Loyola University Health System reports:
Many mesothelioma patients avoid surgery for fear it will degrade their quality of life. But a study has found just the opposite: Patients who underwent an operation called pleurectomy and decortication (PD) generally reported their quality of life improved after surgery.
Click here to read the complete article.
Showing posts with label Surgery. Show all posts
Showing posts with label Surgery. Show all posts
Tuesday, June 14, 2016
Tuesday, January 6, 2015
Selecting the right surgeon is a big deal
Workers' Compensation was designed to provide the best available medical treatment possible. A good surgical results benefits all stakeholders. The patient has a better outcome, the employer gains an employee who is productive in the workplace, and the insurance company ultimately pays less indemnification by way of permanent disability and a reduced cost for medical follow up care.
Over the decades since its original enactment 1911, the issue of cost of medical care has come to the forefront. Some states, such as New Jersey, prohibit an employee's free selection of a medical provider. Additionally, some employers and their insurance companies have contractually negotiated a best price fee with medical providers and have an established medical care networks, consequently restricting the employee's free selection.
A recent article authored by Peter Scardino is the chief of surgery at Memorial Sloan Kettering Cancer Center (MSK) focuses on the need to select the best surgeon in order to obtain the best outcome.
“You can think of surgery as not really that different than golf.” Peter Scardino is the chief of surgery at Memorial Sloan Kettering Cancer Center (MSK). He has performed more than 4,000 open radical prostatectomies. “Very good athletes and intelligent people can be wildly different in their ability to drive or chip or putt. I think the same thing’s true in the operating room.”
The difference is that golfers keep score. Andrew Vickers, a biostatistician at MSK, would hear cancer surgeons at the hospital having heated debates about, say, how often they took out a patient’s whole kidney versus just a part of it. “Wait a minute,” he remembers thinking. “Don’t you know this?”
“How come they didn’t know this already?”
In the summer of 2009, he and Scardino teamed up to begin work on a software project, called Amplio (from the Latin for “to improve”), to give surgeons detailed feedback about their performance. The program—still in its early stages but already starting to be shared with other hospitals — started with a simple premise: the only way a surgeon is going to get better is if he knows where he stands.
Vickers likes to put it this way. His brother-in-law is a bond salesman, and you can ask him, How’d you do last week?, and he’ll tell you not just his own numbers, but the numbers for his whole group.
Why should it be any different when lives are in the balance?
Over the decades since its original enactment 1911, the issue of cost of medical care has come to the forefront. Some states, such as New Jersey, prohibit an employee's free selection of a medical provider. Additionally, some employers and their insurance companies have contractually negotiated a best price fee with medical providers and have an established medical care networks, consequently restricting the employee's free selection.
A recent article authored by Peter Scardino is the chief of surgery at Memorial Sloan Kettering Cancer Center (MSK) focuses on the need to select the best surgeon in order to obtain the best outcome.
“You can think of surgery as not really that different than golf.” Peter Scardino is the chief of surgery at Memorial Sloan Kettering Cancer Center (MSK). He has performed more than 4,000 open radical prostatectomies. “Very good athletes and intelligent people can be wildly different in their ability to drive or chip or putt. I think the same thing’s true in the operating room.”
The difference is that golfers keep score. Andrew Vickers, a biostatistician at MSK, would hear cancer surgeons at the hospital having heated debates about, say, how often they took out a patient’s whole kidney versus just a part of it. “Wait a minute,” he remembers thinking. “Don’t you know this?”
“How come they didn’t know this already?”
In the summer of 2009, he and Scardino teamed up to begin work on a software project, called Amplio (from the Latin for “to improve”), to give surgeons detailed feedback about their performance. The program—still in its early stages but already starting to be shared with other hospitals — started with a simple premise: the only way a surgeon is going to get better is if he knows where he stands.
Vickers likes to put it this way. His brother-in-law is a bond salesman, and you can ask him, How’d you do last week?, and he’ll tell you not just his own numbers, but the numbers for his whole group.
Why should it be any different when lives are in the balance?
Click here to read the entire article: "Making the Cut: Which surgeon you get matters — a lot. But how do we know who the good ones are?"
Monday, December 30, 2013
Common Knee Surgery Does Very Little for Some, Study Suggests
A popular surgical procedure worked no better than fake operations in helping people with one type of common knee problem, suggesting that thousands of people may be undergoing unnecessary surgery, a new study in The New England Journal of Medicine reports.
