This year’s SA Thoracic Society Congress opened with a stimulating video-assisted thoracic surgery workshop on the Westville campus presented by UKZN’s Biomedical Resources Unit (BRU).

Thoracic surgery refers to operations on organs in the chest, including the heart, lungs and oesophagus.

Facilitated by cardiothoracic surgeon Dr Ivan Schewitz, the first day of the workshop involved mentoring registrars (specialists in training) from all seven cardiothoracic training units in South Africa on the minimally-invasive method of surgery which was performed on pigs.

Steve Biko Academic Hospital Registrar Dr Phemelo Leeuw said it was the first time he had worked on a pig and its anatomy, which is quite similar to that of a human. ‘The workshop encouraged teamwork among the institutions, all working towards a common goal.’

UKZN’s Head of Cardiothoracic Surgery Dr Rajhmun Madansein said the first day of the congress equipped members of the society with practical skills to empower them to become better surgeons in the theatre. ‘One wants trainees to be trained and have the necessary skills before they start operating on patients in theatre,’ said Madansein.

‘Known as keyhole surgery, we’re trying to do smaller and smaller incisions so that patients recover rapidly, pain is less of a problem, there are shorter stays in hospital, and scars are generally much smaller. The trend in surgical training is to do more and more in smaller and smaller incisions.

‘Surgical training is different to non-surgical medical disciplines in that the training involves not only reading and acquiring knowledge but also getting the necessary technical skills,’ said Madansein.

‘BRU is an important component in training, not only in veterinary medicine but in human medicine as well. It’s not a dry laboratory where one would use non-animal and non-human materials. A wet laboratory involves using some form of organic tissue, so usually what we would use is pig hearts, their veins and arteries for human simulation.’

He said there were three common groups of heart patients South Africa – those born with defective heart conditions, those with rheumatic heart disease which involves heart valves that often need to be replaced with artificial valves, and patients with coronary artery disease – blockages in the blood vessels that can lead to heart attacks or death if untreated.

Madansein said cardiothoracic surgeons depended on teamwork involving cardiologists, perfusionists, anaethetists and the nursing staff for the success of any theatre procedure. ‘Cardiothoracic surgery is expensive but it is also lifesaving surgery. Other thoracic surgery performed is often on lungs infected by TB and lung cancer. This country is the epicentre for TB, HIV and their co-infection. We have many cases of multidrug-resistant and extensively drug-resistant TB and have also treated a lot of oesophageal cancer,’ he said.

Schewitz said he enjoyed interacting with the registrars, practically exposing them to the instruments and the feasibility of the video-assisted lobectomies (surgery to remove one of the lobes of the lungs), the quality of which was constantly improving.

Trained at UKZN’s Cardiothoracic Department and today a consultant based at Harare’s Parirenyatwa Hospital, Dr Kudzai Kanyepi said she found the workshop to be ‘a great hands-on experience, with excellent mentorship and guidance from senior surgeons.’

UKZN College of Health Sciences Telehealth Senior Technician Mr Mhlengi Zondi said it was always fascinating to record and live-stream such interactive workshops to a virtual audience.

BRU was primarily designed to breed and house a variety of experimental animals with a core focus being to meet the scientific needs of teachers and researchers in an area of the biomedical sciences of the entire eastern seaboard of South Africa.

BRU Manager and veterinarian Dr Nqobile Jaca said that it was gratifying to be able to get back to hosting workshops in the unit post-COVID-19. ‘It is so rewarding to have the human medicine and veterinary fields together to do ground-breaking and life-changing training for the registrars,’ said Jaca. ‘Thank you to vets Dr Sanil Singh and Dr Edmore Mushoriwa, and BRU staff members Dr Linda Bester, Mrs Ritta Govender, Ms Thabisile Mkhize, Bab Thokozani Ndwandwe and Mr Lubabalo Gweleshe.  All these individuals worked tirelessly to ensure the workshop was a success.’