Urinary diversion and reconstruction surgery

Urinary diversion is a way of surgically rerouting or diverting urine flow from its normal pathway in order to treat the condition of diseased or defective ureters, bladder or urethra, either temporarily or permanently. Using the surgical method of urinary reconstruction and diversion a new way is created for the patient to pass urine.

There are three main types of urinary diversion surgeries
• Ileal Conduit Urinary Diversion
• Indiana Pouch Reservoir
• Neobladder to Urethra Diversion

For all of these procedures, a portion of the small and/or large bowel is disconnected from the fecal stream and used for reconstruction.

Ileal Conduit Urinary Diversion: The ileal conduit urinary diversion surgery is used in patients who have had their bladder removed and is usually used in conjunction with radical cystectomy in order to control invasive bladder cancer. In this procedure, the ureters are surgically unattached from the bladder and a ureteroenteric anastomosis is made in order to drain the urine into a detached section of ileum (a part of the small intestine). The end of the ileum is then brought out through an opening (a stoma) in the abdominal wall. The urine is collected through a bag that attaches on the outside of the body over the stoma. The bag must be periodically emptied of urine.

Indiana Pouch Reservoir: The Indiana pouch surgery is used for patients who have had their urinary bladders removed as a result of bladder cancer, pelvic exenteration, bladder exstrophy or who are not continent due to a congenital, neurogenic bladder. In this procedure, a reservoir, or pouch, is created out of approximately two feet of the ascending colon and a portiom of the ileum (a part of the small intestine). The ureters are surgically removed from the bladder and repositioned to drain into the pouch. A piece of small intestine is brought out through a small opening in the abdominal wall called a stoma. Since a segment including the large and small intestines are utilized, also included is the ileal-ceceal valve. This is a one-way valve located between the small and large intestines which normally prevents the passage of bacteria and digested matter from re-entering the small intestine. After a period of several weeks, the body adjusts to the absence of this valve by absorbing more liquids and nutrients. Unlike other urinary diversion and reconstruction techniques, the Indiana pouch has the advantage of not using an external pouch adhered to the abdomen to store urine.

Neobladder to Urethra Diversion: With the Neobladder to Urethra Diversion procedure, the intent is to create a new bladder that mimics the storage function of a normal urinary bladder. The surgery makes a reservoir or pouch by utilizing a small part of the small intestine and connects the pouch to the urethra. The ureters are repositioned to drain into this pouch. As in normal urinary system, urine is able to pass from the kidney, to the ureters, to the pouch, and through the urethra out of the body.

For information about affordable urinary diversion and reconstruction surgery, check out Healthbase.

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By Brian Wallstin
Seven Days
Vermont’s Independent Voice

By January, Jane Schaeffer could barely manage a walk around the block, which was no surprise: She needed a new hip.

Schaeffer, who is 64 and a yoga teacher in Bennington, didn’t like that prognosis. So, she consulted the oracle of Hippocrates — the Internet — and concluded that what she wanted was a Birmingham Hip Resurfacing surgery, or BHR , a less-invasive procedure developed in England and approved in the U.S. in 2006.

Unfortunately, Schaeffer’s insurance company, Blue Cross Blue Shield of Vermont, saw her case differently and insisted that, at her age, she should have her hip replaced . That left Schaeffer, if she wanted to get better, with a choice: Get a new hip on BCBSVT, or pull together $8000 and have the joint “resurfaced” in India.

For Schaeffer, it was no choice at all. On April 18, she underwent a BHR at Apollo Hospital in New Delhi. Two weeks later, she was home, preparing to return to work. “With full hip replacement , I would never have full range of motion in my hip,” she said. “I would never be able to teach properly again.”

Americans have been going abroad for health care for years. Retirement communities in Arizona routinely bus fixed-income residents over the Mexican border, where the prescription drugs and dental care are cheaper. For those with radically different needs, and a certain disposable income, Brazil and Argentina are famous for skilled, cut-rate plastic surgery; a $10,000 tummy tuck in L.A. or Houston might cost a third as much at Plenitas, a boutique clinic in Buenos Aires.

In the last few years, hospitals in exotic locales such as India , Singapore and Thailand have aggressively marketed major surgical procedures — heart bypasses and coronary valve replacements , for instance — at drastically lower prices than are available in the United States. And more and more Americans are taking advantage of it. A 2007 study by the National Center for Policy Analysis in Dallas estimated that about 500,000 U.S. residents traveled abroad for care in 2005. According to the management consultant McKinsey & Company, the worldwide “medical tourism ” industry was worth $60 billion in 2006, and is expected to reach $100 billion by 2012.