The unusual study involved people with a torn meniscus, crescent-shaped cartilage that helps cushion and stabilize knees. Arthroscopic surgery on the meniscus is the most common orthopedic procedure in the United States, performed, the study said, about 700,000 times a year at an estimated cost of $4 billion.
The study, conducted in Finland, involved a small subset of meniscal tears. But experts, including some orthopedic surgeons, said the study added to other recent research suggesting that meniscal surgery should be aimed at a narrower group of patients; that for many, options like physical therapy may be as good.
The surgery, arthroscopic partial meniscectomy, involves small incisions. They are to accommodate the arthroscope, which allows doctors to see inside, and for tools to trim torn meniscus and to smooth ragged edges of what remains.
The Finnish study does not indicate that surgery never helps; there is consensus that it should be performed in some circumstances, especially for younger patients and for tears from acute sports injuries. But about 80 percent of tears develop from wear and aging, and some researchers believe surgery in those cases should be significantly limited.
“Those who do research have...
[Click here to see the rest of this post]
The unusual study involved people with a torn meniscus, crescent-shaped cartilage that helps cushion and stabilize knees. Arthroscopic surgery on the meniscus is the most common orthopedic procedure in the United States, performed, the study said, about 700,000 times a year at an estimated cost of $4 billion.
The study, conducted in Finland, involved a small subset of meniscal tears. But experts, including some orthopedic surgeons, said the study added to other recent research suggesting that meniscal surgery should be aimed at a narrower group of patients; that for many, options like physical therapy may be as good.
The surgery, arthroscopic partial meniscectomy, involves small incisions. They are to accommodate the arthroscope, which allows doctors to see inside, and for tools to trim torn meniscus and to smooth ragged edges of what remains.
The Finnish study does not indicate that surgery never helps; there is consensus that it should be performed in some circumstances, especially for younger patients and for tears from acute sports injuries. But about 80 percent of tears develop from wear and aging, and some researchers believe surgery in those cases should be significantly limited.
“Those who do research have...
[Click here to see the rest of this post]
Saturday, November 30, 2013
Hip Replacement Lawsuit: ASR Settlement ($2.5 Billion) Benefits Announced
The settlement terms of the ASR HIp Implant lawsuit have been announced:
The ASR Settlement provides for three basic areas of compensation.
The first is a Base Payment to all ASR Claimants (XL and resurfacing) who have undergone a revision surgery, removing the
acetabular cup, prior to August 31, 2013.
The second is for Claimants who have undergone a revision surgery in both their left and right hips (Bilateral Claimants).
The third addresses patients who have suffered a variety of medical complications following a revision surgery (Extraordinary Injury Fund).
In addition, the Settlement provides for the resolution of healthcare insurance liens for
medical costs that are directly associated with the revision surgery, at no additional cost to the
claimant.
Click here to read the complete press release issued by the Settlement Oversight Committee
Click here to read about the lawsuit.
The ASR Settlement provides for three basic areas of compensation.
The first is a Base Payment to all ASR Claimants (XL and resurfacing) who have undergone a revision surgery, removing the
acetabular cup, prior to August 31, 2013.
The second is for Claimants who have undergone a revision surgery in both their left and right hips (Bilateral Claimants).
The third addresses patients who have suffered a variety of medical complications following a revision surgery (Extraordinary Injury Fund).
In addition, the Settlement provides for the resolution of healthcare insurance liens for
medical costs that are directly associated with the revision surgery, at no additional cost to the
claimant.
Click here to read the complete press release issued by the Settlement Oversight Committee
Click here to read about the lawsuit.
Friday, November 8, 2013
New ligament discovered in knee, Belgian surgeons say
Today's post is shared from the bbc.com
[Click here to see the rest of this post]
The anterolateral ligament (ALL) may hold the key to common knee injuries, researchers say
Two knee surgeons in Belgium say they have identified a previously unfamiliar ligament in the human knee. Writing in the Journal of Anatomy, they suggest the fibrous band could play a part in one of the most common sports injuries worldwide.
