Tag Archives: Bogota

PGA tour comes to Bogota..

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The misnamed “*Nationwide’ PGA golf tour kicks off in Bogotá, Colombia next week with former United States president, Bill Clinton in attendance.   Former president Clinton will play in the Pacific Rubiales Colombia Pro-Am on February 16th at the Country Club of Bogotá.  Golfers will be competing for their share of a $600,000 purse..

For a run down of the other competitors, click here.   Native Colombian David Vanegas will be representing his home country in the tournament.

More about the Pacific Rubiales Colombia Championship

The full PGA Tour Schedule for 2012

* I am guessing ‘Nationwide’ insurance is one of the big sponsors of this event.

Looks like Panama may bite off more than they can chew..

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In a recently published story, the government of Panama is now offering medical  insurance for all tourists to Panama for free.  This insurance is not  ‘Complication Insurance’ which is offered by private surgeons in Colombia and other countries for patients traveling specifically for medical tourism.  Complication insurance covers all possible medical complications resulting from medical procedures at the designated clinic or destination..

No – Panama is taking the European and socialized medicine approach and is offering general medical coverage for ALL short-term travelers to Panama.  (The long-term exclusion is a wise move given the numbers of Americans and other overseas residents who make Panama their retirement home.)  This insurance resembles typical travel policies in that it covers injuries, accidents and other medical situations that may occur while on vacation..  I just hope the Panamanian government hasn’t underestimated its tourists and their injury/ illness potential.

Now readers – don’t get any wild ideas.. This is not the time to stress that ‘trick knee’ while hiking to visit the Naso-Teribes..

Meanwhile, Costa Rica is making a pitch for more corporate clients such as Pepsi-Cola.  These multi-national corporations can potentially bring hundreds of millions of healthcare dollars by diverting their employees to medical tourism destination such as Costa Rica.  (Like Colombia – Costa Rica is an ideal destination for North Americans due to proximity, quality and diversity of services available.)

A new medical center for Bogota?

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There’s a new article over at IMTJ about a new medical facility being built in Bogotá – but it’s not the facility itself that is interesting (sounds like a new private cosmetic surgery mega-clinic).

It’s the statistics within the article that caught my eye.  I’m not sure how accurate these statistics are, but if true – it confirms much of what we’ve been saying here at Bogotá Surgery.  I’ve placed a direct quote from the article below:

“According to Colombia’s Ministry of Commerce, Industry and Tourism the most popular treatments sought by visitors are heart surgery (41%), general surgery (13%), gastric band surgery (10%), cosmetic surgery (10%), cancer treatment (6%), orthopedic treatment (4%, dental care (2%) and eyecare (1%).”

If this information is even remotely accurate – it confirms what many of within the medical tourism have been saying – and contradicts much of the popular media reports.

People aren’t just going overseas for breast implants and face-lifts – people are going overseas for essential lifesaving treatments, and procedures to improve their quality of life.

This is an important distinction to  make, but many people tend to see cosmetic procedures as frivolous, and consider the issues around medical tourism, and travel health to be equally unconcerning*.  So when they see flashy news stories (good or bad) about patients having overseas surgery (which the media usually portrays as plastic surgery) they shrug and change the channel.

Hmmm.. patient died of liposuction in Mexico (or Phoenix or India..)  Or Heidi whatshername had 26 procedures at a clinic overseas..

But as these statistics show – that’s not the reality of medical tourism – and that’s what makes all of the issues around it even more important.

People may not get fired up about insurance coverage for medical tourism for cosmetic surgery – but what about tumor resection?  or mobility restoring orthopedic procedures? Or as cited above, life-saving heart surgery?

When put into this context – the government (President Obama’s) stance against medical tourism looks a little less democratic – particularly given the state of American healthcare.

* This is not the opinion of the author – but an accurate reflection of statements made in multiple articles and news stories

 

In other news:  Joint Commission take note:  The Indian Health Commission plans to perform surprise health inspections of Indian facilities to ensure quality standards.  (Joint Commission announces their impending visits months ahead of time.)  Joint Commission is the organization that accredits most American hospitals.

