Why the cost of laparoscopy for infertile couples should be zero
A major problem with infertility treatment is that they can be so expensive. This is a major limiting factor for infertile patients , who are obviously going to try looking out for the most cost effective doctor.Thus, they will shop around and try to find out what the cost of a laparoscopy , so they can find the doctor who is cheapest and will do it for the lowest price.The problem is lots of doctors will do laparoscopies cheaply , but they will not do a good job. Thus, they will not do any video documentation , as a result of which the patient doesn't know what was done. There is no video record of the surgery, so th...
Source: Dr.Malpani's Blog - August 3, 2018 Category: Reproduction Medicine Source Type: blogs
A Look Back in Time: Free Internet Access in Hospitals
This note marks the beginning of a new continuing series in which I will look back in time and quote an earlier blog note. I will then comment about how the key ideas covered earlier have changed in the ensuing years.In January, 2006, I posted a note about the innovative idea at that time of providing free Wi-FI to patients and visitors in a hospital (see:Free Wi-Fi for Patients in Hospitals). Here is a quote from the article:TheRichardson Regional Medical Center now provides free Wi-Fi Internet access to patients and visitors throughout the hospital.What started as a WLAN to support paperless charting became a broader dep...
Source: Lab Soft News - August 3, 2018 Category: Laboratory Medicine Authors: Bruce Friedman Tags: Healthcare Business Healthcare Delivery Healthcare Information Technology Healthcare Innovations Quality of Care Source Type: blogs
Orthopedic Surgeons are Training in Virtual Reality : Interview with J & J ’s David Badri
The Johnson & Johnson Institute has recently launched a virtual reality training program designed to prepare orthopedic surgeons and nurses for a couple common procedures. The program will expand to other surgeries, but for now it’s focusing on total knee replacement with direct anterior approach and hip fracture treatment with a proximal femoral nail. The hope is that using virtual reality to learn and practice surgical techniques will help improve clinical outcomes for patients.
We spoke with David Badri, Virtual Reality and WW Professional Education at Johnson & Johnson, about the new program and what it ...
Source: Medgadget - July 16, 2018 Category: Medical Devices Authors: Editors Tags: Exclusive Orthopedic Surgery Source Type: blogs
TransEnterix Senhance Surgical Robotic System Cleared for Hernia Repair and Gallbladder Removal
TransEnterix, the first real competitor to have emerged to Intuitive Surgical in the assisted surgical robotics field, just won FDA clearance for new indications for its Senhance System. Specifically, laparoscopic inguinal hernia repair and laparoscopic cholecystectomy (gallbladder removal) procedures can now be performed with the Senhance.
The Senhance is already cleared for colorectal and gynecologic procedures, but considering the frequency of inguinal hernia repairs and laparoscopic cholecystectomies, the new clearance effectively doubles the number of cases that the system can be used on.
“We have utilized Senhanc...
Source: Medgadget - May 29, 2018 Category: Medical Devices Authors: Editors Tags: Surgery Source Type: blogs
Rethinking consent in the age of Facebook and Cambridge Analytica
As physicians and particularly surgeons, we deal with consent all the time. The process can be complex particularly for pediatric surgeons because we obtain it from the parents and the participation of the child in that process varies. For example, it is not unusual to be confronted with a parent who wants their child to undergo an elective operation. Yet that child, being 15 years-old, may have zero interest in submitting themselves to that procedure. The other end of the spectrum can be vexing as well when you have a power of attorney/family member trying to make medical-legal decisions for a demented, legally incompeten...
Source: Kevin, M.D. - Medical Weblog - May 27, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/peter-f-nichol" rel="tag" > Peter F. Nichol, MD, PhD < /a > Tags: Social media Facebook Practice Management Source Type: blogs
What could be worse than being sued for malpractice? Prison.
Kang Se-hoon, a surgeon in South Korea, operated on a popular rock singer and song writer in October 2014. According to reports, Shin Hae-chul had abdominal pain, and the surgeon performed laparoscopic lysis of adhesions. Without having obtained consent, he decided to also do a weight reduction procedure.
The patient was discharged a few days after surgery but returned a day later with fever and severe abdominal pain. Kang did not investigate the cause of the pain and instead prescribed pain medication. Shin Hae-chul was eventually transferred to another hospital where he underwent an attempt at life-saving surgery.
Ten da...
Source: Kevin, M.D. - Medical Weblog - May 6, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/skeptical-scalpel" rel="tag" > Skeptical Scalpel, MD < /a > Tags: Physician Surgery Source Type: blogs
How the overdiagnosis of TB harms infertile women
A patient sent me this emailI had Laparoscopy 4 months back, was diagnosed with TB PCR, and now I am 5 Weeks Pregnant. My concern is should I continue the medicines prescribed by the doctor? will it cause any birth defect in the baby if i consume the medication like cleft lip ? or will I lose the pregnancy if i don't have the medicines, please advise.These TB PCR tests are very unreliable ! They are plagued by the problem on false positives - read more about this at http://blog.drmalpani.com/2015/03/laboratory-tb-versus-genital-tb.htmlSadly, most gynecologists are routinely treating all their infertile patients with anti-T...
Source: Dr.Malpani's Blog - April 25, 2018 Category: Reproduction Medicine Source Type: blogs
FujiFilm Releases New Minimally Invasive Imaging Systems in U.S.
FUJIFILM is releasing a couple surgical visualization systems that were designed to improve minimally invasive procedures.