But experts say more studies are needed to prove its relevance to knee surgery. Four main ligaments - or thick fibrous bands - surround the knee joint, criss-crossing between the upper and lower leg bones to provide stability and prevent excessive movement of our limbs. But the anatomy of the knee remains complex, and several international groups have been exploring the less-defined structures of the joint for some time. The notion of this particular ligament was first made by French surgeon Paul Segond in 1879 but it has evaded definitive surgical classification for many years. 'Extensive search' Now building on the work of other surgeons, Dr Claes and Professor Johan Bellemans of the University Hospitals of Leuven, Belgium, say they have closely mapped the band which runs from the outer side of the thigh bone to the shin bone. And they say this anterolateral ligament could play an... |
Sunday, November 3, 2013
A Vital Measure: Your Surgeon’s Skill
Today's post is shared from the nytimes.com
[Click here to see the rest of this post]
To those of us in training, the hospital was cursed. At least when it came to a certain operation.
We dreaded being asked to scrub in at these operations because we knew we would be forced to hold patient parts until our fingers went numb and arms quivered. The surgeons hunted, stabbed and slashed their way through the procedure; and whenever their knife would go a little too far, or their knot would slip, or their stitch pull, we braced ourselves for their fury…and for the inevitable extra time it would take for them to correct their errors. The patients, many of whom had come in to the hospital walking and talking, ended up lingering for weeks afterward with infections, open wounds and other complications. But everything changed when a new surgeon came on board. Built like a rugby player, he shocked us first with his speed, and then his results. The once unbearable day-long slog became a morning’s work; and instead of spending weeks in the hospital, his patients went home after eight days. In the operating room, his bear paw hands turned delicate, teasing out tissues, caressing vessels and nimbly knotting thread as fine as human hair. There was not a single wasted movement; and each step blended seamlessly with the next, giving those of us who had the fortune to observe the sense that we were watching not surgery, but a well-choreographed ballet. “It’s like you’re just standing there holding the needle or... |
Friday, November 1, 2013
As Robot-Assisted Surgery Expands, Are Patients And Providers Getting Enough Information?
Today's post is shared from kaiserhealthnews.org.
The use of robotic surgical systems is expanding rapidly, but hospitals, patients and regulators may not be getting enough information to determine whether the high tech approach is worth its cost. Problems resulting from surgery using robotic equipment—including deaths—have been reported late, inaccurately or not at all to the Food and Drug Administration, according to one study.  The FDA assesses and approves products based on reported device-related complications. If a medical device malfunctions, hospitals are required to report the incident to the manufacturer, which then reports it to the agency. The FDA, in turn, creates a report for its Manufacturer and User Facility Device Experience database. The use of surgical robots has grown rapidly since it was first approved for laparoscopic surgery (a type of surgery that uses smaller incisions than in traditional surgery) by the FDA in 2000. Between 2007 and 2011 the number of da Vinci systems installed increased by 75 percent in the United... |
Tuesday, October 29, 2013
Spinal fusions serve as case study for debate over when certain surgeries are necessary
| The necessity of medical treatment is coming under increased questioning as payers want to rein in costs. This article is shared from the washingtonpost.com. By some measures, Federico C. Vinas was a star surgeon. He performed three or four surgeries on a typical weekday at the Daytona Beach, Fla., hospital that employed him, and a review showed him to be nearly five times as busy as other neurosurgeons. The hospital paid him hundreds of thousands in incentive pay. In all, he earned as much as $1.9 million a year. Yet given his productivity, some hospital auditors wondered: Was all of the surgery really necessary? To answer that question, the hospital in early 2010 paid for an independent review of cases in which Vinas and two other neurosurgeons had performed a common procedure known as a spinal fusion. The review was conducted by board-certified neurosurgeons working for AllMed, a company accredited to audit health-care businesses. Of 10 spinal fusions by Vinas that were selected, nine were deemed not medically necessary, according to a summary of the report. Vinas is still working at Halifax Health, and a hospital spokesman said that, after the AllMed report, the hospital conducted an internal review that validated his surgeries. Another review conducted this year in response to litigation also validated them, the spokesman said. The hospital would not answer further questions or release details of those reviews. Vinas “has never and will never perform an unnecessary surgical procedure on any patient,” his attorney, Robert H. Pritchard, said in a statement. More than 465,000... |
Thursday, October 24, 2013
US Inspector General Wants More Disclosure By Back Surgeons Who Implant their Own Devices
Back surgery is a big business and the selling of implanted medical devices are costly transactions. The US Office of Inspector General has issued a report today that their should be more disclosure to patients when back surgeons implant their own devices.
