the management of patients with physical disability and deformity.
3. To implement the training programme in cleft lip and palate
surgery for a Timorese surgeon.
INTRODUCTION
Beginning in 2007, the RSKM
hospital complex in Halilulik, West Timor became the second site at which
OSSAA teams deliver a plastic and reconstructive surgical service to the
people of Nusa Tengarra Timur (NTT). In an effort to spread this service
equitably across the province and maximise delivery of this surgery to those
most in need, it is hoped to expand it further by activating a third
location in Lela, Eastern Flores later in 2009.
This visit the 4th
plastic surgical team here since 2007 continued the focus on the management
of cleft lip and palate in the region. Extending the mission of the team
from simply clinical service delivery, we on this visit commenced a
programme teaching a Timorese surgeon cleft lip surgery.
Whilst the focus of this
visit was principally in Halilulik, a pilot orthopaedic surgical visit was
undertaken at nearby Naob, overseen by our Indonesian counterpart Dr
Harianto.
TEAM MEMBERS:
Dr Mark Moore,
AM Plastic Surgeon/Team Leader
Dr Joao Ximenes
Surgeon
Dr David
McLeod Anaesthetist
Ms Penny
Craig Theatre Nurse
Ms Ruth Boveington
Coordinator / Interpreter
Counterparts: RSK Marianum
Sr Helma SSpS
Director RSK Marianum
Sr
Theodorine SSpS Theatre Nurse
Sr
Josepha SSpS Ward Nurse
Br
Rufinus Theatre Nurse
Nn
Grace
Nn
Adel
LOCATION
Rumah Sakit Katolik Marianum,
Halilulik, Kab Belu, West Timor, NTT
This
visit was coordinated by the SSpS sisters who administer this hospital
facility, at the invitation of the local government authorities. Assistance
with the team travelling through Timor Leste to West Timor was provided by
the resident RACS staff in Dili
OVERVIEW
With the two-fold purpose
of providing a clinical service and the commencement of a teaching programme
in cleft lip and palate surgery for a Timorese surgeon, this team approached
Halilulik via Timor Leste. Departing Darwin on an Air North flight, the
team arrived in Dili where it was met by Dr Eric Vreede (Leader ATLASS
project) and Dr Joao Ximenes (Timor Leste surgeon). Transport and a driver
had been previously arranged allowing the team to travel directly on to
Batugade and crossing the border into Indonesia. The visas organised from
the Darwin Indonesian Consulate allowed uncomplicated passage across the
border. Indeed, an Indonesian customs official recognised members of our
team, as his son with a burn contracture had been previously treated by
OSSAA teams in Cancar, Flores.
The SSpS sisters met the
team and facilitated our onward transfer to Halilulik where we arrived mid
afternoon.
Consultation with a number
of assembled patients occurred soon after arrival. During these assessment
clinics the team was accompanied by the young resident Indonesian doctors –
this provided a welcome additional teaching opportunity.
Whilst the initial turnout
of cases on Saturday and Sunday was smaller than anticipated, as the news of
the team’s presence was further disseminated, more patients presented and a
full week’s operating planned. It appears that either there are fewer cleft
patients than expected in this region, or more likely that there are
unresolved difficulties in distributing details of the team’s visit to the
more remote locations, especially when compared to Cancar.
The operating theatre,
newly commissioned before the December 2008 visit was again in use and all
supplies and equipment left from that visit were available to the team. The
new Penlon anaesthetic machine was employed all week without event – the
team’s anaesthetist using the OMV portable machine for several cases on the
final day as a teaching and learning exercise. Local nursing staff and
sisters assisted in all cases and the resident junior doctors and some
colleagues from Atambua and the surrounding districts also frequently
attended theatre.
The post operative care of
all patients occurred uneventfully in the wards of RSKM, supervised by Sr
Josepha and St Helma. All cleft patients were discharged by the second post
operative day and only one burn contracture release case would require
ongoing care by local staff after the team’s departure.
