Surgeons trained to put patients on lists, says doctor

Waiting lists for surgeries in Quebec are growing, but the pandemic only exacerbates an enduring problem.

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For Dr. Robert Turcotte, president of the Association de l’orthopédie du Québec, “surgery is a bit of the poor child” of the health system.

“We have always had waiting lists. Lists, yes, some attention has been paid to it in trying to limit the deadlines, but the injection of resources has been severely limited, ”he says.

He denounces in particular that surgeries are more valued in other provinces.

“Most of my colleagues in Canada operate two days a week, whereas in Quebec, the average is more than one day, maybe a day and a half a week,” says Dr. Turcotte.

“So we are expensive trained surgeons and maybe we spend more of our time putting patients on our waiting list than operating them,” he adds.

Between 130,000 and 140,000 patients are currently awaiting surgery, according to the doctor.

Even if Quebec has announced the sending of reinforcements to hospitals, this assistance will be of little use for operating theaters, assures Robert Turcotte.

“In the operating room, it may prevent nurses from the operating room being withdrawn to go to intensive care or the emergency room, but certainly not that CLSC nurses will be useful for our patients on the waiting lists,” he says.


No more premiums for surgeons to arrive on time

The $ 110 bonus paid to surgeons who show up for surgery before 8 a.m. will soon be a thing of the past.

From next Monday, the “attendance bonus” will no longer be able to be billed by specialists, as has been the case since 2011.

“At the time, it often happened that surgeons arrived at nine o’clock and it delayed the operating room,” said the director general of the Institute for the relevance of medical acts (IPAM), Jean-François Foisy.

This amount was negotiated by the former president of the Federation of Medical Specialists, Gaétan Barrette and the former Minister of Health, Yves Bolduc.

Anesthesiologists too

In 2018, our Bureau of Investigation revealed that the RAMQ had paid $ 41 million over three years for this bonus. Several nurses and even medical specialists were outraged.

The sum is paid to the surgeon if the anesthesiologist takes care of the patient before eight in the morning.

They are also entitled to an attendance bonus which will be abolished.

The only exception is that surgeons can continue to bill $ 22.15 per 15 minutes for procedures between 5 and 7 p.m. Previously, they could invoice as early as 3 p.m.

This is in addition to the amount billed for the surgery itself.

The end of the attendance bonus is one of the first measures taken by the Institut de la relevance created following the compensation agreement between Quebec and the FMSQ in 2019.

The money saved will have to be used in particular to improve access to specialized medicine.


In addition to the repeal of the attendance bonus, another measure will come into force on Monday.

It will no longer be possible to bill for x-rays for patients suspected of having sinusitis.

“This type of exam will no longer exist. We want to eliminate exams with low added value, ”says Jean-François Foisy.

By 2023, the Institute should have identified $ 240 million in “relevance” in the billing of medical specialists.


Girl walks normally after Dubai surgeons correct club foot

The surgery was conducted as Aster Hospital, Mankhool
Image Credit: Supplied

Dubai: A one-and-a-half year-old girl, who underwent a life changing foot correction procedure as soon as she was born and for several months thereafter, is able to walk normally thanks to the surgeons of Aster Hospital Mankhool.

The girl, who was born on July 15, 2019, had a congenital abnormality called ‘Club foot’ from birth. In fact, doctors had detected the anomaly before birth during an ultrasound and counselled the parents regarding the surgery. The newborn underwent the correctional surgery in September when she was two months old and had to undergo splinting of the site and special shoes for one-and-a half years until her left foot and ankle grew normally.

Elaborating on the case, Dr Alexis Jude Dominic Xavier, specialist orthopaedic surgeon at the hospital, who performed the procedure said, “The child suffered from Congenital Talioes Equuino Varus (CTEV) commonly known as club foot. This is a congenital foot deformity in newborn babies. The deformity develops in the uterus at about the third month of pregnancy during which the foot starts to turn inward. It can affect both legs but in this case the deformity was only in the left leg of the baby.”

Dr Xavier explained that in this case, the baby was born with the left foot smaller, turned inward and downward with the heel pointing outwards with tight structures affecting the muscles and tendons around the ankle and foot. “Without treatment, it would have impacted the child when she started walking, causing excruciating pain, limping and difficulty in walking. Our main objective was to correct this deformity right after birth so that she would have no complications with her foot while growing up. The procedure we have used is called the ‘Ponseti Method’ named after its pioneer, Dr Ignacio V Ponseti and involves an in-depth knowledge of the functional anatomy of the foot and responses of muscles, ligaments and bones. Using this method, we were able to perform the corrective surgery,” he explained.