"PODs have a substantial presence in the spinal device market. PODs
provided devices used in nearly a fifth of the spinal surgeries billed to
Medicare in FY 2011, and over a third of the hospitals in our sample
purchased spinal devices from PODs. Many of these hospitals began
purchasing from PODs after 2009. Also, few hospitals in our sample
required physicians to disclose their ownership in device companies,
such as PODs, to their patients.
"In FY 2012, hospitals that purchased from PODs performed more spinal
surgeries and had slightly more complex spinal surgery caseloads than
hospitals that did not purchase from PODs. After they began purchasing
from PODs, hospitals experienced increased rates of growth in the
number of spinal surgeries performed as compared to the growth rate for
hospitals overall. Determining the cause for the increased rate of spinal
procedures was beyond the scope of our review.
"In addition, our findings raise questions about PODs’ claims that their
devices cost less than other suppliers. Within the device categories we
examined, PODs’ devices either cost the same as or more than devices
from companies not owned by physicians. This, combined with the
volume of spinal surgeries we found at hospitals that purchase from
PODs, may increase the cost of spinal surgery to the Medicare program
and beneficiaries over time. Further, hospitals inconsistently required
physicians to disclose ownership interests in PODs to either the hospitals
or their patients. Thus the ability of hospitals and patients to identify
potential conflicts of interest among these providers is reduced.
"The Sunshine Act may improve the ability of hospitals and patients to
identify physicians’ investment in device companies. The Act will
require most PODs to report to CMS all physician ownership and
investment interests.18 CMS plans to list these companies and their
payments on a publicly available Web site.
Click here to read the complete report.
"PODs have a substantial presence in the spinal device market. PODs
provided devices used in nearly a fifth of the spinal surgeries billed to
Medicare in FY 2011, and over a third of the hospitals in our sample
purchased spinal devices from PODs. Many of these hospitals began
purchasing from PODs after 2009. Also, few hospitals in our sample
required physicians to disclose their ownership in device companies,
such as PODs, to their patients.
"In FY 2012, hospitals that purchased from PODs performed more spinal
surgeries and had slightly more complex spinal surgery caseloads than
hospitals that did not purchase from PODs. After they began purchasing
from PODs, hospitals experienced increased rates of growth in the
number of spinal surgeries performed as compared to the growth rate for
hospitals overall. Determining the cause for the increased rate of spinal
procedures was beyond the scope of our review.
"In addition, our findings raise questions about PODs’ claims that their
devices cost less than other suppliers. Within the device categories we
examined, PODs’ devices either cost the same as or more than devices
from companies not owned by physicians. This, combined with the
volume of spinal surgeries we found at hospitals that purchase from
PODs, may increase the cost of spinal surgery to the Medicare program
and beneficiaries over time. Further, hospitals inconsistently required
physicians to disclose ownership interests in PODs to either the hospitals
or their patients. Thus the ability of hospitals and patients to identify
potential conflicts of interest among these providers is reduced.
"The Sunshine Act may improve the ability of hospitals and patients to
identify physicians’ investment in device companies. The Act will
require most PODs to report to CMS all physician ownership and
investment interests.18 CMS plans to list these companies and their
payments on a publicly available Web site.
Click here to read the complete report.
Thursday, October 10, 2013
Robot Surgery Damaging Patients Rises With Misleading Marketing
Many injured workers' require surgical intervention. Safety in these procedures is questioned. Today's post was shared by votersinjuredatwork and comes from www.claimsjournal.com
[Click here to see the rest of this post]
Porter Adventist Hospital in Denver announced last year that Warren Kortz, a general surgeon on the medical staff, was the first in the Rocky Mountain region to use a technique known as robotic surgery to remove gall bladders through one incision in the belly button.