The clinical focus, as with
previous visits, was on the surgical treatment of cleft lip and palate
patients. Whilst most cleft lip cases were in the younger age bracket (less
than 1 year), there were still three adult unrepaired cleft cases who
presented for treatment. This suggests that there remains a large pool of
untreated clefts still in this region. All cleft lip patients had their
anaesthesia delivered via a laryngeal mask, this now becoming the most
common approach of our teams. This has to date proved safe
intra-operatively and assists with recovery and early post operative care,
while dramatically improving surgical turnover time.
The cleft teaching
programme for Dr Joao Ximenes commenced with a focus on incomplete
unilateral cleft lip. By week’s end he had successfully performed six such
unilateral cleft lip repairs in concert with the senior surgeon – this
possibly represents the first cleft repairs performed by a Timorese
surgeon. It is hoped to progress Dr Joao’s training later this year, whilst
in the interim he commence these simple cases by himself on his return to
Dili.
The number of cleft palate
patients continues to grow, with many of these being patients happy with
their lip repairs on a previous visit. Two patients with isolated cleft
palate, identified because of their major speech deficits, also presented
for treatment. One of these was an adult, a trainee SSpS sister based in
Halilulik.
The only burn case
requiring treatment was the teenager whose unhealed chest wall burn wound
was skin grafted on our visit in December 2008. Whilst the graft was well
healed, his severe anterior neck contracture was in need of wide release and
grafting. Post operatively he was splinted in extension, and detailed
description for aftercare left with the local nursing staff.
Several cases of perioral
and nasal soft tissue deformity following childhood infection (noma, cancrum
oris) were assessed. The first stage of their reconstruction was commenced
with local soft tissue flaps. These cases will likely require repeat and
revisionary surgery to achieve the desired final outcome and will be
re-assessed on future visits.
Drs Harianto, Keenan and
the Naob team visited briefly on the Wednesday, the same day that our team
was privileged to a 3 hour church service celebrating 12 SSpS sisters taking
their final vows.
Dr Harianto returned on
Friday to perform a list of local anaesthetic excisions of small skin
lesions and lipomas. He undertook these with the assistance of the local
Indonesian junior doctors.
All surgical procedures
during the week proceeded without event. One young child had her surgery
deferred for several days when it became apparent at induction of
anaesthesia that she had not been properly fasted – the dangers of this were
communicated to the family and staff.
At week’s end the team
discussed with Sr Helma and her colleagues the types and frequency of
surgical service needed at RSKM – in summary there was agreement that a
general surgical team focussing on hernias and other similar level problems
would be welcome, especially as there is no resident general surgeon in
Atambua at present. Plastic surgical team visits will continue on a once a
year basis.
The team returned via the
same route taken to enter West Timor, assisted by the SSpS sisters and the
vehicle and driver from Dili. An overnight stay in Dili allowed a short
discussion with Dr Eric Vreede (RACS team leader) about Dr Joao Ximenes
cleft surgical training and the expectations of him over the next few
months.
Return to Australia
occurred on Sunday 28 June, allowing Dr Moore and Ms Boveington to meet with
the Indonesian Consul and his staff in Darwin, to update them on OSSAA
activities in NTT.
SUMMARY OF THE VISIT
STRENGTHS:
·
The maintenance of a regular cleft lip and palate surgical
service to West Timor allowing infant and children with cleft lip and palate
to receive early treatment.
·
The initial steps in a programme of teaching cleft lip and
palate surgery to a Timorese surgeon.
·
Involvement of the local junior doctors in the team’s
activities.
·
More efficient travel to and from Halilulik via Timor Leste
·
The continued support from the local and provincial
governments for the OSSAA team work in Halilulik.
·
The continued support of the Indonesian Consul in Darwin for
the provision of appropriate visas and documentation to allow easy travel
within Indonesia.
WEAKNESSES:
·
Ongoing concerns regarding the efficiency of notification of
team visits.