The treatment continued and for over a year. After use of five corrective casts, from toes to thigh, applied once a week, the foot and ankle was assessed thoroughly again. A Tendo Achilles Tenotomy (cutting open a tendon at the back of the heel) was performed to achieve a full correction of the foot. The foot was then plastered for three weeks and then a custom-made splint was prescribed for the child. By the time the child was about nine months old, she began to walk and was given special shoes to prevent the recurrence of the deformity. By the time the child is ready to attend preschool, she will have a perfectly functioning leg, requiring no further treatments other than regular follow-ups.

Dr Sherbaz Bichu, CEO, Aster Hospitals and Clinics, UAE, said:“The parents were kept informed and intimated about the leg deformity of their child at every stage of the pregnancy. Doctors have worked together to ensure that the baby received the corrective procedure right after her birth. The parents have shown immense trust in our doctors and our doctors have been able to perform the correction up to their expectations. The child has begun walking without any complications and that in itself is the reward of our efforts.”


Dubai surgeons remove a massive heart tumour to save young expat’s life

Janak Bahadur posing for camera after successful surgery at the NMC Hospital, in Al Nahda. Dubai.
Image Credit: Antonin Kélian Kallouche/Gulf News

Dubai: In a three-hour surgery carried out on December 28, a heart surgeon in Dubai excised a large tumour that had grown in the heart of a young Nepalese expatriate.

According to the doctor, the tumour that was 10cm long and 6cm in width was the largest reported heart tumour in the UAE and was occupying the full space in the left atrium of the patient pressing upon his mitral valve.

Dr Girish Chandra Varma, Cardio-thoracic surgeon add head of the department at the NMC Specialty Hospital, Dubai, told Gulf News: “The patient, Janak Bahadur Karki, was suffering from a rare benign tumour called left atrial myxoma. The 37-year-old laundryman working at a Dubai-based five-star hotel came to me two weeks ago with classic symptoms of valve disease. He was complaining of incessant coughing and breathlessness. A scan revealed the huge myxoma was growing between the walls of the left and right atrium. The tumour almost blocked the left side of his mitral valve. He came to us at the right time as there was a risk of the tumour getting attached to the walls of the atrium,” said Dr Varma.

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Left to Right, Dr Girish Chandra Varma, heart surgeon, Janak Bahadur Patient, and Dr Sunil Shetty, at the NMC Hospital, in Al Nahda. Dubai.
Image Credit: Antonin Kélian Kallouche/Gulf News

The patient had a good recovery post-surgery and was weaned off the ventilator in six-eight hours. He had begun taking food orally the next day said Dr Varma who expects the patient to be discharged from hospital in a few days. “He will be able to resume his normal life and activities in a few days,” added Dr Varma.

No more cough or breathlessness

Karki, whose persistent cough has disappeared, is thrilled with the surgery. “I had a very bad and incessant cough, which refused to respond to any medicine and even a light jog of two seconds would make me gasp for breath. I had no idea such a huge tumour had been growing inside. I am so relieved that I am not coughing anymore and hopefully, as I heal and gain strength, I will be able to run without feeling breathless,” said Karki who is looking forward to playing some sport with his 12- year- old son.

What is an Atrial Myxoma?

An atrial myxoma is a non-cancerous tumour in the upper left or right side of the heart. It most often grows on the wall that separates the two sides of the heart. This wall is called the atrial septum. Going by previous precedents, a myxoma has a growth rate of 1.36×0.3 cm/month. Going by this rate of growth, in the case of Karki, it appears that the tumour may have been growing within his heart for at least eight-nine months, prior to the diagnosis, approximately.


Hamdan hails pioneering surgery conducted by Emirati surgeons

Shaikh Hamdan bin Mohammad bin Rashid Al Maktoum, the Crown Prince of Dubai and Chairman of the Dubai Executive Council, with the Dubai Health Authority (DHA) team.
Image Credit: Twitter

Dubai: Shaikh Hamdan bin Mohammad bin Rashid Al Maktoum, the Crown Prince of Dubai and Chairman of the Dubai Executive Council, took to twitter to praise the pioneering surgery conducted by Dubai Health Authority (DHA) surgeons.

Earlier this month, a 20-member multidisciplinary team headed by Dr Mohammad Olama, paediatric and functional neurosurgeon from Rashid Hospital and Dr Muna Al Tahlak, obstetrician, gynaecologist and CEO of Latifa Hospital for women and children, carried out the complicated five=hour intra uterine surgery on a 25-week male foetus to correct Spina Bifida, a congenital spine defect. This was a first intrauterine surgery for the UAE and the region.

Shaikh Hamdan expressed his pride on twitter. He tweeted two messages spefically congratuating the team and also heaping praise on the stellar contribution of the medical fratenity.