BBC, Dr. Celso Borhoquez and Breast Implants

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In this story from BBC, Dr. Celso Borhorquez, media spokesperson or the Colombian Society of Plastic and Aesthetic Surgery  (and previous interviewee here at Bogotá Surgery) talks about breast augmentation in the wake of the PIP scandal.  Dr. Borhorquez reports that many Colombian women are reconsidering their options, and electing to forgo breast implantation procedures after widespread media reports on the defective french implants.  (More on the defective implants can be found here.)

And for the estimated 14,000 women in Colombia who already have PIP implants – Thanks to the Colombian government, implant removal is free..

The future of medical tourism: the glass ceiling

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The International Medical Travel Journal has a new article that questions the notions that ‘the sky is the limit’ in the medical tourism industry.  This article discusses the belief that many investors have that as long as there is a new shiny facility, medical tourists will flock..  In reality, the market for medical tourism is fairly narrow, particularly for American medical tourists – who are the ones most likely to open their wallets and pay cold hard cash for surgical procedures overseas.  (That’s because medical care in many other countries is less expensive for residents – so why travel and pay cash for something you can get at home for relatively little expense (even if it requires waiting.) Many of these Americans are uncomfortable or unwilling to travel to more exotic locations – as Dubai has found out first hand.

Of course, plastic surgery and other elective procedures are a little different.)  But most Europeans, Canadians etc.  aren’t going to have to fork over 100,000 for heart surgery (or be uninsured) so the pool is limited.

The other class of medical tourist – the wealthy residents of countries that may not have elite services is also a mixed bag,  Many of these patients are going to elect to go to ‘big name’ American facilities despite the cost – for a specific level of care.  They may seek out specialized procedures that are unavailable or even illegal in their home countries – but that market is smaller than most of us realize.

It’s a good article that brings a dose of reality to the concept of medical tourism as a ‘cash cow’ route to easy and limitless cash.  Medical tourism is not for everyone, as investors are finding out.

HIPEC: the latest research results

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If you remember, previous New York Times articles questioned the efficacy of hyperthermic chemotherapy given during cytoreductive surgery.  We promised to investigate, and return with more results to this question.

Recently several articles have been published on the topic, including this one – in the journal of Clinical Oncology.  This narrative by Maurie Markman talks about the quick dismissal of HIPEC by many oncologists, particularly for larger tumors – and he questions the wisdom of this approach in light of recent research results.

In fact, several large new American studies – including one at Case Western are examining the use of HIPEC, particularly in gynecological cancers like ovarian and uterine cancers which carry a dismal prognosis.

American Hospitals are finally jumping on the HIPEC bandwagon…

Detroit hospital offering HIPEC

Atlanta docs, robots and HIPEC

This last link isn’t really news – it’s a press release, but since it’s on a surgical oncologist (Dr. Wilbur Bowne) who was an early American adopter of HIPEC, I thought readers might be interested.

Previous Bogota Surgery posts on HIPEC

HIPEC: The basics

Bogota Surgeons stay ahead of the curve

The Future is Now: HIPEC

Looks like it’s about time to check in with our favorite surgical oncologist, and HIPEC expert, Dr. Fernando Arias..

Check back soon for more..

Colombian life: an outsider looking in..

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There’s a great blog here on WordPress that I wanted to recommend to anyone interested in Bogota – and all things Colombian.  The blog is called The Wanderlust Chronicles and it follows the life, and adventures of Kate – a young teacher / translator (who reminds me a bit of myself).  I do have to say – that as I ‘cruised’ around the site, reading her posts – tears almost came to my eyes, and I became wistful for all the things I loved and enjoyed about my time in Colombia.

For everyone else –

It’s a great reference for all of you who want a bit of a different vantage point (nonmedical) on the beauty of Colombia and Colombian culture.  I hope you enjoy!

Medical Tourism Forecast for 2012

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Where is Medical Tourism & Travel headed for 2012?   Predictions vary according to sources, but all sources expect the medical travel phenomenon to continue, unabated.

Maria Lenhart at the Medical Travel Report (a private travel company blog) estimates 35% growth over the next year, based on Deloitte statistics.

Where are they going?  According to Depak Datta of the Medical Tourism Corporation – for the most part, people are staying fairly close to home..  Meaning that people from the United States and Canada favor locations in the Western Hemisphere over Thailand, India and other destinations popular with Europeans, Africans and Asians..

Domestic medical tourism remains a popular option with American corporations who are sending their employees to large, well-known facilities within the United States.