SUMMARY OF TEAM ACTIVITIES
June 20,
2009. Team departs Darwin for Dili with onward
land
transport to Halilulik.
Consultation clinic at RSKM
June 21,
2009. Consultation clinic
Preparation of operating theatre
June 22,
2009. Operations, consultations, ward rounds
June 23,
2009. Operations, consultations, ward rounds
June 24,
2009. Operations, consultations, ward rounds
June 25,
2009. Operations, consultations, ward rounds
June 26,
2009. Operations, consultations, ward rounds
June 27, 2009. Depart Halilulik for the Timor
Leste border and onward
..........transport to Dili.
June 28,
2009 Depart Dili for Darwin
SUMMARY OF CLINICAL ACTIVITIES
June 20 – 28, 2009.
TOTAL
CONSULTATIONS: 62
TOTAL
SURGICAL PROCEDURES: 49
CLEFT
LIP 18
CLEFT
PALATE 10
BURN 01
OTHER 20
ACKNOWLEDGEMENTS
·
The sisters and staff in Halilulik for their organization and
support of
the team’s
visit.
·
The Bupati of Belu, the NTT Health Ministry and the Office of
the
Consulate of
the Republic of Indonesia in Darwin for their continuing
support of our
work, documentation and provision of visas
·
Air North for its assistance with the team’s excess baggage
requirements
·
Rentlo, Dili and the RACS team in Dili for organising land
transport through Timor Leste.
·
The various public and private hospitals in Adelaide and
Darwin, as
well as the
anaesthetic and suture companies who have assisted OSSAA
in this visit.
***************************************************************************************************
Program: Plastic Surgery/Bedah Plastik Hospital: RSK MARIANUM - HALILULIK
Date: JUNI 20-27, 2009
|
No |
Name/Nama |
Age / Umur |
Address/Alamat |
Clinical
Notes/Plan |
Surgical Notes
/ Follow up |
|
L |
P |
|
1 |
Ronald A.S. Nahak |
15y |
|
Rev |
Paul Tessier R3. Previous cleft palate repair 12/08. Needs lower ®
ala |
22/06/09: Release ® ala nasi Tessier 3) & nasolabial flap.
LA/Adr. 6-0 Nylon.
ROS 1week
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Br Rufinus |
|
2 |
Jesika Efelen Hatumale |
|
1y 5mo |
Rev |
BCL/P – previous bilateral cleft lip repair 12/08. For CP repair |
22/06/09: Repair cleft palate. LA/Adr. 2-flap technique,
Intravelar veloplasty. 4-0 Vicryl, Surgicel.
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: PCraig |
|
3 |
Yosef Masa |
4y |
|
Alor
(new) |
Left cleft lip / palate, wide cleft lip. For cleft lip repair this
visit. W/L for cleft palate repair |
22/06/09: Repair left complete cleft lip & nose. LA/Adr. Rotation
advancement technique. Nasal dissection. 4-0 Rapide, mucosa
4-0 Vicryl – Muscle
6-0 CG - Skin
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Br Rufinus |
|
4 |
Maria Klante Lea |
|
10/12 |
Raihat
(new) |
Right cleft lip. For repair |
22/06/09: Repair ® incomplete cleft lip & nose.
4-0 Rapide
4-0 Vicryl
6-0 CG
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Br Rufinus |
|
5 |
Adi Kurnia Labino |
4y 10mo |
|
Rev |
Left cleft lip/palate + haemangioma. Previous cleft lip / palate
repair. Haemangioma ↓ size. Good scars. Review next visit |
Rv |
|
6 |
Patriks Klan Teti |
4y |
|
Webriamata
(new) |
Infection at age 1wk. Right ala & columella absent / scarred. For
nasolabial flap to ® ala |
23/06/09: Release & reconstruct ® ala nasi with nasolabial flap.
Very small ® nasal aperture.
