Surgical Technology in the Philippines – A Look at 3D and Da Vinci Surgery

Will Da Vinci Surgical Technology Be Popular in the Philippines?

The future of surgical technology means no more incisions. That said, there are no more reasons for patients to go under the knife, when surgery is necessary.

St. Luke’s Medical Center is one of the well-known hospitals, not just in the Philippines, but also in Asia. Recently, they introduced the 3D laparoscopic surgery.

This is not only ideal for complex procedures but patients who just need simple surgery can take advantage of this latest surgical technology at said hospital.

This surgical technology can be performed on biliary, adrenal, hernia and colorectal, among others. If you opt for it, it means less scars.

Hospitalization will also be shorter. Plus, it is safer than the old surgical method.

What is 3D laparoscopic surgery?

It involves the use of various 3D instruments during the procedure. The surgeon utilizes a 3D monitor to look into the patient’s body cavity.

With this advanced surgical technology, doctors will have better viewing of the operative field. As a result, they can make precise and accurate procedure.

Thus, errors involving poor depth perception can be prevented.

• The 3D image offers excellent perception.
• For surgeons, it means better accuracy and greater precision.
• The operating time is also faster. It will be easier for the surgeons to navigate to the targeted organ.
• Apart from improving the operation’s length of time, surgeons can also work more confidently.

Surgeons at St. Luke’s who will perform the latest laparoscopic surgical technology utilize Dr. Camscope 3D laparoscopic system from Sometech.

The system involves 3D binocular laparascope in navigating the surgical site. Then, doctors will use medical-grade glasses with 3D technology. It is like watching movies in 3D.

The only difference is that doctors are using dark sunglasses that are of medical-grade.

When doctors utilize the 3D monitor, they can easily see the target organ in real distance. The enhanced vision reduces surgical errors, significantly.

The use of this surgical technology has become a trend worldwide.

In the Philippines, there are only a few hospitals that utilize such technology. Unfortunately, Davao Doctor’s Hospital does not have one yet.

What Philippine surgeons are saying about this surgical technology?

Surgeons in the Philippines prefer this future technology than the old method or the 2D technology because of the enhanced imaging.

It is not only limited to gastroenterology but other specialties can also take advantage of it, including urology and gynecology.

It was only in 1993 that the minimally invasive surgical operation, like laparoscopic surgery, was introduced. This future technology brought a great shift in surgery – from an open incision to a simple incision method.

This advanced surgical technology allows men and women to undergo surgical operation with little down time. It means that they can go back to their work, a day or a few days after the operation.

Some patients think that this surgical technology no longer needs surgeons to perform the procedure. But the role of surgeons in this type of procedure is imperative.

Just like the older method, surgeons will still have stand beside the patient to operate them. This would still cause fatigue to the surgeon while performing the procedure.

The overall procedure is considered counterintuitive to the brain. When the doctor inserts the instrument into the abdomen of the patient, the tip goes forward, while the doctor moves the instrument backward.

If it must go left, the doctor must go right. Surgeons are moving the instrument inside the patient’s body while looking at a 3D monitor.

Because of this counterintuitive movement, it took a long time for doctors to get used to it. In fact, there are only a few hundreds of surgeons who are qualified and certified to perform this type of surgical operation.

But the introduction of Da Vinci Robot offers surgeons to easily carry out invasive procedures. The best thing about this surgical technology is that it only requires one to two centimeters incisions.

Features of Da Vinci

The entire machine consists of console, patient cart and vision system.

During the operation, your surgeon navigates and operates while sitting comfortably at the console. He/she views a 3D image of your body’s interior. While operating, your doctor utilizes master controls. They work like forceps.

The Da Vinci surgical technology responds to any type of input your doctor is making. And it responds in real-time. Any wrist or finger movements will be translated into precise movements.

The patient’s cart of Da Vinci can hold up to three EndoWrist instruments, plus a 3D camera. Your doctor uses the EndoWrist instrument to make precise control within your body.

But these instruments are not the only ones being used by surgeons. Instead, there are wide range of instrument types to help them perform the task with precision, accuracy and better control.

Are there complications?

The future of surgical technology may improve the results of a procedure. But it still comes with serious complications. Anything can happen during the operation.

The most serious is death.