In fact, large American healthcare institutions often have the most to gain from medical tourism via international affiliations with institutions in South America, India,  and Asia.  John Hopkins, Cleveland Clinic, Duke, Harvard and several other well-known top-tier American medical giants have branding agreements and other lesser affiliations with hospitals and clinics across the globe.

In the midst of this growth, concerns over patient safety and quality of care should remain at the forefront (in all facilities – domestic and international.) But until more potential customers demand (or even display any interest) in quality, and safety issues – the industry is not going to go out of its way to provide this information.

Colombian government steps up..

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In a surprising but admirable move, the Colombian government has announced that it will pay for the removal of PIP implants.    As we discussed at our sister site, Cartagena Surgery, recent disclosures that the French company knew their breast implants were defective as far back as 2005 has sent shock waves of outrage through the medical community.  Further disclosures that the implants contained substandard construction grade materials (not medical grade) and fuel additives which contributed to the exceedingly high rupture rate (7% versus an average rate of 1% for all other implants) has important health implications for women world-wide.

In the wake of this scandal, hundreds of thousands of women across the globe, particularly women in Latin America where the implants were heavily marketed, have been panicking and storming physicians’ offices for answers.

(In a related post at our sister site – we reassured readers who received implants in 2011 by some if the surgeons profiled here..

With the French government advising over 30,000 french recipients of these implants to have them removed promptly, this goodwill gesture by the Colombian government should go far to reassure and calm Colombian women.

Update: 14 Jan 2012

Medpage Today just published a nice comprehensive article on the Poly-Implant Prostheses (PIP) implant controversy.  It’s a good story for people playing catch up on this story – and wondering if they may be affected by this news.

2011 in review: State of the Blog

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Thank you to everyone for making Bogotá Surgery.org a phenomenal success!  Surprisingly – this annual report shows a few less views than our own counters – but we are thrilled all the same..  Here’s hoping for more and greater successes in 2012!

Here’s an excerpt:

The concert hall at the Syndey Opera House holds 2,700 people. This blog was viewed about 9,700 times in 2011. If it were a concert at Sydney Opera House, it would take about 4 sold-out performances for that many people to see it.

Click here to see the complete report.

Feliz Navidad and Happy Holidays, my friends!

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Click here to see a photo array (presented by Colombia Reports) showing the lights of Christmas time..

You can find more information about Christmas, Carnival and other festivals year-round in Bogotá at this webpage here.

Wishing all of my readers and friends a happy holidays and a healthy new year!

The Motley Fool & Medical tourism

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The Motley Fool takes on medical tourism.  For you aren’t familiar with this site, it’s a very popular financial blog with stories on the economy, popular stock picks, predicted trends and investment strategies for retirement planning.  I am only passing familiar with the site myself since I come from a family of economists, but you can imagine my surprise (and delight!) to see medical tourism given serious consideration and discussion on their blog.

It’s about time that people talk about medical tourism in a fair and realistic fashion.   It tends to be sensationalized in extremes either fantastic! amazing! awesome! extreme plastic surgery makeover style or devastating.  graphic. and disturbing horror stories.

But this is a more rational and balanced discussion of health care and medical tourism – by the numbers, so to speak.. and it’s about time.

Por la navidad…

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Perdoname porque mi espanol es un poco malo pero me gustaria dar vosotros una regalos por la navidad. Por todos mis amigos quien de leimos en espanol :

Ahora, en Smashwords.com – es un promocion por este libro – Bogota! una guia de quirofano. Este descuento es 25% cuando usas codigo TA47T.

Ir a Smashwords rapido! porque este promocion es corte – solomente desde ahora a 17 de enero.

I apologize to all my Spanish readers – my written Spanish is even worse than my spoken words.  (Luckily, I hired an excellent translator, Sra. Ochoa for the spanish edition of the book.)  Happy Holidays, and here’s wishing we all enjoy the best of health in 2012.

Bogota receives high marks from the Boston Globe

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Ivy Hughes at the Boston Globe recently discovered the charms and attractions of this fair city in a feature article published  today.  She reviews some of the most popular sites and scenes of the city, while dispelling many of the myths surrounding Colombia and enjoying the Transmileno experience..

In other city news, Colombia Reports just published a new story on the development of a new plastic surgery center – catering to the needs of medical tourists.