4-0 Rapide,
6-0 Nylon
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Br Rufinus |
|
7 |
Graciana Klarisa Mau |
|
7mo |
Aitoun – Haekesak
(new) |
Left cleft lip. For cleft lip repair |
22/06/09: Repair left incomplete cleft lip & nose.
4-0 Rapide
4-0 Vicryl
6-0 CG
Surgeon: JXimenes/MMoore
Anaesthetist: DMcLeod
Nurse: Br Rufinus |
|
8 |
Aprianus Mau |
1y |
|
Buitae |
Left incomplete cleft lip / palate. For cleft lip repair |
23/06/09: Repair incomplete cleft lip and nose.
4-0 Rapide
4-0 Vicryl
6-0 CG
Surgeon: JXimenes/MMoore
Anaesthetist: DMcLeod
Nurse: Br Rufinus
|
|
9 |
Maria Jenitrriana Seuk |
|
1y |
Halidais |
Bilateral cleft lip / palate. For cleft lip repair |
23/06/09: Repair bilateral cleft lip and anterior palate. Millard
type repair. Muscle repair.
4-0 Rapide
4-0 Vicryl
6-0 CG
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Br Rufinus |
|
10 |
Arianto Siki |
5y |
|
|
Lump left back since birth. Epidermoid cyst. |
22/06/09: Excise epidermoid cyst left back. 5-0 Nylon
Surgeon: JXimenes
Anaesthetist: DMcLeod
Nurse: Br Rufinus
|
|
11 |
Hildegardus Noo |
|
5y |
Ponu |
® external angular dermoid cyst. Exc. Friday |
26/06/09: Exc ® external angular dermoid cyst.
Surgeon: JXimenes/MMoore
Anaesthetist: DMcLeod
Nurse: Br Rufinus |
|
12 |
Aklibertus Kehi |
49y |
|
|
Left inguinal hernia. Refer general surgeon |
Refer General surgeon |
|
13 |
Thomas Inonsensius Bere Asan |
18y |
|
|
Left cheek epidermoid cyst. Excise under local anaesthetic |
22/06/09: Exc epidermoid cyst left cheek.
Surgeon: JXimenes
Nurse: Sr Theodorin
L/A procedure |
|
14 |
Satriana Mura |
|
9y |
|
Left forearm lipoma. Excise Wed |
24/06/09: Excision left forearm intramuscular haemangioma. 4-0
Monocryl
Surgeon: JXimenes/MMoore
Anaesthetist: DMcLeod
Nurse: Sr Theodorin |
|
15 |
Maria Elisabet Hatumale |
|
37y |
|
Right breast lumps 1yr, upper outer & lower. For wide local excision |
Did not arrive for surgery – tidak datang
|
|
16 |
Petrosa Yuliance Ona Being |
|
22y |
Halilulik |
Isolated cleft palate. For cleft palate repair |
25/06/09: Repair isolated cleft palate with Furlow double –
opposing Z – plasty & Langerbeck release. 4-0 Vicryl
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Br Rufinus
|
|
17 |
Marcelino |
14y |
|
Rev |
Burn – Previous SSG neck 12/08. For release neck & SSG |
24/06/09: Release burn contracture anterior neck & SSG. Donor left
thigh, stapled SSG/ Sponge.
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Br Rufinus / PCraig |
|
18 |
Sr. Yohana Maria |
|
60y |
Halilulik |
Left leg lesion. 2 operations previous, last 3yrs ago, previous
1986. ? dematofibroma. Advise massages soften tissue, then Rv. |
|
|
19 |
Yuventus Manehitu |
4.5y |
|
Mamsena
Rev |
Left cleft lip / palate. Previous cleft lip and palate repair by
us. Has prealveolar, fistula & tooth visible. |
24/06/09: R/O upper inscisor & canine (infant teeth). Closure
prealveolar fistula. 4-0 Vicryl
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Sr Theodorin
|
|
20 |
Vinsens Nifron |
20y |
|
Humusu, Vomi |
Left external angular dermoid cyst |
23/06/09: Excise left external angular dermoid cyst.
