Category Archives: orthopedic surgery

Dr. Alberto Martinez, Sports Medicine/ Orthopedic surgeon

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Dr. Martinez (right) in the operating room

(Out of respect for patient privacy – I’ve done my best to crop the patient ‘bits’ from the photo.)

Spent some time last week with Dr. Alberto Martinez of Med-Sports Orthopedic Clinic here in Bogotá.  Dr. Martinez specializes in arthroscopic surgery of the hips, knees and shoulders.   As we talked about before, shoulder surgery is its own subspecialty in orthopedics due to the increased complexity of this joint.

We talked a bit about hip arthroscopy,which is still a relatively new procedure in orthopedics and the fact that one two surgeons in Bogota are currently performing this procedure.

Arthroscopy is the orthopedic minimally invasive counterpart to general surgery’s laparoscopy or thoracic surgery’s thoracoscopy.  It involves insertion of a camera and several tools through small (1 cm) incisions in the skin.  Arthroscopy itself has been used in orthopedics for many years but it is just now making inroads in hip procedures.

I’ll be publishing an upcoming article based on my observations over at ColombiaReports.com

For more information

Rath E, Tsvieli O, Levy O. (2012).  Hip arthroscopy: an emerging technique and indications.  Isr Med Assoc J. 2012 Mar;14(3):170-4.

Haviv B, O’Donnell J. (2010). The incidence of total hip arthroplasty after hip arthroscopy in osteoarthritic patients.  Sports Med Arthrosc Rehabil Ther Technol. 2010 Jul 29;2:18

The authors found that 16% of patients in their study eventually required hip replacement after hip arthroscopy during seven years follow-up.

Nord RM, Meislin RJ. (2010).  Hip arthroscopy in adults.  Bull NYU Hosp Jt Dis. 2010;68(2):97-102. Review.

Back in the OR with Dr. Sergio Abello

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Clinica Shaio

Spent part of yesterday back in the operating room with Dr. Sergio Abello.  Dr. Abello is an orthopedic surgeon who specializes in foot and ankle surgery.  (He also have a specialized computer system in his office for truly customized orthodics).

Dr. Sergio Abello de Castro, Foot & Ankle Center 

It  was a chance meeting in the hallway, but as always, with the gracious and genial surgeon – it led to the operating room.  He apologized, “it’s just a small case,” but everything went perfectly.

Dr. Sergio Abello (right) with orthopedic resident, Dr. Juan Manuel Munoz

 

Patient was prepped and draped in sterile fashion, with no breaks in sterile technique.  Case proceeded rapidly (previous surgical pins removed).

The was no bleeding or other complications.

Yvonne (left), surgical nurse

Anesthesia was managed beautifully by Claudia Marroqoon, RN – with a surgical apgar of 10.  The patient received conscious sedation and appeared comfortable during the procedure.  There was no hemodynamic instability or hypoxia.  Oxygen saturation 100% for the entire duration of the case.

Canadians use medical tourism to skip lines, long waits

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More and more Canadians are becoming frustrated with the wait times for surgical procedures in their native country – as wait times for procedures such as joint replacement routinely take years.. instead they are turning to medical tourism to satisfy their immediate medical needs, and to get back to a normal, functional life faster..

This is big news in a country that prides itself of its ‘universal’ health care system – which fails to acknowledge the tolls their lengthy waits take on their patients.  So – it may be free, but many residents are opting out.

In this story – documenting several patients who traveled abroad in the last several years – patients express their satisfaction with overseas services (which they rated as ‘excellent’ and ‘superior to care received at home’ despite having to pay-out-of-pocket.)

Interestingly enough – one of the main brokers (or travel agents) for these services – Shaz Pendharkar is a retired school teacher who readily admits he has no medical training. Despite that – he feels confident enough to recommend the services of medical providers overseas.  He states that despite this obstacle, he “knows the doctors.”

While I am in favor of medical tourism to improve the quality of life for patients in North America (and other locations), I am still uneasy about the ready assurances Mr. Pendharker offers his clients, and his easy dismissal of the unhappiness of one of his former clients.  “It was a butt-lift” he says, as if this in itself is enough to dismiss the patient’s claims of dissatisfaction.

I don’t know the facts of the case – so maybe his claim has merit – maybe it doesn’t.  While patients should continue to seek medical care where they can find it – and overseas options are an excellent choice – I’d rather that someone better informed perform the brokering.  How about you?