I also wanted to thank everyone – we recently reached over 10,000 visits – in just the few short months since we started this site..

Hopefully, in the future, I’ll be able to afford to make this, (and the sister sites) ad free for less distractions..

Bogota’s LBGT community, tolerance and gender reassignment surgery

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Here’s the link to a nice story published on Off2Colombia as part of a press release for the city of Bogotá.  It’s a nice article (and video) that shows the diversity of this beautiful city.  As someone who lived in Bogotá for several months – I have to say that everything about this story is very true – and people in Bogotá are very friendly, warm and welcoming to EVERYONE.

Just another interesting facet of this lovely, fascinating and teeming city in the Andes..

 

Heart Surgery Abroad – coming to the big screen?

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Too bad, the independent filmmaker from Tennessee elected to travel to India rather than closer to home (like Latin America.)  Still – it places a lot of what we talk about into context – the affordability (or lack of) life-saving treatments in the United States versus numerous countries abroad..

Interestingly enough – despite making the choice to travel thousands of miles for a huge operation – it doesn’t sound like he throughly researched his surgeons, facilities  etc.  That is certainly troubling as medical tourism has not yet reached the Kayak, or Expedia level for interested travellers.  While I am very happy, relieved, pleased that everything worked out well – this could have easily been a cautionary tale (and loss for medical tourism) as a well-publicized win.

But, I will continue to hope that stories like his will help promote safe medical tourism, through the establishment of standards and regulations for medical tourism promoters.

Colombia and cultural standards of beauty

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This article on Sabotage Times talks about some of the different cultural ideas of beauty – in this case, the cultural and historical appeal of the large behind or bottom in Colombia.  (This is definitely a case of Latin influence on the United States – as this beauty ideal has been rapidly adopted here at home) – leading to an increase in the number of ‘booty enhancement procedures’ for American patients.

These different cultural standards of beauty are also something we have talked about before – and how Latin America is setting the styles for USA and much of the world.  These ideals have been quickly adopted into the mainstream American beauty ideals of the 1990’s and beyond.

(If you remember the late 1070’s and 1980’s – most of us up here in North America [and our mothers] – were out there starving and aerobicizing ourselves to try an obtain the tiny, flat bottom of a 12 year old boy.)

While some of this is undoubtably related to the large population of American residents with hispanic origins and the reflection of their beauty ideals – Colombia, Brazil, and Argentina have long been trend setters for fashion and beauty (which includes plastic surgery.)  This is one of the trends that makes these destinations so popular for plastic surgery.

For more on Bogotá plastic surgeons – see here, here and here.

For more on plastic surgery and ‘booty enhancement’ gone wrong – see here at our sister site.

New article at Eternal Beginning blog

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Eternal Beginning is book review blog by avid reader (and fellow writer), Christine Cunningham.  (It is also the title of her first book.)  Christine was kind enough to feature the Bogota book on her blog.

Clinica Shaio & Dr. Hernando Santos

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Fundacion Clinica Shaio – the first cardiac hospital in Colombia has recently unveiled the updated english-language version of their website, as part of an effort to aid international travelers, and attract medical tourists.  As long time readers know, I spent quite a bit of time at Clinica Shaio, with the Doctors Santos, (and several others).    Now as part of our new podcasting project – we will be sharing one of my favorite surgery videos from the operating room of Dr. Hernando Santos.  (If you’ve spent time here at www.BogotaSurgery.org than this video will be familiar to you.)  To my new readers from iTunes – welcome & enjoy!

Brief introduction to Dr. Hernando Santos, MD.

Bogota Surgery Podcasts

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As part of our continuing efforts to bring medical tourism and travel information to people in a multitude of formats, we are planning to begin a series of podcasts featuring physicians and topics discussed here at Bogotá Surgery.

Come back soon for more information on our latest endeavor.

The road to Monserrate

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no, this isn’t some sort of quasi-poetic allegory, or sophomoric metaphor.  The road to Monserrate – really is a path, or more accurately, the stairs to Monserrate.   Monserrate is a popular tourism destination in Bogotá:  a church set high on the Mountain above the bustling city.  Despite the religious themes, Monserrate appeals to the faithful and the agnostic alike – due to the impressive and expansive views of the valley below.

the view from Monserrate

Traditionally, pilgrims climbed to the top of Monserrate on a worn-down path.  A train and a cable car also served to bring travelers, and tourists to the top of Monserrate.

