Posts Tagged ‘surgery’

Waking up during surgery – what are the chances of a patient to come to his senses during surgery

Tuesday, March 12th, 2013

 Oxford – The thought of waking up during general anesthesia while the surgeon is using the scalpel is just so disturbing that the risk of intraoperative awareness (AWR) is often overestimated by the general public. A survey conducted with the participation of all British anesthesiologists reveals just how rare these sorts of events are.

The National Audit Project 5 “Accidental awareness during general anesthesia” (AWR) included the two societies RCoA (Royal College of Anesthetist) and AAGBI (Association of Anesthetists of Great Britain and Ireland) and all anesthesia specialists in the United Kingdom in order to record all events of AWR in 2011.

More than 80% of interrogated doctors have filled out the questionnaire revealing an incident  AWR in of 1 in 15414 or 0.0065 %.

This study is by far the largest study ever conducted on this subject and is considered to reveal credible information.  Reassuring is that only 30% of the AWR events occurred during the actual surgery. Another 47% were in the induction phase and 23% in the recovery phase.

 

Source of the article here

Experience is privileged in the field of surgery

Tuesday, February 5th, 2013

 

The patients, who have suffered a surgical intervention by an experienced surgeon, have a rate of mortality on long term with 22% inferior to those who have been treated by surgeons with a lower volume of surgical interventions in their list of achievements.

According to which criteria should one chose his/her doctor or surgeon in case of a relatively severe disease? The experience is an important factor of the doctor´s quality. A new proof has been given by Swedish researchers who have substantiated that a patient suffering of oesophagus cancer benefits from a longer survival on long term if he/she has been operated on by an experienced surgeon, who has the experience of such difficult interventions, in comparison with a novice or a doctor not specialized in this pathology. As one could have suspected, they have substantiated it in a masterly manner. The researchers at the Institut Karolinska, who have published their result on the 7th of January in The Journal of Clinical Oncology , estimate that the surgery of the oesophagus cancer should be concentrated in the hands of licensed surgeons.

The surgical removal is the basic treatment of the esophagus cancer. This is a difficult intervention, but it allows to a certain number of patients to be healed and to others to have a survival of more than 5 years. The Swedish study tilted on 1335 operated patients between 1987 and 2005 in Sweden, who have benefited from a regular supervision until 2011. The authors analyzed the global surgical volume of the hospitals where each patient has been operated on, the number of this kind of interventions realized each year by the surgeon being in charge of the patient and his/her experience accumulated in the respective field since the end of the academic course. They have then analyzed the survival period of the patients according to the surgeon´s experience.

The results are quite spectacular, as the patients operated on by physicians having a high cumulated surgical volume  present a less than 22% long term mortality risk in comparison with the surgeons having a low surgical volume in their list of achievements in this kind of pathology. However, the hospital´s surgical volume has no effect on the long term survival. It is clear for the researchers having led this evaluation, that this type of surgery must be centralized to some surgeons having a great experience in these important and difficult interventions.

The question of the surgeon´s training exceeds the framework of the oesophagus cancer. A study in France has shown, for example, that concerning the removal of the prostate for cancer reason, the risk of death during the surgical intervention is multiplied by 3,5 when the surgeon makes less than 50 removals per year, in comparison with the surgeon who makes more than 100.

Source of the article here

The German experience of a young Romanian Surgeon

Tuesday, December 11th, 2012

Once Romania entered the European Union in 2007, significant advantages for the highly skilled and educated were created with the liberalization of the labor-market.

Gabriel B. lives in Germany since 2007, and is currently in the 5th residency year as a General Surgeon. After graduating medicine in 2007, Gabriel moved to Nordrhein-Westfalen in a city with about 25 000 inhabitants in order to start his medical career.

The hospital in which Gabriel is currently working, benefits of 150 beds for inpatient care and 59 beds for the surgical department. Offering high quality diagnostic and therapeutic procedures with comprehensive and modern medical equipment, combining high tech medical care with humanity and personal attention is a high priority of the hospital. The hospital benefits from:

  • CT scanner
  • Ultrasound devices
  • High quality video and X-ray systems
  • Zeus and Cicero devices

“Starting off in a smaller city and a smaller hospital is ideal for foreign doctors. Accommodation with the system and integration in the medical team is the key factor and one of the hospitals focal points when it comes to foreign doctors. Colleagues are patient and helpful, soon I felt like part of the team”, stated Gabriel.