He tweeted: “Our expert Emirati medical talents continue to uplift our confidence in our health care services. To all our medical and nursing staff, you are extremely valued. Thank you for your tireless efforts. The health and happiness of our society is in your hands.”

In the next tweet, he congratulated the Emirati medical team for their pioneering surgery and expressed great pride in the efforts the team made to bring relief and happiness to an Emirati mother.

Spina Bifida is a congenital neural tube defect that occurs in the first month of pregnancy where the spinal cord does not develop or close properly leaving open a bundle of nerves in a sac on the patient’s back. One of the most common causes of Spina Bifida is a deficiency of folic acid in the mother.

These exposed nerves can seriously affect the mobility of the child, disrupt bladder functions and normal healing capacity of the body as well as cause hydrocephaly (filling up of the cerebrospinal fluid in the brain) which requires a brain shunt surgery later. The defect was picked up in the young Emirati mother of two healthy children in her third pregnancy during an ultrasound in the 24th week of her pregnancy. A foetal MRI confirmed the position and location of the spision.

According to members of the team, the foetus which is due to be delivered by the 34th week of pregnancy via C-section, will provide precious time for the spine to develop well.

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Surgeons from the UAE health ministry conduct three robotic surgeries to correct uterus prolapse in Sharjah

The surgeries took place at the Al Qassimi Women and Children’s Hospital in Sharjah. Picture for illustrative purposes only.
Image Credit: AP

Dubai: The Ministry of Health of Prevention recently conducted three surgeries for uterine prolapse using the Da Vinci Robtic surgical system. This is the first time such surgeries are being conducted in the UAE.

The surgeries that took place at the Al Qassimi Women and Children’s Hospital in Sharjah display the success of the newly-introduced robotic surgery programme in gynaecology developed by the health ministry.

The three surgeries were carried out by Dr Labib Riachi, Reconstructive Surgery and Robotic Gynecology specialist. Dr Riachi used the robotic arms connected to 3D laparoscopy. The painless surgery was done through a small opening in the abdomen and patients went home within 24 hours without complication and with minimal pain compared to traditional surgeries.

AI powered surgeries the future of health care

The achievement crowns the efforts being made by the Visiting Consultant Office, which is doing its best to bring about its strategic goals set by the ministry concerning robotic operations, and reaffirms the ministry’s keenness to support the Visiting Consultants Programme with the latest equipment and technologies to render quality health care services for patients.

Complimenting the team on this milestone achievement, Abdul Rahman bin Mohammad Al Owais, Minister of Health and Prevention, stressed that the ministry was keen in harnessing the latest robots to conduct surgeries, and was doing its utmost to redouble its achievements in the artificial intelligence field. “This stems out of the wise directives of the UAE government, which seeks to become an excellence hub in the Middle East for performing robotic surgeries in most medical specialities,” Al Owais said.

Emirati doctors to be trained in robotic surgeries

Dr. Mohammad Salim Al Olama, Under-Secretary of the Ministry of Health, further added that a total of 126 robotic surgeries had been successfully carried out under the aegis of the health ministry between 2019-2020 in addition to 130 clinical consultations in 6 medical specialities. He lauded the remarkable achievements made by the medical team of Al Qassimi Women’s & Children’s Hospital and Al Qassimi Hospital in cooperation with the Visiting Consultants Programme. Al Olama said: “The programme sought to establish a centre to train Emirati doctors and qualify them to use robots safely and in all specialities.”

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Technology US

Surgeon Simulator 2 is now free for NHS surgeons

Bossa Studios, the developer behind the cult classic Surgeon Simulator and the recently released Surgeon Simulator 2, has taken the bold step of making Surgeon Simulator 2 free for doctors, nurses, and surgeons working in Britain’s National Health Service. To get your copy, all you need is a working NHS email address, a PC, and this link.

The Surgeon Simulator franchise is known for its antic, physics-based model of surgery; it is in no way similar to the actual thing itself, which for casual players is a blessing. “Surgeon Simulator 2 is absolutely NOT a viable medical training tool,” said Dr. Idris Morgan in a press release. Morgan is a real doctor who also streams and makes YouTube videos under the name Doctor Mim.

A screenshot of Surgeon Simulator 2.
Bossa Studios

“However, I do enjoy playing video games in my spare time and I’m confident medical professionals around the world will find Bossa’s interpretation of medicine, and the possibility of five-second heart-transplants, very amusing,” Morgan added.

Truly. Surgeon Simulator 2 is out now on the Epic Games Store. And more importantly: NHS workers can pick up their free copies of the game until October 22nd.

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