The new upgrades to the footpath have just been completed – making the walkway more accessible to visitors.

The Bogotá Hilton (located in the financial district) also opened this week.

HIPEC in the news again..

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Another story about bringing HIPEC to the masses – this time in Mumbai, India..  I have to wonder about the research for the article – everytime I see the phrase, “A ray of hope”..  sounds suspiciously like the original title of a certain article (in Colombia Reports.com) all of us are familiar with over here at Bogota Surgery.org.

HIPEC and peritoneal mesothelioma – more effective in women?

Dental care overseas

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As reported in numerous stories, many Americans are travelling to Mexico and other countries for dental care. Ex-pats or Americans living abroad are also seeking dental services.

However, as highlighted in this article – determining the quality of your provider overseas is not easy.  (Of course, it’s not easy to find a good dentist for many of us at home – but that’s a separate issue.)

Evaluating dentists and dental services is different that evaluating other health care providers – due to the nature of the service.  Unlike most surgical procedures – most dental procedures do not require anesthesia, (which means that they can be evaluated on a first-person basis).  Of course – for my colleagues who assisted me in writing Bogotá! – it meant quite a bit of time in the dentist’s chair..

Ahora en espanol!!

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El turismo quirúrgico llega a Bogotá ! La autora de La Gema Escondida:
Una Guía para el Turismo Quirúrgico en Cartagena , Colombia, ahora le
trae la historia completa de los hospitales, tratamientos y médicos de
Bogotá, Colombia.  Investigado de forma metódica, este libro lo lleva a
las salas de operación para contarle lo que usted necesita saber. Esta
guía es esencial para algo más que sólo turismo quirúrgico – es algo que
cualquiera que viaje, viva o trabaje en Colombia debe tener.

K. Eckland, ACNP-BC, MSN, RN es una enfermera calificada para ejercer la
medicina.   Ella tiene extensa experiencia en cirugía cardiotorácica –
dentro y fuera de la sala de operación.   Ahora ella comparte sus
descubrimientos desde su última investigación sobre la industria del
turismo médico y servicios disponibles en Bogotá, Colombia.  Traduccion
de Constanza Isabella Ochoa Mendigaña.

November for Colombia’s tourism industry

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This month (November) is a big month for the Colombian tourism industry – and the Colombian government with several big events and meetings taking place to promote the tourism sector.

This week, the Secretary – General of the United Nations World Tourism Organization (UNWTO)(who knew such things existed?) heads to Bogota to participate as a guest of the Colombia’s minister of tourism – as part of the Tourism Race 2011..

Later this month – at the JW Marriott in Bogota – is the high end tourism conference, “Chic Travel Market“which promotes luxury tourism to Colombia.  I’m not sure if surgical tourism counts as luxury tourism but it sounds interesting, nonetheless.  (I consider surgical tourism to be “life-saving tourism”..)

iTunes book catalog

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It looks like after several weeks of tedious reformatting to meet Apple’s strict e-book standards – the revised 2011 edition of Cartagena! will be in the Apple iBook catalog.  I’m still working on re-formatting The Thoracic Surgeons, and I have barely begun Bogota.

However, the Spanish translation of Bogota! is complete – so once I finish some formatting and final editing – I’ll be publishing Bogota! en espanol to Amazon.com. Loks like I have a couple of weeks in front of the computer ahead of me but let’s hope that everything goes smoothly.

Free trade, Colombia and Medical Tourism

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A new trade agreement between the United States and Colombia may usher in a new era of economic growth and strengthen political ties between the two nations.

As reported in Colombia Reports, Colombia’s biggest English language news source, while some experts caution that parts of this trade agreement may temporarily lower prices of some Colombian goods – other economic forecasters believe that this will bring financial growth and economic stability to both countries. In this webpage from US Government trade officials – the proposed benefits of this alliance our outlines – with job creation as a number one priority. I have contacted Ellie Shay at the Office of the United States Trade Representative for further comment on how this new agreement will impact medical tourism and travel to Colombia, and am awaiting a  response.