The operation, performed while the doctor sits at a video- game-like console, was “taking advantage of another breakthrough in robotic surgery” and is “easier on the patient,” the hospital said in a press release. “It’s Star Wars stuff,” Kortz was quoted as saying in another article put out by the hospital touting another operation, robot-assisted parathyroid surgery, in 2010. “My prediction is it will eventually replace everything else.” What the hospital and Kortz didn’t reveal was the risk. Even as Kortz promoted robotic surgery, 10 patients he treated suffered injuries or complications between 2008 and 2011, according to an April complaint by the Colorado Medical Board. Five had arteries punctured or torn. Objects were temporarily left inside two, and others had nerve damage. One died and another needed cardiopulmonary resuscitation. The complaint charges Kortz with 14 counts of unprofessional conduct, including sometimes not advising patients on alternatives to the robot. Robotic surgeries are on the rise, fueled by aggressive marketing by doctors, hospitals and Intuitive Surgical Inc., which manufactures the $1.5 million robot. Advertising on... |
Tuesday, September 10, 2013
New Concerns on Robotic Surgeries
 In early March 2009, Erin Izumi, a woman in her 30s from Tacoma, Wash., underwent robotically assisted surgery to treat endometriosis. The operation at St. Joseph Medical Center dragged on for nearly 11 hours. Ten days later, Ms. Izumi was rushed to an emergency room, where doctors discovered that her colon and rectum had been torn during the operation. She was hospitalized for five weeks, undergoing a series of procedures to repair the damage, including a temporary colostomy, according to her attorney Chris Otorowski. But even though medical device manufacturers and hospitals are required to report every device-related death and serious injury to a database maintained by the Food and Drug Administration within 30 days of learning about an incident, no report about the case was made in 2009. Hospital officials declined to comment, and a spokeswoman for the manufacturer said it became aware of the incident only when Ms. Izumi filed a lawsuit. It disputed the claim and settled the case in May 2012. That was not the only lapse in reporting problems with robotic surgical equipment, a new study has found. The equipment, called the da Vinci system, is made by Intuitive Surgical Inc. of Sunnyvale, Calif. It has been on the... |
Thursday, October 6, 2011
Surgery Common for Medicare Patients in Final Year of Life
Source reference:
Kwok A, et al "The intensity and variation of surgical care at the end of life: a retrospective cohort study" Lancet 2011; DOI:
10.1016/S0140-6736(11)61268-3.
Friday, May 27, 2011
Top 10 Surgery Center Violations
A recent report reveals that 1 out of 2 surgical centers have serious health safety violations. Workmens comp insurance carriers, as well as others, rely heavily upon these centers for surgery since they are less costly to operate than hospitals.
The New Jersey Health Care Quality Institute, (NJDHQI) reviewed state violations in a program funded by a Federal grant. NJDHQI published a report noting that more than 25% of the surgery centers were cited for "Immediate Jeopardy," which is a violation defined as noncompliance with established rules that has caused, or is likely to cause, serious injury, impairment or death to a patient.
The top violations were:
- Staff members walked through the sterile operating room in street clothes
- The surgery center did not have mandated emergency equipment and medicines on site
- The surgery centers had no system to track controlled and regulated medications on site
- Physicians and staff did not have current licenses and credentials
- The patient beds and floors were not sanitized correctly
- Surgical instruments were not cleaned or sanitized correctly
- The staff filled out patient charts in advance for convenience
- Single use items were used more then once on a patient
- The facility did not maintain an ongoing infection control program
- The surgery center failed to obtain consent from patients prior to permitting physician residents in an educational program participate in their surgeries.
For over 3 decades the Law Offices of Jon L. Gelman 1.973.696.7900 jon@gelmans.com have been representing injured workers and their families who have suffered occupational accidents and illnesses.
Thursday, March 10, 2011
Another Hernia Patch Recall by FDA
Image via WikipediaThe US Food and Drug Administration (FDA) issued another hernia and abdominal patch recall. The FDA on March 4, 2011 issued a Class 1 Recall Notice for Davol's XenMatric Surgical Graft.The FDA indicated that the recall was issued because “Testing cannot confirm that all units of XenMatrix Surgical Graft are within FDA requirements for endotoxin levels. Several lots have been found to have elevated endotoxin levels. Endotoxins (pyrogens) are substances found in certain bacteria that, at elevated levels, can cause serious illness which can be fatal.”
This product was manufactured from June 1, 2010 through October 31, 2010 and distributed from July 1, 1010 through October 31, 2010. For more information, please see the FDA’s safety alert.
Litigation is pending against Davol, Inc. is pending in both federal and state court on behalf of patients who suffered serious injuries or complications related to the company’s Composix® Kugel® Mesh hernia repair patch.
Subscribe to:
Posts (Atom)