Concerns about the quality of care abroad have all but disappeared, thanks to improved standards of care that are monitored by accreditation bodies, such as Joint Commission International and the International Society for Quality in Health Care. Studies have shown that mortality rates at hospitals that specialize in medical tourism are as low as, or lower than, those at U.S. hospitals.

Jane Schaeffer said Apollo Hospital in New Delhi “was really a whole different universe.

“The whole situation there is set up for people who have hip resurfacing,” she said. “I had [physical therapy] twice a day, the surgeon came in twice a day to visit . . . I can’t recommend it highly enough.”

Schaeffer made her own travel arrangements to New Delhi but relied on an online broker, Healthbase , to find a doctor and hospital for the operation. Saroja Mohanasundaram, Healthbase’s chief executive officer, said her company has formed “partnerships” with major hospitals in 11 countries . Her staff handles everything from digitizing and transferring patient medical records, to arranging airport transfers and hotel accommodations.

“The medical part is the main thing,” Mohanasundaram said. “Once they like the facility and the doctor, then we try to help them with the logistics.”

Schaeffer said she arranged any needed follow-up care with an orthopedic surgeon in Bennington prior to her trip — a practice the AMA lists among its guidelines for those considering traveling abroad for health care. But, since her return from New Delhi on April 30, she has been walking without crutches and has full range of motion in her hip.

Her next step is to ask Blue Cross Blue Shield, which declined to authorize the Birmingham Hip Resurfacing, to reimburse her for the surgery.

“I’m going to appeal it, based on: I saved a lot of money, I can still continue with my work, and they were wrong,” she said. “We’ll see what happens.”

More at: http://www.7dvt.com/2008vermont-yoga-teacher-tries-out-medical-tourism

To arrange your medical travel trip overseas for any medical , dental or cosmetic procedure , contact Healthbase. Healthbase is an award-winning medical tourism facilitator connecting patients to leading healthcare facilities worldwide. Cost of surgical care at Healthbase’s partner hospitals is a fraction of the cost of similar care in the US for equal or superior outcomes.

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Healthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: http://www.healthbase.com Login to get FREE quote. Access is free.

DENTAL TOURISM

Healthbase, an award-winning Dental Tourism Facilitator, connects you to dental care facilities overseas where you can get top quality dental care for a fraction of the cost in the US. Waitlists like those in Canada and the UK are literally eliminated and access to world-class dental care is within reach. For e.g.: dental implants which cost over $4000 in the US can be had for as low as $650 in Mexico. Dental tourism is ideal for crowns, implants, implants-in-a-day, veneers, bridges, root canal, dental surgery and many other dental procedures. You will save so much that you can even enjoy a luxurious retreat at exotic destinations after your treatment.

Healthbase has partner dental care facilities located in Mexico, Costa Rica, Panama, Hungary, Belgium, Turkey, India, Thailand, Singapore, South Korea, etc. Dental practitioners in these countries are educated or trained at top US/UK/Canadian universities and hospitals.

Get more information about dental tourism or medical tourism and get a FREE quote for any dental procedure or medical procedure.

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Brought to you by Healthbase www.healthbase.com info.hb@healthbase.com 1-888-MY1-HLTH

ANATOMY AND FUNCTION OF THE HEART

The heart is a muscular organ a little larger than your fist weighing between 7 and 15 ounces (200 to 425 grams). It is responsible for pumping blood through the blood vessels by repeated, rhythmic contractions. The average heart beats 100,000 times per day pumping about 2,000 gallons (7,571 liters) of blood. The average human heart beating at 72 BPM (beats per minute), will beat approximately 2.5 billion times during a lifetime of 66 years.

The heart is usually situated in the middle of the thorax with the largest part of the heart slightly offset to the left underneath the breastbone or sternum and is surrounded by the lungs. The sac enclosing the heart is known as the pericardium.