What will this new trade agreement mean for medical consumers and medical travel, if anything?  The Huffington Post previously predicted big wins for Colombia (2010, July) but is it too early to tell what impact this will have on the burgeoning medical tourism industry?

We’ll keep this story updated as it develops.

 

 

More mobile applications

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As you know, I am a nurse practitioner and medical writer  – not a programmer, but I am still working on expanding our mobile applications to include Apple, Kindle, Blackberry and other mobile products.

The latest version of “The Bogotá Companion” is a bit more limited than previous Android Market versions.  (The new application doesn’t allow for some of the features such as interactive maps.)  However, it does have video clips, some links to helpful travel information and feeds to our blog.

Here’s a browser app version..

Interview with an Escape Artist

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I had an interesting telephone interview with Jane MacLean Craig from the Escape Artist.com, a website for north American ex-pats, retirees and other people interested in living overseas.  She’s currently writing her fifth (or sixth?) book.  Her latest book is about overseas living, and we talked about the medical tourism and medical care abroad as part of that.

She’s very easy to talk to – and I love talking about the book and my day-to-day life as a nurse practitioner in cardiothoracic surgery, so we had a fine time!  I even talked a bit about my own experiences as a patient last winter, and how it sparked the Bogota book.

Her book is untitled as yet – but will be published by Random House in early 2012, so we’ll keep an eye out for it in the future..

Goodreads Giveaway ends Sept 18th!

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Just a reminder – your chance to win a free autographed copy of (the newly revised) Bogotá! a hidden gem guide to surgical tourism ends September 18th.  You can still enter here!

If you aren’t familiar with Goodreads – it’s an on-line ‘Book Club’ that allows people to share their reviews of their favorite (and not so favorite books.)  It also allows readers to catch up with and connect with their favorite authors..

More photos from Bogota event

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Back stateside, and bracing for Irene.  We are pretty far inland so probably just a lot of rain and refugees from the storm but the sky is black and still – so you never know.  I missed the recent earthquake – safe in Colombia! and despite being a historic home, it was a small quake (5.8) so we made out just fine.

I have some more pictures – sent over from Author’s Cafe that I thought I’d share.  Readers will recognize most of the players – since it was a ‘thank you’ party to everyone that participated in the book.

with Ximena Reyes, RN

 

 

 

 

 

 

 

Dr. Gamboa looks really stern, but that’s not his nature at all – they just caught him in-between laughs.

with Dr. Gamboa and a friend

with Dr. Francisco Cabal, Orthopedic Surgeon, Medical Director of Clinica del Countrywith Ximena Reyes, RN

Dr. Roosevelt Fajardo (left) and Dr. Francisco Holguin

More scrutiny for medical tourism and patient safety.

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Another article detailing the importance of investigative medical writing projects such as the Bogotá book.  Hopefully, this increased scrutiny will bring more attention to projects such as this – and the need for a comprehensive, detailed review of services by qualified individuals.

Maybe this will bode well for a possible Cali book in the future.

Interview

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Just had a really nice visit with James Gherardi, and his cameraman from the local TV station, WSET – 13 to talk about the book.  Now if only all my poise hadn’t suddenly fled – leaving me an awkward mess!  Gratefully, all my loyal readers know that despite all outward appearances, I really am a capable, competent individual with full use of my faculties.

Lets hope viewers are as kind.

It is scheduled to air as just a quick segment this evening at 6pm.. and let me warn my devoted readers – yes, I had a hair tragedy, but it’s only temporary (and for a good cause!)..

Independent Authors & Writers

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Excited to report that I have received “Book of the Day” on Independent Authors & Writers.org. You can check out their facebook site here.

I’ve also added a link to their blog, here at WordPress.

As many of my long-time readers know, it’s very difficult to get books like this published by commercial publishing houses – since it’s considered a ‘niche’ title with limited marketing potential.  Of course, I hope to prove them wrong but I am grateful to organizations like the Independent Authors for giving unknowns like myself a chance to be discovered by the reading public.

For all my Colombian readers, I am bringing copies down to Bogotá next month – they will be available at Authors Cafe – Calle 70, No. 5- 23.  (Otherwise, it’s about 30 dollars to have a copy of the book shipped from the US.)

Final drafts.

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Looks like I am getting closer to the finish line; I submitted what is (hopefully) the last and final draft last week.  After one last round of review – it will be off to the publisher.. (This is the most frustrating part of the process – it’s all formatting issues – unrelated to content.)