5-0 Nylon
Surgeon: JXimenes/MMoore
Anaesthetist: DMcLeod
Nurse: Br Rufinus
|
|
21 |
Maria Angelina Satban |
|
10mo |
Noemuti
Banfanu TTU |
Left cleft lip/palate. For cleft lip repair |
23/06/09: Repair left cleft lip & nose. Nasal dissection.
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Br Rufinus
|
|
22 |
Yunesti Tero Lajar |
|
11mo |
Kupang |
Bilateral cleft lip / palate. Previous cleft lip repair 12/08. For
cleft palate repair |
23/06/09: Repair cleft palate. LA/Adr. 2 flap technique,
Intravelar veloplasty.
4-0 Vicryl, Surgicel.
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Br Rufinus
|
|
23 |
Klemen Belong Goron |
4.5y |
|
Larantuka
Flores |
Left cleft lip / palate. Hypertelorism. Cleft lip repair age 6/12
– Kupang. |
24/06/09: Repair cleft palate. LA/Adr. 2 flap technique,
Intravelar veloplasty. 4-0 Vicryl, Surgicel.
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Sr Theodorin
|
|
24 |
Rudi Imanuel |
10/12 |
|
Kupang |
Bilateral cleft lip / palate. Left=microform, R=complete.
Antibiotics for chest |
25/06/09: Repair right complete cleft lip / anterior palate & nose.
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Br Rufinus
|
|
25 |
Dominggus Sutrio |
2y 8mo |
|
Kupang |
Bilateral cleft lip/palate. Previous cleft lip repair 1yr ago
here. For cleft palate repair |
23/06/09: Repair cleft palate. LA/Adr. 2 flap technique,
Intravelar veloplasty. 4-0 Vicryl, Surgicel.
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Br Rufinus
|
|
26 |
Nn Detha Rouk |
|
18y |
Weklalenouk |
Left cleft lip/palate. No previous treatment. |
22/06/09: Repair left complete cleft lip & nose. Nasal dissection
4-0 Rapide
4-0 Vicryl
6-0 CG
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Br Rufinus |
|
27 |
Marcel Funome |
1y |
|
NikiNiki |
Left cleft lip/palate. For cleft lip repair |
25/06/09: Repair left complete cleft lip, palate & nose.
4-0 Rapide
4-0 Vicryl
6-0 CG
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Br Rufinus |
|
28 |
Sandito |
9y |
|
Soe |
Bilateral cleft lip. Cleft lip repair two times, Soe, Poor repair.
Cleft palate repair Sumba 2002. failed repair – for cleft lip and
palate repair. |
25/06/09: 1. Redo repair cleft palate. Largerbeck type repair.
4-0 Vicryl, surgicel
2. Complete redo bilateral cleft lip.
4-0 Rapide
4-0 Vicryl
6-0 CG
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Br Rufinus
|
|
29 |
Melki Modokh |
24y |
|
Kupang |
Cancrum Oris left upper lip & nose. Previously seen. Do stage 1 –
nasolabial to upper lip & nose. |
22/06/09: Release left oral commissure and upper lip nasal labial
flap reconstruction, extraction left upper canine tooth. 4-0 Rapide,
4-0 Vicryl, 6-0 Nylon
Surgeon: MMoore/ JXimenes
Anaesthetist: DMcLeod
Nurse: Br Rufinus
|
|
30 |
George Ferari |
2y |
|
Atambua |
Bilateral cleft lip / palate. Needs revise Cleft Palate – soft
palate only. |
26/06/09: Revision cleft soft palate. 4-0 Vicryl.
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Marta/Sr Theodorin
|
|
31 |
Nifron Leo |
4y |
|
|
Right cleft lip / palate. Previous cleft lip repair. For cleft
palate repair |
24/06/09: Repair cleft palate. LA/Adr. 2 flap technique, Intravelar
veloplasty.
4-0 Vicryl, Surgicel.
