However, these physicians sometimes have special opportunities to help disadvantaged children and adults in other nations and to train surgeons with new skills that will impact the lives of many patients.
Emory limb repair and transplant surgeon Linda Cendales, MD, recently embraced such an opportunity by returning to Vietnam for the second year with a team of other specialists from the United States, including plastic surgeons and anesthesiologists. The team treated both pediatric and adult patients with a variety of specialized needs involving limb injuries.
In addition to performing numerous surgeries and providing clinical visits for dozens of other patients, Cendales used the opportunity to train Vietnamese surgeons with new and valuable skills. This training will help patients who otherwise might not have access to such medical options in a country with few specialized surgeons.
“The trip was very special and incredibly rewarding,” says Cendales. “We performed technically challenging and sophisticated surgeries at two important hospitals in Hanoi – the National Hospital of Pediatrics, which is the leading pediatric hospital in Vietnam, and the Viet Duc University Hospital, which is the largest surgical center in the country. We followed up on the cases from last year, particularly an 11-year-old boy in whom we performed the very first toe-to-hand- transfer a year ago. He is doing extremely well now and has use of a hand that, until this surgery, he did not use.”
In that particular patient, the young boy, who lost four fingers on his right dominant hand, received a transplant of a toe, which was surgically fashioned into a finger – allowing him to perform such simple tasks as holding a cup.
“Most people do not realize how important such basic tasks can be unless they do not have the ability to do them,” notes Cendales. “This young boy could not dress himself properly or hold a pencil. Needless to say, the day- to- day challenges and the stigma such a child faced was very difficult for him and his family. Having the opportunity to go back and check on his progress and see the smile on his face is priceless. In fact, the opportunity to spend time with so many patients in need of our care, and to be able to train the surgeons in Vietnam on how to perform these procedures will help so many men, women and children. We certainly made a difference in the lives of children and adults in Hanoi through surgery and in the Vietnamese surgeons through teaching.”
Cendales is the only surgeon with formal training in each of hand, microsurgery and transplant surgery in the United States. In addition to the clinical study of hand transplantation, she established a comprehensive program at Emory University to systematically study Vascularized Composite Allotransplantation. VCA is the term used to describe transplantation of multiple tissues (skin, muscle, bone, cartilage, nerve, tendon, vessels) as a functional unit. Thus, in addition to her experience with clinical hand transplantation, Cendales is trained in hand and microsurgery and transplant surgery. In addition to being a reconstructive surgeon, she is director of the Emory Transplant Center’s Vascularized Composite Allotransplantation (VCA) program and Laboratory of Microsurgery.
Under the leadership of Cendales, the Emory Transplant Center recently established a novel transplant program to evaluate hand transplantation as a potential therapy for replacement after loss of one or both hands. The study is open to those with interest in a potential hand transplant who have specifically lost one or both hands below the elbow. Hand transplantation, like other forms of organ transplantation, requires a major surgical procedure followed by drug therapy for life after the procedure to maintain the function of the transplanted hand(s).
“I enjoy practicing in the academic environment provided by Emory and the Atlanta VA Medical Center. It allows me to provide advanced care to patients and perform research, while at the same time teaching and training other surgeons. It is a highly rewarding career,” says Cendales. “However, when the opportunity to reach out across the globe to others in more disadvantaged countries with limited resources presents itself, I believe that answering that call fits with our overall mission of service to others through medicine, education and training. I certainly plan to go back to Vietnam and continue to grow our relationship with the physicians there, who are eager to learn how to better care for the people in their own country.”
The Robert W. Woodruff Health Sciences Center of Emory University is an academic health science and service center focused on missions of teaching, research, health care and public service. Its components include the Emory University School of Medicine, Nell Hodgson Woodruff School of Nursing, and Rollins School of Public Health; Yerkes National Primate Research Center; Emory Winship Cancer Institute; and Emory Healthcare, the largest, most comprehensive health system in Georgia. Emory Healthcare includes: The Emory Clinic, Emory-Children’s Center, Emory University Hospital, Emory University Hospital Midtown, Wesley Woods Center, and Emory University Orthopaedics & Spine Hospital. The Woodruff Health Sciences Center has a $2.5 billion budget, 17,600 employees, 2,500 full-time and 1,500 affiliated faculty, 4,700 students and trainees, and a $5.7 billion economic impact on metro Atlanta.