One of my over-riding philosophies in laparoscopic surgery is to use technology to make as few incisions and possible and, when necessary, make them as small as possible. This was not possible in Saudi Arabia. Their scopes were wide and lacked the HD I am used to. I operated with two very talented surgeons (one Saudi and one Sudanese). As a testament to the skills of my colleagues, we completed the case laparoscopically and the patient did very well. They showed me how to maximize the use of their instruments and I, in return, introduced them to some new techniques and instruments we use. I think we all came out of the case better surgeons with new skills.
The first case took a little longer than expected and we hurried to a private hospital for an afternoon case. What a difference! Though parking was still difficult and I had to walk a while in the Saudi heat in my dark wool suit, I was amazed at the luxury of the private hospital. The floors were immaculate white marble. The walls were freshly painted. The laparoscopic equipment was mounted on booms. Very modern. The case, another difficult rectal cancer, went well. The Saudi surgeon, like so many I know in the US, spent the entire case teasing the anesthesiologist, his partners, and the nurses. In an act of true hospitality, I think I was the only one spared. It was a lot of fun.
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