Joint Base Lewis-McChord, Washington -- Medical personnel assigned to Madigan Army Medical Center teamed up with Soldiers from the 758th Forward Surgical Team May 15-19, at Joint Base Lewis-McChord for an exercise featuring live surgical operations."Its invaluable training," said Lt. Col. Joanna Branstetter, an orthopedic surgeon at Madigan. "It's allowing the Forward Surgical Team personnel to work together doing a more cohesive training and utilize their equipment…on actual patient surgeries instead of just simulated patients. There is certainly more training and real life (value) when you are able to use actual patients."Branstetter, the lead surgeon of the same day surgeries, May 17, said the operations were all successful, and included removing ganglion cysts from the wrist of three patients and an ulnar nerve relocation on a Soldier who had elbow pain performing pushups.During the weeklong training exercise, Soldiers of the 758th FST set up a six-tent hospital system just outside Madigan as they would if deployed. Branstetter, also a professional filler to the FST, would deploy with the unit if it were called to action. Stationed at JBLM for over four years, she was once the unit's commander."The communication and coordination has gone very well," said Branstetter. "This unit has trained together for several years with the same personnel, so they have it down to a well-oiled polished machine."Branstetter said having the FST operations on Madigan grounds made it more logistically possible for Madigan personnel to also participate in other simulated training during the week.A full staff for the FST includes 20 personnel capable of performing surgeries within one hour of boots on ground, and is usually the next line of care for casualties on the battlefield said Maj. Erick Gabriel, officer in charge intensive care unit and advanced trauma life support, 758th FST."We do damage control surgery," added Gabriel. "We provide emergency stabilization, surgery and postoperative care for up to 30 critically wounded patients for up to 72-hours by doctrine with the supplies we have on hand. However that changes based upon the severity of casualties and the situation."Unlike the live surgery day, the simulated training operations were purposefully hot, uncomfortable and chaotic according to Col. Imad Haque, general surgeon at Madigan. The medical teams worked at times in a 90-degree, noisy environment, with rapidly changing patient conditions to test their ability to adapt with limited supplies.Haque said one intent of the training was to aid three Madigan section chiefs who would be joining FSTs over the next six-months in unpleasant places where conditions won't always be as accommodating as that of a hospital building."The biggest thing is understanding capabilities -- knowing what you have, what's your left and right limits and trying to work and think outside the box," said Gabriel.