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Sr Theodorin |
|
32 |
Satria William |
1.5y |
|
|
Left cleft lip/palate. Previous cleft lip repair 12/08. For cleft
palate repair. Unwell – request for blood
test. W/L next visit |
W/L
Sakit |
|
33 |
Wilhemince Talelu |
|
36y |
|
Left cleft lip. For cleft lip repair. Palate OK |
26/06/09: Repair left incomplete cleft lip & nose.
4-0 Rapide
4-0 Vicryl
6-0 CG
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Ibu Marta |
|
34 |
Titus Maleno, |
65y |
|
Lotas |
RIH – refer General surgeon |
Refer general surgeon
|
|
35 |
Melkianus Retriggis |
23y |
|
Wameda |
® thigh lump. For exc Friday – dr Harry |
26/06/09: Exc ® thigh mass
Surgeon: Dr Harry
L/A |
|
36 |
Rosalinda Luruk |
|
54y |
|
Left Breast cancer ‘peau d’orange’ with axillary metastiso. Refer
local general surgeon |
Refer local general surgeon - Kupang |
|
37 |
Damiael Mau |
28y |
|
Boraktetuk |
Mass left hip from itches. Refer dr Harry, Friday |
26/06/09: Exc mass left hip
Surgeon: Dr Harry
L/A |
|
38 |
Daniel Klaran |
54y |
|
Labur |
Mass left hip. Lipoma – exc Friday |
26/06/09: Exc lipoma left hip
Surgeon: Dr Harry
L/A |
|
39 |
Andreas Naikofi |
10y |
|
Atambua - Alas |
BCL: L=microform, ® cleft lip repair 2000 – doctor from Jogyakarta.
For ® cleft lip revision |
24/06/09: Revise right cleft lip scar.
4-0 Rapide
4-0 Vicryl
6-0 CG
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Sr Theodorin |
|
40 |
Adelina Meah |
|
22y |
|
Keloid R+L breast. Previous surgery Dr Harry. Pregnant 7mo, need
kenacort injection – next visit |
W/L - kenacort injection |
|
41 |
Emanuel Loe Soro |
53y |
|
|
® Radial artery ganglion |
26/06/09: did not arrive for surgery –
tidak datang
Dr Mark |
|
42 |
Julia Almeira |
|
43y |
|
Scalp – pilar cyst. |
26/06/09: Exc pilar cyst scalp
Surgeon: Dr Harry
L/A |
|
43 |
Robrianus Bria |
40y |
|
|
Left cheek sebaceous cyst. |
26/06/09: Exc sebaceous cyst left cheek
Surgeon: Dr Harry
L/A |
|
44 |
Oktavianus M Am Lupu |
|
30y |
|
® leg mass ?lipoma
|
26/06/09: Exc lipoma ® leg
Surgeon: Dr Harry.
L/A |
|
45 |
Daniel Nahak, |
42y |
|
Hanemasin |
Mass right abdomen - ?Spigelian hernia. Refer general surgeon |
Refer general surgeon. |
|
46 |
Chrisriansel Manek |
23y |
|
Halilulik |
PO Stage I serial excision lesion ® cheek. Developed keloid. |
24/06/09: Kenacort injection to keloid scar ® cheek.
Surgeon: MMoore
L/A
|
|
47 |
Juvinal Da Fum Vikasui |
25y |
|
|
® parotid lump. Epidermoid cyst. L/A |
26/06/09: Exc. Epidermoid cyst ® parotid.
Surgeon: Dr Harry
L/A |
|
48 |
Krisanti Isna Seran |
|
5y |
Laleti |
Isolated cleft palate |
25/06/09: Repair isolated cleft hard & soft palate. Repair cleft
palate. LA/Adr. 2 flap technique, Intravelar veloplasty.
4-0 Vicryl, Surgicel.
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Br Rufinus
|
|
49 |
Marik Mariyanto Moruk |
1y |
|
Ainiba |
Left incomplete cleft lip. |
26/06/09; Repair Left incomplete cleft lip & nose. Repair left
incomplete cleft lip & nose.