Serious complications associated with this type of surgical technology will include the following:

• Bleeding
• Injury to the target organ or surround tissues/organs
• Bleeding
• Infection
• Internal scarring which can result in long-lasting pain

The complications can be the result of human error or equipment failure. Hence, it is important to only undergo such operation with a qualified physician.

Those who underwent minimally invasive surgery trough Da Vinci surgical technology system may have the following risks:

• Temporary pain as a result of positioning
• Temporary discomfort from gas during procedure
• Longer operation, which is especially true if your surgeon needs to change from one surgical operation to another surgical technique.

If you are not a good candidate of non-robotic surgical operation, you are also not a good candidate for this type of surgical technology.

There are only 3,000 Da Vinci robots installed and being used all over the world. Most of them are in the US. And there is only one in the Philippines.

When it was approved by the FDA to be used for prostatectomies, a rapid decline in open surgery for the removal of the male prostate was seen.

In the US, 87% percent of prostatectomies are done robotically. But this is not the same in the Philippines. The reason for this is that most patients still prefer the open-wound method because, well, it is cheaper.

However, whether it is performed in the Philippines or not, the complications associated with it must be taken into account.

According to some researchers at the John Hopkins in 2013, some doctors performing Da Vinci surgery did not report or underreport the complications with this surgical technology.

Between 2000 and 2012, there were incidents that occurred in relation to this technology. Some of them involved several deaths and injuries.

In fact, some patients in the US are suing the manufacturer of this robotic technology. They claimed that the product is faulty and must not be on the market.

One man reported to have a routine prostatectomy but he ended up spending 13 hours in the OR, instead of the five hours as he was quoted. To add insult to the injury, he was left incontinent. He also suffered from kidney and lung damage.

Before he passed away, he had sepsis and stroke.

Then another woman was reported undergoing endometriosis through this surgical technology. For nearly 11 hours, she remained in the OR. Then, a few days after the surgery, she was rushed to the ER.

Doctors discovered that she had torn rectum and colon because of this robotic surgical technology.

Surgeons all over the world who performed with Da Vinci said that they experienced serious malfunctions when they used such machine. The FDA revealed that there were one third deaths being reported to them during gynecological procedures.

How much will it cost for you to undergo this type of surgical technology?

According to St. Luke’s Medical Center, the entire cost can be around PHP500,000. To get more people interested in this type of technology, said hospital is offering a promo that let patients take advantage of it a more affordable price.

You can say that it is twice or thrice the price of a laparoscopic surgery. But some would say that it is all worth it.

One of the reasons patients would opt for it is the shorter time it would take for them to stay in the hospital. They will not only be living with a big scar. Thus, most of the patients in the entertainment industry would go for it. Some patients who are following tight work schedules would find this option a more practical choice.

Is the price of this surgical technology cheaper?

You may think that PHP500,000 is a very expensive rate. But, if you compare it to other countries, our rate here is a lot cheaper.

This is why some patients from the US and other parts of the world are coming  here to take advantage of this service. Although it is not yet included in our country’s medical tourism, some people in the government are looking into its benefits.

Still, it is an expensive technology for an average Filipino. This may be the reason DDH is not yet considering it because each robot can cost around $1 million. But the cost will depend on the model. Replacements of its parts can go around $1,500.

Then, the hospital has to pay around $140,000 to maintain it. That said, not all hospitals are opting for it. Doctors are also needed to be trained to perform robotic surgery, which is an additional expense to them.

The extra cost of this equipment and maintaining it will be, of course, passed on to the patient. So, if the ovarian cyst removal will only cost less than PHP 50,000 through traditional laparoscopic surgery, the robotic surgical technology can go three times more than that.

In a Columbian study, researchers revealed that robotic surgical technology costs more than the regular surgical operation. And the complications are greater than opting for the regular minimally invasive surgery.

The makers of this technology are making billions of dollars for one robot. Unfortunately, there is the lack of clinical evidence that this type of technology is more superior than the traditional method.

Nevertheless, the popularity continues to grow. In fact, in 2011, the use of it has increased more than 200 percent of what has been predicted.

If you were to ask a regular person in the Philippines, he/she will just opt for the traditional surgery. Even though it has been predicted that robotic surgical technology will grow exponentially, it may not peak here in the Philippines, where most people are receiving an average salary.

Unless you belong to the elite, your pocket may not be able to handle the overall cost.

It is true that robotic surgical technology is here to stay. But its advantages are only appropriate for those who can afford it.