Do you want a high school principal chosing your surgeon, and your medical facility?  Or would you rather someone with experience in evaluating medical standards do the job for you? I think it’s time people start applying objective criteria to the entire industry – and leave medical travel to the health care professionals.

The reason for the time out

Ranks & Measures

Why Colombia (versus India and Thailand)

The ethics of Indian Medical Tourism

The Department of Orthopedics at Clinica San Rafael

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Dr. Victor Lizcano, Chief of Orthopedics

Spent the day with several surgeons from the Department of Orthopedics at Clinica San Rafael – which has a city-wide reputation for excellence.

Dr. Victor Lizcano, MD is the charming Chief of Orthopedics who opened his busy, 11 surgeon department to me. I watched surgeries, talked to patients, reviewed films, and interviewed the surgeons in his department, with free rein.

Orthopedics surgical team; two instrumentadors and 4th year resident (center)

Dr. Maria Angela Gomez, MD, a busy surgeon who nevertheless took the time to talk to me; manages dual practices; both as a plastic surgeon (at Clinica de Marly) and an orthopedic (hand) surgeon. She’s currently involved in a very interesting research project – tell you more about it later… A very fascinating lady.

Dr. Martha Pincon, MD an orthopedic surgeon specializing in foot and ankle surgery, also a very interesting and enjoyable surgeon.

Dr. Martha Pincon, during a complex case at Clinica San Rafael

There’s a lot more to tell – but I have another interview in a few minutes..

In the OR with Dr. Mauricio Largacha, Orthopedic Surgeon

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The rest of Bogota may be quiet for the Easter holidays (la semana santa) but the operating rooms were busy at Unidad Medica Cecimin.

Dr. Mauricio Largacha, Shoulder and Elbow surgeon

I spent an interesting and enjoyable morning in the operating room with Dr. Mauricio Largacha, MD for an arthroscopic Rotator Cuff Repair. Dr. Largacha is a natural teacher, and did an excellent job at explaining different aspects of the procedure, expected post operative outcomes, and specialized equipment – since I am less familiar with shoulder and elbow surgery than other surgical procedures. (Unsurprising since as I mentioned previously, he is an expert in this area, and the author of several chapters in multiple orthopedic surgery textbooks on elbow, shoulder and ankle surgery).

Dr. Mauricio Largacha (left) and author

Surgery went beautifully, and surprisingly quick.. No intraoperative complications.

Dr. Mauricio Largacha, orthopedic surgeon

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Dr. Mauricio Largacha is an orthopedic surgeon specializing in shoulder and elbow surgery including arthroscopy, rotator cuff repair and joint replacement.  I’ll be following him to the operating room this weekend – so check back in for more details..

For readers unfamiliar with orthopedic surgery – ankle and shoulder joint surgeries are a particular sub-specialty only practiced by a few orthopedic surgeons.  Luckily for readers here – Dr. Largacha is the author of several of the most heavily used textbooks (and chapters in American medical textbooks) on both ankle and shoulder surgery.

New article at Colombia Reports.com

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Bogota’s Hottest Young Surgeons is my latest article on Colombia Reports – talking about some of the great young surgeons here in the capital;

1. Dr. Juan Pablo Umana (cardiac surgeon)

2/3. Dr. Ivan Santos and Dr. Freddy Sanabria, (plastic surgeons)

4. Dr. Costanza Moreno (orthopedics)

5.  Dr. Juan Carlos Garzon (thoracic surgeon) and

6. Dr. Jose Felix Castro (general surgeon)

and some of the things they are doing (which all of my loyal readers already know all about!)

It was a different style of writing than I am used to – but I enjoyed it, and hope to do another article in the future.

Update: After getting a few requests – I’ve re-posted the article here.  (But, I’d appreciate it if you went to Colombia Reports anyway, so the editors can know how many people are reading the articles – and hope that they will publish more in the future!)

From Colombia Reports.com

Bogota’s Hottest Young Surgeons
Don’t let their youth fool you. These young Bogota surgeons are well versed in the latest technologies and the newest surgical techniques, and are changing the face of, and bringing new sophistication to the capital’s medical community.

