Imported surgeons could cut by 80 per cent

`Imported surgeons could cut by 80 per cent...

By Rosemary Mirondo, Ifakara

It has been revealed that Tanzania is the largest exporter of surgery patients for overseas treatment in sub-Saharan Africa due to lack of surgeons and facilities needed to conduct surgery in the country.

This was said by president of the Tanzania Surgical Association, Dr Petronila Ngiloi, during an official opening of the Second Congress of the International Federation of Rural surgeons held at St Francis Hospital, Ifakara on Thursday.

Dr Ngiloi said that 95 per cent of patients went overseas for surgery, while 80 per cent could otherwise be treated locally if the country were to substitute the export of patients with importation of surgeons.

`It is cheaper and less risky for a surgeon to travel to follow a patient than a patient to follow a surgeon and it also strengthens the local capacity,` said Dr Ngiloi.

She said that the association`s target was to have at least one surgeon in each regional hospital.

She added that for 13 years, her association had been striving to promote the art of surgery and inspiring young doctors to take up the trade as their specialty.

Dr Ngiloi said that the number of surgeons in Tanzania was less than 100 for a population of more than 35 million people, leaving the bulk of surgeries to be conducted by medical officers or Assistant Medical Officers.

Elaborating, she said that there were only four pediatric surgeons for the whole country, three neurosurgeons and only two thoracic surgeons who however, did not have the necessary equipment to fully utilise their skills.

She said under such circumstances, patients who needed surgery services could take several months or even years before getting one.

She called on the government to train surgeons in various super-specialties by setting up a programme in collaboration with overseas colleagues.

She added that if one surgeon of a certain special skill was invited during the setting of surgical camps, Tanzania could gain by having more patients operated and it would help capacity building locally so that in a few years there would be non or very few overseas referrals patients.

She also urged the government to improve operating theatres and to recognise the contribution of the private sector saying that 70 per cent of health services in Dar es Salaam were provided by private hospitals.

The Vice President, Ali Mohammed Shein who graced the meeting, commended surgeons who work in rural areas.

He said the burden posed by surgical problems in rural areas especially in developing world was working on constrained budgets leading to inadequate health financial allocations, crisis of human resources and poor infrastructure and illiteracy.

He added that the government would take seriously the importance of developing and promoting rural surgery.

SOURCE: Guardian

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SA surgeon in trailblazing TV operation

SA surgeon in trailblazing TV operation

Xolani Mbanjwa

A leading South African doctor has shown the world how it's done in a groundbreaking surgery viewed by thousands of doctors around the world.

Professor Heine van der Walt, from Pretoria, a world leader in laparoscopic surgery, performed seven surgical operations during a live transmission at Netcare's Unitas Hospital in Centurion, Tshwane, to colleagues around the world.

The operations were broadcast live to a two-day Digestive Apparatus Surgery Conference in Rome, where surgeons and surgical students, including 2 500 conference attendees, watched the procedures on big screens.

Thousands more also viewed the operations in various countries, including Australia, Japan, Belgium and the United States.

While many doctors around the world still cut their patients to perform medical operations, Van der Walt demonstrated the delicate operation, which requires only about three to five holes, no more than 3mm, to be drilled in the surgery area.

He said that while the procedure is expensive, it saves time as most patients take only two days to recover instead of the normal six weeks when they are cut open.

"Instead of cutting a patient to get to a particular organ, you drill small little holes where you insert a camera and your working tools.

"You look at the monitor to view your surgery. It's cleaner, quicker, pain-free and chances of infection are minimal."

It was the third time Van der Walt had participated in the conference to demonstrate what he calls "telemedicine".

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Pioneering surgery cuts out scalpel

Pioneering surgery cuts out scalpel

Provided by: Sun Media
Written by: MEGAN GILLIS

Dr. Marc Ruel has pioneered the surgical technique of placing grafts on a beating heart through an incision a little bigger than a paper-clip.

But even more revolutionary is his research at the University of Ottawa Heart Institute into using cells transplanted from the bloodstream to regenerate the heart without using a scalpel at all.

It's made the surgeon, scientist and scholar the first cardiovascular surgeon to win the Royal College of Physician and Surgeons' prestigious gold medal in surgery.

