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2007 Mission to Hue, Vietnam

We established a rudimentary microsurgical suite consisting of a Zeiss OPM-1 microscope,
microdissection tools, bipolar cautery and craniotomes. The surgeons have had the equipment
since April and have, with minimal instruction, been able to advance the case type there.
However, they have requested additional training in the retromastoid approach for MVDs, the
pterional approach to the suprasellar cistern, as well as general microneurosurgical techniques.

The hospital has a catchment of 20 million people so there is no shortage of pathology.
Support services include a CT scanner, a 0.5T MRI and a Gamma Knife.
There is no angiography (installation planned for later this year) and no C-arm so
we cannot do cerebrovascular work. There is an endoscopy system without scopes.
It is a challenging environment to work in to say the least, but extremely rewarding.
The goal is not to render a clinical service to a few patients, but to improve the quality and
level of care delivered by the local practitioners.
"Thank you very much for what you have done to help us. We are very grateful.
Thanks to the microscope and the other equipment you gave us, we have very much
improved neurosurgical practice in our hospital. We are now able to operate on the skull
base tumors or the tumors deep in the brain which used to be treated by Gamma Knife
radiosurgery, sometimes by staged Gamma Knife treatment if the tumors were big.
In the past, many patients with brain tumors in Hue city and the nearby provinces had
to go to Hanoi capital or Ho Chi Minh city but now they can be cured in our hospital.
We have operated on 30 patients since you gave us the microscope in April 2007,
of whom two cases suffered neurologic deficit post-operatively and one died.
The rate of complication is much lower than in the past. But we still can not
operate on some pituitary adenomas because we do not have the materials for
transphenoidal microsurgery. I would like to send you the photos of tumors we operated
and the ones of pituitary adenomas we could not operate on."
-- Dr. Truong Van Tri
We will be going back to complete this mission in March, 2008. Click here for details.
2002 Mission to Cuzco, Peru

Our inaugural mission was to Cuzco, Peru, in May of 2002. Three operating teams consisting of two
neurosurgeons, one orthopedic spine surgeon, RNs, and perioperative personal spent 10 days in
Peru. In collaboration with Dr. Diomedes Arias Villena, the local neurosurgeon, a total of 25 cases
were performed over the course of that time. Cases ranged from reconstruction of complex spinal
deformities to repair of pediatric skull fractures and adult brain tumors. There were no complications
and at a two year follow up all the patients were doing well.

This mission led to a change in the medical care model that AMCANI uses. Rather than focusing on
providing temporary neurosurgical services, we now focus on enabling the local practitioner to
deliver modern neurosurgical care.
AMCANI team arriving at Cuzco Regional
Hospital
Supply crates in transit in Lima, Peru.
Drs. Heit and Villena working on a
pediatric case.
Drs. Villena and Gupta.
AMCANI personnel working with their
Peruvian counterparts.
An AMCANI nurse caring for a
post-operative patient
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Supporting modern neurosurgery in
developing countries