Colombia news - docDr. Juan Pablo Umana, 46, Cardiac surgeon

A Bogota native, Dr. Juan Pablo Umana, with his Stanford education, quintessential rugged good looks and a refreshing outlook, brings a California flavor to Fundacion Cardioinfantil, where he has been the Chief of Adult Cardiac Surgery since 2004.  He, along with Dr. Nestor Sandoval have ushered in a new era of Cardiac Surgery in Bogota with a expanding and state-of-the-art cardiac surgery service line.  Notably, in 1997, Dr. Umana along with Dr. Memhet Oz invented the first mitral clip for percutaneous valve repair. During surgery, he is focused, meticulous and unflappable.  Despite being the most senior of the surgeons listed here, he is just hitting his stride.

Colombia news - doc

Dr. Ivan Adolfo Santos, 41, Plastic Surgeon

Dr. Ivan Santos operates at Clinica Shaio, and is one of a trio of celebrity plastic surgeons here in Bogota. Genetically blessed, he looks ten years younger than his 41 years. In spite of his boyish good looks and shy nature, Dr. Santos is a confident and talented surgeon; more importantly, he gets results. Watching Dr. Santos operate is similar to watching a symphony conductor orchestrate classic music composures with 160 musicians. He never misses a beat, and he is simultaneously aware of everything around him. With his precision in the operating room and aggressive post-operative therapies, patients recover faster, with less pain, and leave his office looking and feeling their best.

Colombia news - doc

Dra. Constanza Moreno Serrano, 40, Orthopedic Surgeon

Dra. Constanza Moreno is orthopedic surgeon specializing in hand and microsurgery such as digital reattachment after traumatic injury, reconstructive surgery and correction of congenital deformities. After training with the famed Dr. Harold Kleinert and Dr. Breidenbach III in Louisville, Kentucky, she returned to Bogota in 2005.  She is currently developing a hand transplant program for victims of landmines. Next week, she is presenting her proposal at the International Hand and Composite Tissue Allotransplantation Society in Atlanta, Georgia.

Colombia news - doc

Dr. Juan Carlos Garzon, 39, Thoracic Surgeon

Dr. Juan Carlos Garzon is a man of action; operating at several facilities across Bogota. Trained in Hong Kong, Dr. Garzon excels at the more difficult thoracic cases. As one of just a few board-certified thoracic surgeons in Colombia, he is using video-assisted thoracoscopy to able to treat complex disease with minimal incisions.  He is also teaching this technique to surgeons across Colombia. During cases, he is relaxed, controlled and ready for anything.

Colombia news - doc

Dr. Freddy Sanabria S., 38, Plastic Surgeon

Dr. Freddy Sanabria, a young Richard Gere look-a-like, makes his own pretty women as one-half of the Sanabria plastic surgery practice. Trained at the University of Pennsylvania and Stanford University, he brings skill, dedication and the latest cosmetic innovations to a well-established surgical clinic. While operating, he is confident, focused and detail oriented, and his surgical team anticipates his every need.

Colombia news - doc

Dr. Jose Felix Castro, 37, General Surgeon

Dr. Jose Felix Castro is a staff surgeon at Clinica del Country. This magna cum laude academic scholar is one of a few of the talented young general surgeons in Bogota who have embraced single port laparoscopy, which means abdominal surgery without a scar. While Dr. Castro is the youngest of our line up, he brings a wealth of experience to the operating room.

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Upcoming week: more thoracics!

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It’s good to be back in Bogota!  Now, if only I could line up all my appointments as easily.

I had anticipated more neurosurgery this week, but with the big neurosurgery conference in Mexico, it’s not turning out that way.  So far, it looks like it’s going to be more of a Thoracic surgery week – with some orthopedic surgery and general surgery mixed in..

I’m going to see Dr. Osorio again, at the hospital in Chia this time, (if I can find it…)

I’m hoping to meet with Dr. Stella Martinez too.. I’ve heard a lot of great things about her from several of her colleagues, so I am really looking forward to it.

I’m still trying to arrange a meeting with Dr. Jimenez sometime this week – so I will keep you updated with how that turns out..

Tomorrow, I’m interviewing Dr. Klaus Mieth, an orthopedic surgeon – and I am hoping to catch up with Dr. Roosevelt Fajardo, (general surgeon) over at Santa Fe de , to get together later this week..

There are a few other physicians, I am still hoping to hear back from – so we’ll see how the week unfolds.

Update: 6 April 2011

Met with Dr. Klaus Mieth yesterday – interesting gentleman; speaks three languages; english, german and spanish.. Works full time as an orthopedic surgeon specializing in knee procedures – but also serves as the Director of the largest (and non-profit too) bone and tissue bank in Colombia..