The heart consists of the following parts:
Aorta: It is the largest artery and carries oxygenated blood from the heart to the rest of the body.
Superior Vena Cava: Deoxygenated blood (blood low in oxygen and rich in carbon dioxide) from the upper parts of the body returns to the heart through the superior vena cava.
Inferior Vena Cava: Deoxygenated blood from the lower parts of the body returns to the heart through the inferior vena cava.
Pulmonary Veins: They carry oxygenated blood (blood rich in oxygen and low in carbon dioxide) from the lungs back to the heart.
Pulmonary Arteries: They carry blood from the heart to the lungs to pick up oxygen.
Right Atrium: It collects deoxygenated blood returning from the body (through the vena cavas) and then forces it into the right ventricle through the tricuspid valve.
Right Ventricle: It collects deoxygenated blood from the right atrium and then forces it into the lungs through the pulmonary valve.
Left Atrium: It collects oxygenated blood returning from the lungs and then forces it into the left ventricle through the mitral valve.
Left Ventricle: It is the largest and the strongest chamber in the heart. It pushes blood through the aortic valve and into the body.

HOW DOES THE HEART FUNCTION?

The right side of the heart collects de-oxygenated blood from the body into the right atrium and then via the right ventricle pumps it into the lungs so that carbon dioxide can be dropped off and oxygen picked up.

The left side of the heart collects oxygenated blood from the lungs into the left atrium. From the left atrium the blood moves to the left ventricle which pumps it out to supply oxygen to the body.

Register to Healhtbase to request a FREE quote for affordable cardiac surgery overseas.

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Healthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: http://www.healthbase.com or call 1-888-MY1-HLTH. Login to get FREE quote. Access is free.

ORTHOGNATHIC SURGERY

Orthognathic surgery is surgery to reposition the maxilla (upper jaw or jawbone), the mandible (the lower jaw or jawbone), and the dentoalveolar segments (teeth and their sockets) to achieve facial and occlusal balance. One or more segments of the jaw(s) can be simultaneously repositioned to treat various types of malocclusions (bad bite) and jaw deformities. It is also used in treatment of congenital conditions like cleft palate. Bones can be cut and re-aligned, held in place with either screws or plates and screws.

Orthognathic surgery is performed by an oral and maxillofacial surgeon almost always in collaboration with orthodontic treatment, often including braces before and after surgery, and retainers after the final removal of braces. Orthognathic surgery is often needed after reconstruction of cleft palate or other major craniofacial anomalies.

Unless medical conditions necessitate that the surgery be performed earlier, orthognathic surgery is often delayed until after all of the permanent teeth have erupted. To improve the aesthetic results, orthognathic surgery can be combined with soft tissue contouring in adult patients.

TYPES OF ORTHOGNATHIC PROCEDURES
•  Mandibular Sagittal Split Osteotomy
•  Maxillary osteotomy surgery or Le Fort Osteotomy (Le Fort I osteotomy, Le Fort II osteotomy and Le Fort III ostetomy)
•  Genioplasty (chin surgery)

DETAILS OF THE PROCEDURE
Usually surgery is performed under general anaesthetic and using nasal tube for intubation. The surgery might involve one jaw or both the jaws during the same procedure. The modification is done by making cuts in the bones of the mandible and / or maxilla and repositioning the cut pieces in the desired alignment. The surgeon is often able to go through the inside of the mouth without having to cut the skin.

Cutting the bone is called osteotomy and in case of performing the surgery on the two jaws at the same time it is called a bi-maxillary osteotomy (two jaws bone cutting) or a maxillomandibular advancement. The bone cutting is traditionally done using special electrical saws and burs, and manual chisels, and most recently by using ultra-sound waves (though not used on a wide scale). The maxilla can be adjusted using a ” Lefort I” level osteotomy. Sometimes the midface can be mobilised as well by using a Lefort II, or Lefort III osteotomy. These techniques are utilized extensively for children suffering from certain craniofacial abnormalities such as Crouzon syndrome.

The jaws will be wired together (inter-maxillary fixation) using stainless steel wires during the surgery to insure the correct re-positioning of the bones. This in most cases is released before the patient wakes up after the surgery.

COST OF ORTHOGNATHIC SURGERY
Register to Healhtbase to request a FREE quote for affordable orthognathic surgery overseas.

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Healthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: http://www.healthbase.com or call 1-888-MY1-HLTH. Login to get FREE quote. Access is free.

SEPTOPLASTY

The surgical procedure to treat problems associated with a crooked or deviated nose, such as chronic sinusitis, inflammation, bleeding, or sleep apnea, is termed septoplasty.

Septoplasty, submucous resection of the septum, or septal reconstruction is a corrective surgery to straighten or repair a deviated nasal septum - the wall between the two nasal passages. Usually the septum is straight and upright, and runs down the center of the nose. A deviated septum occurs when the cartilage or bone of the septum is not straight, thereby narrowing the cavity into which it deviates and making breathing difficult. This condition can lead to snoring and sleep apnea, and in certain serious deviations may frequently lead to chronic sinus problems.