"Our work at the Heart Institute shows the potential to regenerate the heart and takes us one more step toward new treatments to restore heart function," Ruel said. "We are just scratching the surface in this area. But our cardiac surgery research team is still growing, moving us into the future with a new vision of how cardiac research will evolve."

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Ruel won the gold medal for research that suggests that transplanted cells from the patient's bloodstream could be used to regenerate blood vessels, restoring blood supply to the heart.

Ruel studied medicine at the University of Ottawa but left Canada for a fellowship at Harvard University. He was lured back to Canada with a grant from the Canadian Centre for Innovation, which allowed him to set up a lab.

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'Controversies And Advances' Conference For Cardiologists And Heart Surgeons

'Controversies And Advances' Conference For Cardiologists And Heart Surgeons

Main Category: Cardiovascular / Cardiology News

Stem cell therapy for cardiac regeneration and the controversial issue of medicine and the media will be the focus of the keynote addresses at the seventh annual "Controversies and Advances in the Treatment of Cardiovascular Disease" conference. Conducted by Cedars-Sinai Medical Center at the Beverly Hills Hotel on Oct. 4 and 5, the conference is co-sponsored by the California Chapter of the American College of Cardiology, the California Chapter of the Society of Thoracic Surgeons, and Promedica International CME.

Professional differences of opinion often have stood between heart surgeons and cardiologists, and recent innovations in minimally invasive medical procedures have done nothing to reduce the friction. The ongoing debate as to whether it is better to replace and repair aortic and mitral valves surgically or to manage them medically is just one example. And when considering treatment options for Atrial Fibrillation, the choices are even more diverse -- should the physician opt for minimally invasive surgery, drugs or a catheter treatment? And then there is the highly controversial stent issue -- drug-eluting vs. bare metal which is better?

This major symposium -- one of the very few that brings together both cardiologists and heart surgeons -- will directly explore the controversies and latest medical and surgical advances in an open forum. Many subjects will be addressed in debate formats. Others will be lectures presented by highly respected leaders in their fields.

Lawrence K. Altman, M.D., author of the book "Who Goes First? The Story of Self-Experimentation in Medicine" and a member of the New York Times science news staff since 1969, will be one of two keynote speakers. Altman, senior medical correspondent at the Times, has published an average of 100 scientific stories a year and writes the column "Doctor's World." His remarks will focus on medicine and the media.

A clinical professor at New York University Medical School, Altman has received three Howard W. Blakeslee Awards from the American Heart Association and the George Polk Award for excellence in journalism.

Eduardo Marbán, M.D., Ph.D., recently named director of the Cedars-Sinai Heart Institute, will be the second keynote speaker and will discuss stem cell therapy for cardiac regeneration. Prior to joining Cedars-Sinai, Marbán was a member of The Johns Hopkins University School of Medicine faculty for 22 years, most recently serving as chief of cardiology and professor of cardiology, physiology and biomedical engineering.

Editor-in-Chief of the journal Circulation Research and an expert in molecular and cellular mechanisms underlying heart problems, Marbán is widely known for directing major multidisciplinary research programs leading to gene therapy, drug treatment and stem cell discoveries.

"The field of cardiology is poised for a revolution in which cell-based methods will be used to regrow healthy heart muscle after myocardial infarction or in chronic heart failure. Cardiac stem cells (CSCs) show great promise for regenerative therapy. Before 2003, when these resident stem cells within the heart were first discovered, the heart was thought to have little or no regenerative potential," said Marbán, providing a preview of his address.

"We have isolated cardiac stem cells from adult human and porcine endomyocardial biopsy specimens, differentiated them in vitro and characterized their functional properties. They can regrow healthy heart muscle and blood vessels," Marbán continued. "We also have developed methods to isolate and expand CSCs from routine biopsy specimens; they readily become excitable and contractile. These observations provide both a simple method and a solid rationale for the use of CSCs for autologous cardiac regeneration therapy."

Autologous refers to cells reimplanted within one patient, not transplanted from one person to another.