Dr. Constanza Moreno Serrano, Hand & Microsurgeon

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Dra. Constanza Moreno is an orthopedic surgeon specializing in hand and microsurgery.  She specializes in the treatment of traumatic injuries such as digital and limb re-attachment, reconstructive surgery and correction of congenital deformities.  Next week she is traveling to Atlanta, Georgia to give a presentation at the International Hand and Composite Tissue Allotransplantation Society on the Hand Transplant Program she is developing at Santa Fe de Bogota.  Her aim is to restore limbs (and functionality) to the lives of Colombians affected by landmines. 

I hope to follow her to the operating room when she returns.. Look for more exciting news from this gracious physician in the future..

Colombia and Landmines

21 April 2011 – since I originally posted, I’ve received a lot of questions about hand tranplantation.. Here’s a Yahoo article discussing a recent hand transplant.

Dr. Francisco Cabal, Dr. Jaime Rojas, Orthopedics

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Dr. Cabal, (left) and Dr. Rojas, Orthopedic Surgeons

Good morning over at Clinica del Country with Dr. Francisco Cabal, and Dr. Jaime Rojas in an interesting orthopedic case this morning.. Everything was beautifully smooth – great anesthesia with Dr. Douglas Leal.. Attended a nursing lecture on orthopedic patients..

Interview with Dr. Edgar Prieto, General and Biliary surgeon this evening.. Clinica de la Mujer is reviewing my credentials before I check out their OR. Supposed to hear back this evening – in time for Dr. Prieto’s cases..

To the OR with Dr. Abello, Orthopedics

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Going to the OR today with Dr.  Sergio Abello, the Foot and Ankle surgeon I mentioned previously. He has six cases today, so it will be a full day. It’s several different procedures, so it should be pretty interesting – and a change from what I’ve been seeing for the last few weeks..

Dr. Sergio Abello, prior to ankle arthroscopy case

 

Met with Dr. Alfredo Hoyos, Plastic Surgeon yesterday – despite his over-the-top website, he seemed pretty down to earth. I’ll be going to the operating room with him at the Santa Barbara Surgical Center on Thursday. He’s actually a pretty interesting guy, and I am really interested in seeing the sculpting liposuction.

Tried to chase down Dr. Camilo Prieto and Dr. Alan Gonzalez yesterday. I heard Dr. Gonzalez is getting married this weekend – so I’ll give him a bit of a pass – I’m guessing his life is probably pretty hectic right now, (so we’ll come back to him later).

Stopped in at Dr. Prieto’s office, hoping to catch him, since my messages haven’t gotten a response – and got stuck leaving another message, but we’ll see if we get any response. I hate to give up – he’s one of the most popular plastic surgeons down here, and well advertised on the internet – so I think he should definitely be included.. But I can’t make people talk to me, so if I don’t get a response this time, I may have to reconsider.

Haven’t gotten anything booked for Saturday, but I am still working on it – I hate to miss any day when the ORs are running..

(center) with nurses at Shaio

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I apologize to all the great doctors who gave me their time and effort – but didn’t make it on the web page (don’t worry, they will be in the book!)

Dr. Sergio Abello and Dr. Felipe Roa

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Met with Dr. Sergio Abello, an orthopedic surgeon specializing in foot and ankle surgery and Dr. Felipe Roa, plastic surgeon.. Dr. Roa is the son of Dr. Tito Roa, and they share a practice..

Planning to follow both of them to the OR tomorrow and next week..

Dr. Francisco Cabal, Orthopedics

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Met with Dr. Francisco Cabal, orthopedic surgeon and international medical advisor (for Colombia) again, and he bids me to extend a warm welcome on his behalf to all North American patients coming to Colombia.  He also states that he is here to help ANY patient, interested in going to ANY city in Colombia for surgery including Medellin, Cali, Cartagena, Bogota and all parts in between.  I’ll be following him to the OR soon – more later.. 

Lest you think surgeons aren’t sympathetic to your discomfort – Dr. Cabal recently had ankle surgery, so he is definately walking a mile in your shoes..

Also met with Dr. Tito Tulio Roa, plastic surgeon, who has the distinction of having taught most of the plastic surgeons here in Colombia.

Filled up my date book with more interviews, and surgeries for the next few weeks..

Meeting with Mauricio Pelaez, Thoracic Surgeon later this afternoon, so I’ll post and let you know how that goes..

Rescheduled with the famous Dr. Hoyos – more on that next week.