Septoplasty is necessary only when the problems associated with crooked nasal septum do not get better without surgery. The surgery may be done along with other procedures to treat chronic sinusitis, inflammation, or bleeding, or to correct sleep apnea. The procedure also may be done to allow access into the nose to remove nasal polyps.

DETAILS OF THE PROCEDURE
The procedure usually involves an excision or cutting of a portion of the cartilage and/or bone surplus. Under general or local anesthesia, the surgeon works through the nostrils, making an incision in the lining of the septum to reach the cartilage targeted in the operation. Often an “L” strut of cartilage in the dorsal and caudal areas (1cm width or more) is preserved for structural support. After excess cartilage and bone have been taken out, the septum may then be stabilized with small plastic tubes, splints, or sutures. The operation takes about 60-90 minutes.

AFTER THE SURGERY
Considerable swelling and bruising can be expected. The nasal cavities may or may not be packed, and a piece of gauze is taped underneath the nose to absorb blood. Postoperative care includes frequent changing of this gauze (roughly every hour or so) and after 1 to 2 days, the excess bleeding normally stops and the inner nasal packing may be removed. The following day, saline irrigations of the nasal cavities are often advised, and the patient may be allowed to gently blow their nose. After 1 to 2 weeks, patients are allowed to blow their nose normally. Patients typically regain about 80% of their energy one week after the surgery.

COST OF SEPTOPLASTY
Register to Healhtbase to request a FREE quote for affordable septoplasty surgery.

Healthbase is a medical tourism expert offering over 200 medical procedures and connecting patients to leading healthcare facilities worldwide for low cost high quality medical care. Healthbase also offers affordable medical tourism plans for self-insured businesses looking for affordable healthcare benefits for employees.

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Healthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: http://www.healthbase.com or call 1-888-MY1-HLTH. Login to get FREE quote. Access is free.

UVULOPALATOPHARYNGOPLASTY

Uvulopalatopharyngoplasty, UPPP or UP3 is the surgical removal of tissue in the throat to widen the airway. It is a surgical procedure to cure problems such as snoring and obstructive sleep apnea. The following tissues may be removed through uvulopalatopharyngoplasty:
•  The uvula (small fingerlike piece of tissue that hangs down from the back of the roof of the mouth into the throat)
•  The soft palate (part of the roof of the mouth )
•  The tonsils (any collection of lymphoid tissue)
•  The adenoids (a mass of lymphoid tissue situated at the very back of the nose), and
•  The pharynx (the part of the neck and throat situated immediately posterior to the mouth and nasal cavity).

Another procedure to treat snoring is laser-assisted uvulopalatoplasty.

Cost of Uvulopalatopharyngoplasty
Snoring is not always considered a medical problem, so insurance may not cover treatment. For affordable uvulopalatopharyngoplasty or laser-assisted uvulopalatoplasty surgery overseas, register to Healthbase.

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Healthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: http://www.healthbase.com or call 1-888-MY1-HLTH. Login to get FREE quote. Access is free.

007 TOP SECRETS OF MESSING UP YOUR MEDICAL CARE OVERSEAS

Ever heard of botched cosmetic jobs in Brazil or crappy dental work in Mexico? Such situations are very real. Here are the 007 top secrets of messing up your medical care overseas.

Top Secret # 001: Not doing research
Don’t do any research and you will successfully fail in your quest for achieving safe and healthy medical treatment overseas. However, if you do want to go abroad and get quality health care while saving some bucks then consider doing thorough homework and collecting enough information. Some sources of information are: websites offering medical tourism services like Healthbase, news, articles, videos, patient testimonials, etc. Satisfied medical tourists claim proper research to be a sure-fire way of happy and healthy medical tourism.

Top Secret # 002: Going abroad for a wrong procedure
Your ambulance will not drive you to India during an emergency (or even otherwise). Reasonably, only non-emergency treatments can be considered for medical tourism but not all such treatments fit the criterion as sometimes the travel costs can outweigh the possible savings achievable by going abroad.

Top Secret # 003: Choosing the wrong place
How about going to Thailand for your half-yearly dental cleaning? Superb idea? Not exactly. How about going there for dental implants? Maybe. And for full mouth restoration? Definitely. Choose a wrong place and you will waste your money on medical tourism instead of saving some. Wise medical tourists consider travel cost, lodging cost and number of visits required for full treatment when calculating potential savings.