Newer upgrades will come in to improve its flexibility. They may also reduce the bulkiness of the machine. As a result, surgeons will have better versatility while performing operation. But the overall cost will or may not go down.

This type of surgical technology was once thought to be a science fiction. It was once believed to be a technological stuff that you would only see on Star Trek or Star Wars. But this technology is now a reality.

However, no matter how real it is, the income of Filipinos may not be able to endure the expensive cost of the technology.

Still, this is a wonderful opportunity for us to experience how easy it is to undergo a surgical operation. Hopefully, St. Luke’s Medical Center will offer huge discount to it. And that discount will allow us, regular people, to pay for this expensive technology.

Some insurance companies may not cover it. This is another disadvantage.

If you do have the money to undergo such operation, then by all means take that opportunity. However, make sure that you are a good candidate for it. Bear in mind that not all patients can embrace the benefits of robotic surgical technology, even if they can afford it.

References:

• http://well.blogs.nytimes.com/2013/09/09/new-concerns-on-robotic-surgeries/?_r=1
• http://www.nlm.nih.gov/medlineplus/ency/article/007339.htm

Benefits of a Cup of Coffee and Quick Ways on How to Make Iced Coffee

While I am writing this post, I am drinking a cup of coffee with milk chocolate. I love to call it as café latte, without the froth.

Many of my colleagues drink cups of coffee each day. We do not just drink it because it reduces our sleepiness/grogginess but coffee offers several health benefits that many people try to ignore.

In the past few decades, coffee has been studied thousands of times. Lately, more and more health benefits of this drink have been discovered. But drinking a cup of java must be balanced.

Unfortunately, there is no ideal dose of drinking coffee. Bear in mind that a cup of coffee can be different from one person to another. My “cup of coffee” is a coffee-mug size. Yours might be a small cup that people would normally use in drinking tea.

Let us not argue about what a cup of coffee must be. Instead, let me start highlighting the benefits of drinking coffee each day.

1. Reduces risk of Alzheimer’s disease

Not only that. It is also shown to reduce the risk of dementia and Parkinson’s disease.

How is this even possible?

The antioxidant content of this drink is what makes this beverage perfect for those who wish to avoid suffering from those mental health conditions.

Coffee’s antioxidants are shown, not only to boost the neurotransmitter effects in cognitive function but they are also reported to prevent brain cells damage as you grow older.

As coffee intake increases, cases of glioma, which is a form of brain cancer, are dropped.

There are also studies going on that may prove that the compounds of coffee may have the power to activate the DNA-repairing protein in a cell. Because of that ability, it may prevent DNA damage.

2. Prevents diabetes

Studies showed that those who drink up to four cups of coffee each day have lowered their risk of having type 2 diabetes. Researchers believe that coffee’s chlorogenic acid and quinides are the ones that boost your cell’s insulin sensitivity. In other words, they help in regulating blood sugar.

But those studies did not verify whether the coffee used was caffeinated or de-caffeinated.

3. Lowers risk of stroke

Some studies about the benefits of a cup of coffee showed that those who drink up to three cups of coffee a day have lowered their rates of strokes. This can be caused by the antioxidant effects of coffee that stop inflammation from causing damage to the arteries.

The compounds in coffee might activate nitric oxide, which is a substance that is known to widen blood vessels.

However, just because it can prevent heart problems does not mean you have to take more cups of it each day. There are studies showing that drinking more than five cups of coffee a day is associated with higher risk of heart disease. This goes to say that excessive caffeine intake can cancel out the antioxidant effects of coffee.

4. Prevents liver problems

I have to emphasize that the research about this health benefit is limited. Despite that, the studies showed that people who drink more coffee have lowered their risk of developing liver diseases, like cirrhosis. This can be due to the coffee’s antioxidant content that prevents liver inflammation, which inhibits the growth of cancer cells.

This benefit is essential if you drink alcohol. In 2006, a study was published about coffee’s effects on people who regularly drink a cup of coffee a day. It was shown that these people were 20% less likely to suffer from liver cirrhosis, which is an autoimmune disease as a result of excessive consumption of alcohol. This liver problem could lead to liver failure and cancer.

Furthermore, studies showed that this beverage can prevent the development of NAFLD or non-alcoholic fatty liver disease. However, the people who participated in the study were drinking at least four cups of coffee a day.

5. Avoids depression

In a study presented by the National Institute of Health, it was shown that those who drink at least four cups of coffee were 10 percent less likely to develop depression than those who do not drink a cup of java.