4-0 Rapide
4-0 Vicryl
6-0 CG
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Marta
|
|
50 |
Saverius Manehat |
1.1y |
|
Motadi |
Right cleft lip / palate |
26/06/09: Repair right incomplete cleft lip & nose
Repair left incomplete cleft lip & nose.
4-0 Rapide
4-0 Vicryl
6-0 CG
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Marta |
|
51 |
Maria Oto |
|
14y |
Ponu |
Left incomplete cleft lip |
25/06/09: Repair left incomplete cleft lip & nose.
4-0 Rapide
4-0 Vicryl
6-0 CG
Excision naevus ® nose. 6-0 CG
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Br Rufinus |
|
52 |
Yansen Untung |
5/12 |
|
|
Right cleft lip / palate |
26/06/09: Repair right complete cleft lip & nose.
4-0 Rapide
4-0 Vicryl
6-0 CG
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Sr Theodorin |
|
53 |
Blasius Nahak |
33y |
|
081353928319 |
5yrs ago bus accident → # ® femur and left BKA. Wow
pain
left thigh. -?release to pin & plate. Need orthopaedic
assessment. ? Prue Keith – Xray. |
Refer orthopaedic assessment |
|
54 |
Referral dr Ensi |
|
18y |
Halilulik |
Fibroma left breast. Refer general surgeon |
|
|
55 |
Ladislaus Kabusu |
3y |
|
Tunabesi |
Left incomplete cleft lip. For cleft lip repair |
26/06/09: Repair left incomplete cleft lip & nose.
Repair left incomplete cleft lip & nose.
4-0 Rapide
4-0 Vicryl
6-0 CG
Surgeon: JXimenes/MMoore
Anaesthetist: DMcLeod
Nurse: Marta |
|
56 |
Maria Fulgensia Tasau |
|
6/12 |
|
Left incomplete cleft lip
R=microform |
26/06/09: Repair left incomplete cleft lip & nose.
Repair left incomplete cleft lip & nose.
4-0 Rapide
4-0 Vicryl
6-0 CG
Surgeon: MMoore/JXimenes
Anaesthetist: DMcLeod
Nurse: Sr. Demetria |
|
57 |
Hilgerdardis Levi |
|
7y |
|
Pyogenic granuloma anterior chest 2months. Refer general surgeon. |
W/L |
|
58 |
Hendrika Kefi |
|
21y |
|
Fibroma ear |
26/06/09: Exc fibroma ear bony
Surgeon: Dr Harry
L/A |
|
59 |
Edmundus Ulu |
27y |
|
|
Foreign body scalp from air rifle bullet. |
Exc foreign body scalp.
Suegeon: Dr Harry
L/A |
|
60 |
Servasius Nggori |
28y |
|
|
Fribroma left forehead |
26/06/09: Exc fibroma left forehead
Surgeon: Dr Harry
L/A |
|
61 |
Agatha Lito |
|
23y |
|
Fibroma left ear |
26/06/09: Exc. Fibroma left ear.
Surgeon: Dr Harry
L/A |
|
62 |
Andreas Nahak |
35y |
|
|
Lipoma arm |
26/06/09: Exc. Lipoma ® arm.
Surgeon: Dr Harry
L/A |
**************************************************************************************************
DAFTAR OPERASI OLEH TIM BEDAH PLASTIK
PADA TANGGAL JUNI 22 s/d 26, 2009
|
SENIN 22/06/09 |
SELASA 23/06/09 |
RABU 24/06/09
|
KAMIS 25/06/09 |
JUMAT 26/06/09 |
|
1. Jesika Efelen Hatumale. 1.5y 11kg,
PO BCL for CP repair |
Aprianus Mau, 1y, 6.5 kg. LICL repair
W/L CP |
Nifron Leo, 4y 13kg
CP repair |
Rudi Imanuel, 10m0,
BCL, R=Comp, L=Microform |
Yansen Untung, 5/12
RCL |
|
2. Josef Masa, 4y, 12 kg,
LCL repair – W/L CP |
Jenitriana Seu, 1y, 6.5 kg
BCL |
Juventus Manehitu, 4 ˝ y, 17kg. PO CL/P, closure fistula |
Marcel Funome, 1y, 10kg.