Top Secret # 004: Choosing an unqualified doctor
Thanks to the power of the Internet, it’s very easy to choose a doctor qualified at accomplishing botched jobs. If you wish to not fall prey to them, better do your homework properly. Check your doctor’s credentials, ask people around and get recommendations from reliable sources to avoid scheduling an appointment with “Dr. Quack”.

Top Secret # 005: Not doing proper planning and preparation
Allowing time for surgery but not for recovery and recuperation? That will require you to modify your itinerary. As a medical tourist you should prepare yourself to stay longer/shorter than expected. If you have travel or tourism on mind, allow time for that as well. A word on arranging your essential documents: Put together your medical records and financial records, acquire passport and visa, and have the information of your important contacts handy. Also, book your travel tickets and hotel rooms well in advance.

Top Secret # 006: Working with a substandard medical tourism agency
There are new agencies cropping up each day. Some of them are there to genuinely help you while others are affiliated with “Dr. Quack”. A good medical tourism agency like Healthbase will have partners that are certified by international or domestic accrediting organizations. It will offer a variety of medical travel services, it will offer numerous medical procedures in many countries, it will have patient testimonials on its website, it will have been covered by media, and much more. Your research will help you identify the good ones.

Top Secret # 007: Failing to follow the right aftercare
Planning to play football the day after your total knee replacement surgery? Ouch, that will hurt! Physical therapy, rest, diet, medication, etc. are all as important as the surgery. Your local doctor might be able to help you with your aftercare so always keep him informed. You might also need his help, for example, for removing sutures or for taking X-Rays.

Remember to avoid the above 7 mistakes and your medical tourism or dental tourism abroad will be happy, healthy and successful.

Register to get your FREE personalized quote for any medical procedure abroad.

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Healthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: http://www.healthbase.com or call 1-888-MY1-HLTH. Login to get FREE quote. Access is free.

THORACIC AORTIC ANEURYSM

Aneurysms involving the ascending aorta, aortic arch and descending thoracic aorta are termed thoracic aortic aneurysms (TAA). Thoracic aneurysms most often occur in the descending thoracic aorta. Others may appear in the ascending aorta or the aortic arch. The most common cause of a thoracic aortic aneyrysm is hardening of the arteries.

Most thoracic aneurysms are asymtomatic. Most patients have no symptoms until the aneurysm begins to leak or expand. Most non-leaking thoracic aortic aneurysms are detected by tests - usually a chest x-ray or a chest CT scan - run for other unrelated reasons. Chest or back pain may mean sudden widening or leakage of the aneurysm.

THORACIC AORTIC ANEURYSM TREATMENT

Once a TAA is diagnosed, routine, scheduled follow-up is necessary by an aortic specialist. Aneurysm size needs to be followed closely and surgery is warranted if there is rapid growth over a short period of time or if a critical size is reached. High death rate is associated with the rupture of a thoracic aortic aneurysm. Also, surgical repair of a ruptured thoracic aneurysm carries a 25-50% mortality as opposed to a 5-8% mortality when such aneurysms are treated electively.

The treatment of thoracic aortic aneurysm depends on the location of the aneurysm.

Surgery to repair an ascending aortic or arch aneurysm is indicated for patients with aneurysm larger than 5-6 centimeters. The surgery involves removing the aneurysmal portion of the aorta and replacing it with a fabric substitute. If the aortic arch is involved, a specialized technique called “circulatory arrest” - a period without blood circulation while on life support - may be necessary.

There are two options for patients with aneurysms of the descending thoracic aorta. If the aneurysm is larger than 6 centimeters, major surgery is done to replace the aorta with a fabric substitute. The other option is endovascular stenting, which is a less invasive option. A stent is a tiny metal or plastic tube that is used to hold an artery open. Stents can be placed into the body without cutting the chest. Instead, tiny, hollow tubes called catheters are inserted into the groin area. The stent is passed through the catheter and into the area of the aneurysm. Not all patients with descending thoracic aneurysms are candidates for stenting.

THORACIC AORTIC ANEURYSM COST AND AVAILABILITY

In the US, thoracic aortic aneurysm repair surgery can be very costly. If you are uninsured or underinsured then this could translate into a substantial out-of-pocket expense for your cardiac treatment.

Healthbase is a medical tourism expert offering a large network of international hospitals which offer the best thoracic aortic aneurysm repair surgery overseas at an affordable price.

Register to get your FREE personalized quote for a cheap thoracic aortic aneurysm repair surgery abroad.

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