The connection between depression and coffee is not caffeine. Instead, the trusty antioxidants found in coffee are the reasons of the link. Pepsi or Coke contains high amount of coffee. But this type of beverage is linked to depression.

Because it can act as a mild anti-depressant, those who drink up to four cups of coffee a day are less likely to commit suicide. The antioxidants and other contents of coffee aid in the production of various neurotransmitters that control depression.

6. Prevents gum disease

Again, the reason for this is the antioxidant content of coffee, and not caffeine. Researchers found that those who drink at least a cup of java a day reduced their risk of having gum disease. They also found a reduction in bone and teeth loss. Furthermore, they found that daily consumption of coffee does not cause adverse effects to the oral health. Instead, it provides protective effects against the development of periodontal disease.

Although further studies are needed to make a proper conclusion about this matter, we can start drinking at least a cup of coffee a day.

Iced coffee for summer

Summer season is here. I can drink hot coffee in the afternoon. But some of you might not like the idea of drinking hot beverage during hot season. Enter iced coffee.

Just because it is an iced coffee does not mean that it is just for the afternoon drink. You can have it in the morning as you wake up. To make the best iced coffee, you do not need the best ice cubes in your glass.

How to make iced coffee? The best one?

As mentioned earlier, it is not about how you add the ice cubes but it is about changing the brewing process. Instead, you make iced coffee fresh from the French press. It is chilled overnight. From the fridge, it will be extra-cold and ready to be diluted using ice and milk.

Processing a cold-brew French press can take a lot of time. But the extra time you put in will make the flavor more delicate and less bitter.

Ingredients

• Whole coffee beans
• Cold water
• Ice
• Milk
• Caramel, chocolate, flavored syrups and other sweeteners you would like to use. But they are optional.

Before you can start, you will need to have a coffee grinder and a French press. You can have the latter from Starbucks. It costs around PHP1,500.

Now, get your coffee grinder and grind your coffee beans. About 1/3 cup of beans is needed for the best cup of iced coffee. Make sure that the beans are coarse enough to be easily filtered by the French press. However, ensure that they are still fine enough to be infused easily.

Now, pour the ground coffee into the press. Then, add 1 ½ cups of water. Stir the coffee and the water until they are well-blended.

Place the press’ plunger in the up position. Put the French press in the fridge. Allow it to steep overnight. Make sure that the plunger is left in the up position. This will ensure that the ground beans infuse the water overnight.

In the morning, separate the coffee from the grounds by plunging the French press.

Then, get a glass and fill partway with ice cubes and milk. Pour the iced coffee to fill the rest of the glass. You may add caramel or chocolate fudge. I like adding dark chocolate in it. It still has the bitter taste of coffee with a touch of sugar from the milk. I also use soya milk. But you can use any type of milk that you have in your fridge.

How many calories are there in the iced coffee?

From the iced coffee that we discuss above, you will have 112 calories for two servings. It is still low in fat, as long as you do not add milk chocolate or vanilla. Sugar content can be 0.7 gram but it depends on the sweetener you add to it.

Now, what if you do not have coffee beans and a coffee grinder? What if you only have is an instant coffee?

It is still possible to make the best iced coffee through an instant coffee. Follow the steps below:

• Take three tablespoons of instant coffee. I would suggest using Folgers instant coffee crystals or Achiever’s instant coffee.
• Prepare the following: Cup of boiling water, sweetener, cups of cold water, milk, coffee creamer, whipped cream (optional but not advisable to those who wish to lose weight)
• Dissolve the instant coffee in boiling water. Make sure that you are using a tempered glass
• Stir
• Add the sugar or sweetener
• Stir
• Add cold water and stir
• Add milk and stir
• Place it in the fridge until it is chilled
• Transfer the cold coffee in a tall glass and pour over ice cubes
• Top it with whipped cream, if you wish. Then again, it is not advisable to those who are trying to lose weight.

Another way to make iced coffee is to blend the ice and make a cappuccino frost. Here are the steps:

1. Prepare cold water, classic roast instant coffee crystals, chilled sweetened condensed milk, ice cubes, and whipped cream.
2. Add water and coffee crystals in the blender. Make sure that all crystals are dissolved.
3. Add the chilled sweetened condensed milk. Blend.
4. Add ice cubes.
5. Blend until the mixture appears smooth and frothy.
6. Pour the mixture into a tall glass.
7. Top it with whipped cream, i.e. if you want to. But be careful with this. Bear in mind that whipped cream contains high amount of calories.