Marbán came to Cedars-Sinai to serve as the first director of the Heart Institute, which integrates and oversees the development of programs in cardiology, cardiac surgery, cardiac imaging and other areas. He has received funding to support three clinical studies reintroducing cardiac stem cells into heart patients, with first enrollment anticipated early next year.

Additional keynote speakers will include Dr. Jack Lewin, CEO American College of Cardiology, who will speak on healthcare reform.

Program directors for "Controversies and Advances in the Treatment of Cardiovascular Disease" include: Gregory P. Fontana, M.D., cardiothoracic surgeon and vice chairman of Surgery; Raj Makkar, M.D., cardiologist and director, Interventional Cardiology; P.K. Shah, M.D., cardiologist and director of the Division of Cardiology; Alfredo Trento, M.D., cardiothoracic surgeon and director of the Division of Cardiothoracic Surgery at Cedars-Sinai; and John G. Harold, M.D., FACC, cardiologist and President, California Chapter American College of Cardiology (ACC), ACC Governor for Southern California, and a recent Chief of Staff at Cedars-Sinai.

Sessions on Thursday, Oct. 4, will address coronary artery disease (part 1), mitral valve and carotid artery disease, arrhythmias and atrial fibrillation, and the future and new techniques. Friday's sessions look at coronary artery disease (part 2), aortic valve disease, congenital heart disease, and surgery and interventional cardiology. Several lectures and/or debates will be presented on each subject.

----------------------------
Article adapted by Medical News Today from original press release.

The first in Southern California and one of only 10 hospitals in the state whose nurses have been honored with the prestigious Magnet designation, Cedars-Sinai Medical Center is one of the largest nonprofit academic medical centers in the Western United States. For 19 consecutive years, it has been named Los Angeles' most preferred hospital for all health needs in an independent survey of area residents. Cedars-Sinai is internationally renowned for its diagnostic and treatment capabilities as well as breakthroughs in biomedical research and superlative medical education. It ranks among the top 10 non-university hospitals in the nation for its research activities and is fully accredited by the Association for the Accreditation of Human Research Protection Programs, Inc. (AAHRPP). Additional information is available at http://www.cedars-sinai.edu/.

Source: Sandy Van
Cedars-Sinai Medical Center

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Dr. Kenrick Spence Named Top Orlando Plastic Surgeon

Dr. Kenrick Spence Named Top Orlando Plastic Surgeon

Readers of Orlando Magazine singled out Dr. Spence as their #1 choice for the sixth consecutive year

ORLANDO, FL, -- Orlando Magazine, the chronicle of central Florida lifestyle, awarded Dr. Kenrick Spence top honors this month in its annual poll of "The Best of Orlando."

The plastic surgeon was singled out as readers from around the area voted for their favorite restaurants, stores, personalities and more.Although the magazine noted that "quite a few categories got a good shake-up this year," Dr. Spence took the top spot in Orlando plastic surgery for the sixth year in a row.

"To be named top plastic surgeon again by residents of a community that calls itself 'The City Beautiful' is indeed a high honor," said Dr. Spence.Dr. Spence feels it's the relationships he develops with his Orlando plastic surgery patients that probably make the difference between him and other plastic and cosmetic surgeons in Orlando.

He emphasizes patient education to the point that he often provides multiple consultations prior to surgery. He also routinely sets aside time in his daily schedule for one-on-one discussions with patients.Another key to good patient relationships, Dr. Spence feels, is to understand not just patients' physical attributes and aesthetic desires, but to learn about their lives as well. "As a trained, experienced surgeon, it's easy for me to understand 'how' to deliver results.

It's more challenging, and just as vital, to understand 'why.'" Knowing patient motivations helps ensure they are candidates for the procedures they're considering, Dr. Spence explained. It's also a good idea to give thought to 'when' it's the right time for a patient to have a procedure. "We tend to be quite active here in Orlando, and plastic surgery patients sometimes underestimate or overestimate recovery time. When I know about the demands of their jobs and families, I can help them plan."

Dr. Spence has other strategies for ensuring he communicates with patients throughout their plastic surgery experience. Workshops he conducts during the year give prospective patients the information they need to consider all their alternatives and decide whether to pursue plastic surgery in Orlando.