LCL comp. |
Maria Fulgensia Tasau, 6/12 - LICL
R=microform |
|
3. Graciana Klansa Mau
7/12, 6.4 kg
LICL Repair. |
Patriks Klau Teti, 4y, 10kg
® nasolbial flap to ® ala |
Klemen Balong Goran, 4.5y, 13kg, 13kg
CP repair |
Satria William, 1.5y
CP repair |
George Ferari, 2y
Revise soft palate fistula |
|
4. Maria Kalanta Lea, 10 bln, 7.2 kg, RICL repair |
Yunesti Tero Lajar, 11mo, 6kg
Cleft palate repair |
Satriana Mura, 9y, 22kg
Exc lipoma (L) arm |
Krisanti Isna Seran, 5y
Repair isolated cleft palate |
Marik Mariyanto Moruk
1y
LICL |
|
5. Arianto Siki, 5y, 14kg
Exc. Sebaceous cyst left shoulder. |
Domiggos Sutrio, 2y 8mo
Cleft palate repair |
Andreas Naikofi, 10y
Right Cleft lip revision |
Sandi Tho, 9y, 20kg
CL/P revision |
Sarvensius Manehat,
1.1y
RCL |
|
6. Ronald Nahak, 15y, 42kg. Z-plasty ® nose. |
Maria Angelina Satban, 10/12, 6kg
Left cleft lip repair |
Marcelino, 14y
Release neck &SSG |
Petrosa Yuliance Ona Being, 22y 54kg – Iso CP
CP repair |
Ladislaus Kabusu, 3y 10kg
LICL |
|
7. Detha Rouk, 18y, Left cleft lip repair
|
Vinsen Nifro, 20y, 37kg
Exc left angular dermoin cyst. |
|
Maria Elisabet Hatumale 37y, 72kg
® breast lumps – wide local exc. Upper outer / lower -
Tidak datang |
Hildergardis Noo, 5y, 16kg.
Exc external angular dermoid cyst. |
|
8. Melki Modokh, 24y 44 kg
Stage 1. Left Nasolabial flap |
|
|
Maria Oto, 14y
Repair left incomp cleft lip |
Wilhemince Talelu, 26y, 50kg.
LCL repair |
|
9. . Thomas Inosensius Bere Asan, 15y. Exc epidermoid cyst
left cheek – L/A |
|
|
|
Emanuel Loe Soro, 53y
® radial artery ganglion
Dr Mark
- tidak datang |
Dr. Harry – Friday 26/06/09
|
1. Daniel Mau, 28y
Exc mass left hip
L/A – dr Harry
|
|
2. Daniel Klaran, 54y
Exc Lipoma left hip
Dr Harry
|
|
3. Juvial da Fum Vikasui
® parotid lump –
|
|
4. Julia Almeira, 43y
Scalp – pilar cyst
Dr Harry
|
|
5. Robianus Bria, 40y
® cheek sebaceous cyst
Dr Harry
|
|
6. Oktaviana M Am Lupu, 30y
Mass ® leg ? lipoma
Dr Harry
|
|
7.Melkianus Retriggis, 23y
Exc lipoma right thigh
L/A – Dr Harry |
|
8. Hendrika Kefi, f, 21
Fibroma telinga bone |
|
9. Edmundus Ulu, m, 27y
Foreign body from air rifle scalp
|
|
10. Servas Nggori, 28y,
Fibroma left forehead
|
|
11. Agatha Lito, f, 23y
Fibroma left ear
|
|
12. Adreas Nahak, 35y, m
Lipoma ® arm |
**************************************************************************************************
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