The FUJIFILM EL-580FN Ultra-Slim Video Laparoscope System uses the firm’s own Super-Honeycomb CCD sensor to produce high quality images that are sharp and reproduce colors accurately. So-called “Chip on the Tip” high definition digital image processing helps improve quality and anti-fogging features allow for a quality image to appear in the first place. The imaging device is autoclaveable, is light, and features a 3.8 mm distal end diameter, nearly half that of most of the competition. The ...
Source: Medgadget - April 16, 2018 Category: Medical Devices Authors: Editors Tags: Ob/Gyn Surgery Thoracic Surgery Urology Vascular Surgery Source Type: blogs
MKSAP: 41-year-old woman with burning epigastric and chest pain
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 41-year-old woman is evaluated in follow-up after presenting to the emergency department 1 week ago for burning epigastric and chest pain. In the emergency department, a complete blood count and liver chemistry studies were normal, but a radiograph of the chest and upper abdomen demonstrated calcified gallstones. The pain resolved with administration of a liquid antacid, and omeprazole was started. The pain had been present intermittently for approximately 6 months prior to the emergency department visit. It o...
Source: Kevin, M.D. - Medical Weblog - April 7, 2018 Category: General Medicine Authors: < a href="https://www.kevinmd.com/blog/post-author/mksap" rel="tag" > mksap < /a > Tags: Conditions Gastroenterology Source Type: blogs
Laparoscopy and IVF - before, after or never ?
Before referring a patient for IVF to an IVF clinic, many gynecologists will insist on doing a laparoscopy . They justify this using all kinds of pretexts. saying" We will get a chance to check your pelvis, so we can clip your tubes, if needed, or burn any endometriosis." Their justification is that doing this will improve the patient's chance of getting pregnant with IVF. This is false, but poor patients don't know any better. They feel that if they are going to spend so much money on IVF, they might as well spend a little bit more on the laparoscopy, if this will improve their IVF success rate !Removing small fibroids an...
Source: Dr.Malpani's Blog - April 5, 2018 Category: Reproduction Medicine Tags: diagnostic laparoscopy Endoscopy ivf operative laparoscopy Source Type: blogs
Ferromagnetic FMsealer Laparoscopic Shears for Faster Vessel Sealing with Fewer Side Effects
Domain Surgical out of Salt Lake City, UT, which is part of OmniGuide, itself based in Lexington, MA, is releasing new laparoscopic shears based on its ferromagnetic technology. The FMsealer Laparoscopic Shears, unlike bipolar electric devices, do not release electric current into the tissues when transecting and sealing. And unlike ultrasonic shears, a lot less heat is transferred to nearby tissues. The company also claims that sealing times are up to 50% faster compared to bipolar and ultrasonic shears.
This is because thermal energy moves from the active to the inactive jaws and dissipating in the tissues between, cre...
Source: Medgadget - April 3, 2018 Category: Medical Devices Authors: Editors Tags: Cardiac Surgery Ob/Gyn Thoracic Surgery Urology Vascular Surgery Source Type: blogs
My doctor is insisting that I do IVF
A patient emailed me.I have had 2 miscarriages. My doctor advised to take a HSG test. The radiologist reported that my tubes are open, but I may have "peritubal disease " because there is "ampullary coiling" and the "fimbrial ends are clumped" . My doctor is insisting that I go for IVF . Can you please provide a second opinion about my case.This is has become a common racket. A HSG is a black and white shadow, and can only tell us if the tubes are open and closed. They cannot tell us if the tubes are working or not - and they definitely cannot tell us anything about what is happening outside the tubes !However, radiologist...
Source: Dr.Malpani's Blog - February 11, 2018 Category: Reproduction Medicine Source Type: blogs
SensOR Medical Allows Surgeons to Feel Again
It’s no secret: minimally invasive surgeries (MIS) are on the rise. The tools used during these advanced scope-based procedures provide little tactile feedback that surgeons used to experience in open surgeries. Working at a distance means it is hard to gauge the force being applied to tissues. The founders at SensOR Medical Laboratories, a medical device start-up based out of Toronto, Canada, saw this as an opportunity and developed an innovative force-sensing electronic skin, called ForceFilm, that augments the existing tools surgeons use to provide a sense of touch.
“Our ultimate goal is to improve surgica...
Source: Medgadget - February 6, 2018 Category: Medical Devices Authors: Miles Montgomery Tags: Cardiac Surgery Neurosurgery Ob/Gyn Thoracic Surgery Urology Source Type: blogs
I am glad patients are learning to say No !
A patient send me this emailSir, I m having a chocolate cyst in my left ovary of 3.6*2.8 CM and a normal right ovary . My first doctor advice me for immediate laparoscopy. I am trying for around 10 months. I changed my doc as I was scared of surgery. Can you help ?I am glad patients are speaking up and refusing to subject themselves to unnecessary surgery !With today's technology, infertile patients do not need a laparoscopy, but doctors continue to do this for them, without any good reason. Read more athttp://www.drmalpani.com/knowledge-center/infertility-testing/laparoscopy-and-infertilitySuch a tiny chocolate cyst will ...
Source: Dr.Malpani's Blog - January 30, 2018 Category: Reproduction Medicine Source Type: blogs
After Surgery in Germany, I Wanted Vicodin, Not Herbal Tea - The New York Times
MUNICH — I recently had a hysterectomy here in Munich, where we moved from California four years ago for my husband's job. Even though his job ended a year ago, we decided to stay while he tries to start a business. Thanks to the German health care system, our insurance remained in force. This, however, is not a story about the benefits of universal health care.Thanks to modern medicine, my hysterectomy was performed laparoscopically, without an overnight hospital stay. My only concern about this early release was pain management. The fibroids that necessitated the surgery were particularly large and painful, and the...
Source: Psychology of Pain - January 27, 2018 Category: Anesthesiology Source Type: blogs