“Social integration is also not an issue. Living in a smaller city, and working with people for people, especially in the respected field of medicine grants you rapid recognition. People greet me on the street, so we get to know each other resulting to mutual respect and of course friendship.

But, of course social integration does not only mean receiving recognition, it also means sharing interests. For example Germans value their gardens, spending a decent amount of their time gardening and making their front and back gardens esthetic. Of course they also love their home, their cars, their sports and to travel,” added Gabriel.

“The home environment is another plus. I enjoy getting to live in a two story house with a beautiful front and back garden in a nice and peaceful neighborhood. I don’t live by myself in the whole house, I have upstairs neighbors but its ok we don’t bother one another, the house has different entrances so we don’t have to bump into one another unless we want to”, stated Gabriel.

A common misconception is created when it comes to thinking about smaller cities. People think that smaller cities bring no opportunities for leisure and entertainment, schools and employment for the rest of the family.

“I can honestly say that in a radius of 20km you can find everything! Pharmacies, schools, kindergartens, cinemas, theaters, malls, stores like H&M or Zara, restaurants ranging from Chinese, Italian and Turkish to restaurants with traditional German food, and of course McDonalds and Burger King.

Sports and other outdoors leisure activities are also easily accessible. Tennis courts, football fields, swimming-pools and indoor swimming pools are close by. Spas and Gyms are easily accessible. Besides all the above, Nordic walks, hiking and biking are sought after activities here in Germany”, stated Gabriel.

Getting from A to B

“One of the most important things about Germany is its infrastructure. Airports, highways, freeways, bike lanes, public transport… they all seem to eat up the distance between different cities, counties and even different countries. No wonder the Germans love to travel!” stated Gabriel.

“I can honestly say I’m proud to make part of the community in the city I live and work in”, Gabriel B.

Surgery is a team effort

Wednesday, August 29th, 2012

 

Berlin – “Surgery consists of more than just the pure surgical act” , this statement was pointed out by the German Society of Surgery, prior to a joint session noted with different sub-affiliates in August.

“A well performed surgery is not composed by only the professionally executed operation, rather it is the result of close teamwork between surgeons and anesthesiologists, emergency medicine physicians, nurses, physiotherapists and experts from quality and safety management,” said Hartwig Bauer, The president of the German Society of Surgery.

All the different indispensable specializations that intertwine and contribute to the success of the surgical act provide services that the surgeon itself can’t manage by himself, emphasized Bauer.

Patients are often unaware about the complex process management and close cooperation involved for their treatment and often overlook the importance of every individual that is involved in their treatment process.

Remember! A doctors work-life is based on team-work and multidisciplinary cooperation!

 

Source of the article here

Online waiting lists form July

Tuesday, May 22nd, 2012

July brings Hungary the first online national waiting list registration system, a system that is meant to be easy to keep track of, highlighting the number of people waiting for various operations throughout the country. 

Zsolt Kiss, the National Health Insurance Fund Strategic Head of the Division of MTI, stated that the new system is a key element for patient choice, because the patient will always follow the money. For example, by accessing the national register and the NHS, a patient can see the institutions in which a certain procedure in made, and can also see the number of patients in front of him waiting for the same procedure. This knowledge will give the patient the capacity to choose the institution.

As explained, the National Health Insurance Fund managed by the new system will be able to keep track of the waiting lists, of the needed treatments and costs of treatments, for example number of painkillers needed for each patient, what kind of care for chronic treatment was received, how many sick days, etc.

The totals, together with the surgery itself provide a clearer image of what the total necessary costs will be.
Zsolt Kiss emphasized that for example in the case of spinal surgery where the waiting list is for years, the NHS will redirect its capacity to eliminate these disparities. Meanwhile the basic rules do not change, said the Head of Department.

All in all the leading institutions are therefore pleased with the new concept of a more transparent system, with rules that disable doctors to forward some patients up the list without purely technical reasons.

The new registration system for the NHS is based on the principle of responsible management of the waiting lists. Zsolt Kiss emphasized that the hospital information system is already there, it just needs to be launched on a nation-wide basis in order to fill out the lists.

source of the article