Otherwise – the book looks pretty darn good!

Proof copies!

Proof copies!!

 

 

Single incision laparoscopy revisited

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A new abstract published [ and re-posted below] in advance of the article – confirms what Bogotá surgeons already know –

Uniport or single incision laparoscopy is a safe, effective surgical treatment which reduces post-operative pain, length of stay and recovery time for patients while providing better cosmetic outcomes.

Surprising to me, it seems there is still hesitation among surgeons in the United States to adopt this technique for routine procedures such as appendectomy, or cholecystectomy.  In fact, during a recent multi-day tour of Duke University – I was unable to find out information/ or confirm the use of this technique by a single surgeon in the facility.  [My methods were by no means definitive or scientific – I questioned surgeons and anesthesiologists but it’s possible that surgeons using this technique were not identified.  However, the majority of people I spoke to didn’t know what SIL was, and required a description of the procedure, which adds to my suspicions that this procedure is not being performed at Duke.   I will be back at Duke later this month, and will continue to investigate.]  if true, this is a significant finding, and failure in American surgery – Duke is one of the leaders in surgical innovation and emerging therapies.

Now the abtract below talks about increased surgical time – which is true, initially as surgeons learn the technique.  However, as surgeons become more experienced in this procedure, this is no longer the case. In the cases I observed in Colombia, there was no increase in surgery time – but the surgeon has been performing this technique for several years.

Correction:  Despite what I was initially informed – Duke general surgeons do use SILS, and use the single incision laparoscopy approach as part of their living donor kidney transplantation.    I apologize for the error. 

Abstract re-posted below:

 Single incision laparoscopic cholecystectomy (SILC) versus laparoscopic cholecystectomy (LC) – a matched pair analysis

Source

Department of Surgery, Krankenhaus der Elisabethinen, Fadingerstrasse 1, 4020, Linz, Austria, odogangl@yahoo.com.

Abstract

INTRODUCTION:

The aim of our study was to compare single incision laparoscopic cholecystectomy (SILC) and laparoscopic cholecystectomy (LC) with respect to complications, operating time, postoperative pain, use of analgesics, length of stay, return to work, rate of incisional hernia, and cosmetic outcome.

METHODS:

Sixty-seven patients underwent SILC. Of a cohort of 163 LC operated in the same time period, 67 patients were chosen for a matched pair analysis. Pairs were matched for age, gender, ASA, BMI, acuity, and previous abdominal surgery. In the SILC group, patient characteristics (gender, age, BMI, comorbidities, ASA, previous abdominal surgery, symptomatic cholecystolithiasis, cholecystitis) and perioperative data (surgeon, operation time, conversion rate and cause, intraoperative complications, postoperative complications, reoperation rate, VAS at 24 h, VAS at 48 h, use of analgesics according to WHO class, and length of stay) were collected prospectively.

RESULTS:

Follow-up in the SILC and LC group was completed with a minimum of 17 and a maximum of 26 months; data acquired were recovery time the patients needed until they were able to get back into the working process, long-term incidence of postoperative hernias, and satisfaction with cosmetic outcome. Operating time was longer for SILC (median 75 min, range 39-168 vs. 63, range 23-164, p = 0.039). There were no significant differences for SILC and LC with regard to postoperative pain measured by VAS at 24 h (median 3, range 0-8 vs. 2, range 0-8, p = 0.224), at 48 h (median 2, range 0-6 vs. 2, range 0-8, p = 0.571), use of analgesics, and length of stay (median 2 days, range 1-9 vs. 2, range 1-11, p = 0.098). There was no major complication in either group. The completion rate of SILC was 85.1% (57 of 67). Although there was a trend towards an earlier return to the working process in patients of the SILC group, this was not significant. The rate of incisional hernias was 1.9% (1/53) in the SILC and 2.1% (1/48) in the LC group indicating no significant difference. Self-assessment of satisfaction with the cosmetic outcome was not judged different by patients in both groups.

CONCLUSION:

SILC is associated with longer operating time, but equals LC with respect to safety, postoperative pain, use of analgesics, length of stay, return to work, rate of incisional hernia, and cosmetic outcome.

Langenbecks Arch Surg. 2011 Jun 22. [Epub ahead of print]