If you want to make almond frost, you can just add almond extract. For vanilla frost, you can add vanilla extract, instead of almond extract. I have tried adding both and the result is still good. You can even add pumpkin spice creamer to make it more flavorful.

A recipe I have not tried yet is the orange with mocha smoothie. It will still be iced coffee but it will have scoops of orange sherbet and a slice of fresh orange. What you will need to gather are chilled chocolate milk, roasted concentrated coffee, milk, whipped cream, orange slice, and scoops of orange sherbet.

To make a mocha orange smoothie, you just need to chill a glass in the freezer. Get your blender and put in the chocolate milk and the instant coffee. Blend them well until the coffee crystals are dissolved. Add the sherbet. Blend until you achieve the desired consistency. Pour the mixture into the chilled glass. Top it with whipped cream. Garnish the beverage with orange slice. Drink it with straw.

Conclusion

No matter what brand of coffee you would like to drink, the benefits of coffee will remain. Some people would love to drink their cup of coffee hot while others love it cold. For me, I love both. But I try not to make iced coffee often as I am usually tempted to add more sweeteners and whipped cream. Coffee may have several health benefits but the added ingredients may cancel them out.

I still need to master how to brew the ideal way. I do not have a coffee grinder so I purchase ground coffee with the right consistency. According to my research, having a coffee grinder is essential in getting the ideal brewing. Coffee experts recommend brewing fresh ground coffee. But this is unattainable for people who do not have coffee grinders.

On how to make iced coffee, the instructions we have discussed will help you make the iced coffee more flavorful. But if you are like my mother who does not want complicated procedure, she just adds her instant coffee to a glass of cold water. Mix and drink. She loves it. I, on the other hand, want the iced brewed coffee and not the instant one.

Eyes: What are the Changes in Your Eyes That You Must Pay Attention To?

Our eyes are a window to our soul. They allow us to see the beauty of our surroundings and the people around us.

Because our eyes play an important role in how we deal with life, let’s take care of them.

If there are changes in their appearances, they can be a sign of an underlying medical problem.

What are these changes?

Yellow spots on eyelids

They can be a sign that your blood cholesterol levels are high. They’re called as xanthelasma or cholesterol-filled lesions. If you have them, then you may have a high risk of developing a heart disease.

You may be more likely to have a heart attack or develop hardening of the arteries.

Eye bags

They could be a sign of chronic allergies. Allergies can cause dilation of blood vessels causing them to leak.

Grey ring

It’s a thin grey ring that appears around the edge of your cornea. Grey ring is a warning sign of high cholesterol and triglycerides. This is also a sign that you’re at high risk to have heart attack or stroke.

Bulging eyes

They are a warning sign that you have an overactive thyroid or hyperthyroidism. Having bulging eyes or exophthalmos is a common sign of Grave’s disease. When you have this type of disease, you’re also experiencing nervousness, weight loss and irregular pulse that’s rapid.

If you see these changes in your eyes, better consult an ophthalmologist. For eyesight protection, read this. Or take this to prevent macular degeneration.

Oesteoarthritis – The Number of Steps to Take to Prevent it

Osteoarthritis can cause debilitating pain, i.e. if you don’t seek medical treatment. While you’re still young, you can prevent this disease from haunting you.

How?

In a study published by the Arthritis Care and Research, it showed that those who made extra 1000 steps each day had decreased their risk of having osteoarthritis by 17%.

The researchers who conducted such study recommended a minimum of 6,000 steps a day, i.e. walking for about an hour, to provide you with utmost protection against osteoarthritis or any type of disability.

To assist you in making 6,000 steps a day to prevent osteoarthritis (which can be difficult for some), you may need the help of your favorite music. 

It’s said that those who listen to music while walking or exercising tend to focus not on the physical activity but the fun associated with it.

With mere pleasure of listening to music, you’re less likely to get a snack right after walking. You’re not only preventing yourself to suffer from osteoarthritis but you’re also avoiding gaining weight.

Should you wear a fitness tracker to monitor your steps? Well, it’s really up to you. The most important thing here is to achieve the required steps.

Source:

http://www.webmd.com/arthritis/news/20140612/can-6000-steps-a-day-keep-knee-arthritis-at-bay