His Web site, devoted to patient education, offers frank, honest information on topics from surgical risks to fees and financing.For more information on Orlando's top plastic surgeon, visit http://www.spencemd.com.

Orlando, Florida plastic surgeon, Dr. Kenrick Spence, specializes in facial plastic surgery, body contouring and breast enhancement for his Orlando area patients. He is fully trained in both cosmetic and reconstructive surgery, and he's certified by the American Board of Surgery and the American Board of Plastic Surgery. For more information, visit the practice on Hillcrest Street in Orlando, call (407) 999-2585, or go to http://www.spencemd.com.

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Navy paid for breast implants for servicewomen

Navy paid for breast implants for servicewomen

THE Australian Navy is paying for women sailors to have breast enlargements for cosmetic reasons, at a cost to taxpayers of $10,000 an operation.Defence officials claim the surgery is justified because some servicewomen need bigger breasts to address "psychological issues''.

Darling Point plastic surgeon Kourosh Tavakoli told The Sunday Telegraph the navy had paid for two officers, aged 25 and 32, to have breast-augmentation surgery at his private clinic. Dr Tavakoli said the women had not been injured but claimed to suffer "psychological'' problems.

"I've had two female officers who have got the navy to pay for breast augmentation for psychological reasons,'' he said. "I know for a fact two patients claimed it back on the navy. They (the navy) knew it was breast augmentation and paid for it.

"I don't know why they pay for it. There's no breast augmentation, that I know of, for medical purposes. You've got to be fair to yourself.'' A Defence spokesman admitted cosmetic surgery occurred at "public expense'' when there were "compelling psychological/psychiatric reasons'', but refused to say how many such cases were taxpayer-funded.

Cosmetic surgery was also provided for servicemen or women who were disfigured by work-related injuries, he said. "Cosmetic procedures undertaken solely for the purpose of preserving or improving a person's subjective appearance will be considered only if the underlying (psychological) problem is causing difficulties that adversely impact on the member's ability to do their job. "Operations purely for cosmetic reasons are not allowed.''

The Sunday Telegraph asked Defence Minister Brendan Nelson, formerly a GP, how many members of the armed forces had received taxpayer-funded cosmetic surgery. A spokesman said figures would not be available until next week.

Australian Defence Association spokesman Neil James defended the practice of taxpayers funding medical proceduressuch as breast enhancement surgery for psychological reasons. He said young men and women were attracted to defence careers because they offered free medical care. This, in turn, improved the efficiency of the force.

"Just as there are in civilian life, there are some females who feel their breasts are too small and if their breasts were bigger, they might be more of a 'normal' woman,'' Mr James said. "If they were lacking in self-confidence, this might provide the measure of self-confidence that would help them tackle their wider job. "There are privacy issues here for people. It's not as if they keep a record of who has had a nose job in the Defence Force over the past 100 years.''

Dr Tavakoli, a member of the Australian Society of Plastic Surgeons, said the navy officers had visited him in 2005 and 2006. Each had had $10,000 worth of surgery, which required a recovery period of at least two weeks. Boosting self-esteem was the biggest motivation for cosmetic surgery, Dr Tavakoli said. The Sunday Telegraph understands Dr Tavakoli is not the usual surgeon used by the navy for reconstructive/cosmetic surgery.

"I don't see a lot of them (naval officers) because they have their own plastic surgeon,'' he said. "I know for a fact they have their own surgeon.'' Last year, a Brisbane surgeon revealed that an army cook had had a taxpayer-funded nose job.

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Plastic surgeons learn new techniques

Plastic surgeons learn new techniques

By...... calgary.ctv.ca
rre

Canada’s plastic surgeons are in Calgary learning some new techniques, in a new way.

On Friday, an expert in body sculpting performed a surgery in a Calgary hospital.

The surgery was then broadcast live to a conference room, in a downtown hotel, for the other surgeons to see.

The live broadcast allows the operating surgeon to answer questions and explain what is going on.
“I think video really gives something that still images, during a lecture, can never do,” says Dr. Fremont Eaves, a body sculpting expert from North Carolina who performed Friday’s surgery.

Over 120 surgeons are taking part in the annual meeting of Canadian plastic surgeons.

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