The President took the chair and welcomed everyone to the Zoom meeting. The minutes of the last meeting were approved. She introduced the evening’s speaker Mr Neil Pearce FRCS who spoke to the title ‘Establishing a Laparoscopic Liver Unit in the Caribbean’. Neil spoke about his career. He qualified at Southampton in 1990 and trained in surgery, with a special interest in patients with complex problems, at a number of surgical units in the UK. He was appointed a consultant in surgery in 2003. His interest in complex problems led him to specialise in liver, biliary and pancreatic surgery. He became especially interested in laparoscopic surgery and developed new techniques. He was invited to operate live, and demonstrate techniques, at European and Asian conferences and he has also been invited to stream operations around the world from Southampton. After a demonstration of laparoscopic hemihepatectomy in Edinburgh he was approached to consider opening a liver service in The West Indies. He was invited to Trinidad on a fact finding mission. In Trinidad there is a mix of government funded health care, private insurance and charity funded care. There were considerable problems to be overcome. There are no blood banks in Trinidad. In Southampton the average blood loss in hepatic surgery in 270ml but if something goes wrong much more could be needed. In Trinidad it is necessary to take 2 units before the operation, replace it with saline, and return it after the surgery is finished. Equipment was needed and In order to finance it it was necessary to have local ‘business partners’ who would provide the necessary investment. The business plan allowed for a mixture of second hand US equipment [apparently they discard equipment after a low number of operations in the US] for which they allowed £50000 and an additional £70000 for new equipment. Plus bribes to get it through customs. He also had to bring out instruments from the UK in his hand luggage on a number of occasions. The local media was interested in the new venture but for the first case there was to be no publicity. Indeed to make life difficult there was a bleed from the primary liver tumour. At which point the theatre began to fill up with a number of observers, which included the Minister of Health for Trinidad, whom someone had invited. There were other problems too - the stapler could not be found, the theatre sister went missing and was found asleep in the anaesthetic room. To top it all a Q and A session had been arranged on breakfast TV early next morning. The arrangements went better after that and the team began to gel. Neil also set about training the next generation of hepatic surgeons. There was one young trainee surgeon who was very promising and it was arranged to pay for him to come to Southampton as a trainee fellow. He is now the surgeon running the Trinidad hepatobiliary unit.
Neal developed MS in 2011 and had to give up operating.
The President thanked the speaker for his interesting and entertaining talk. There being no other business the meeting was closed.