Dr. Martinez (right) in the operating room
(Out of respect for patient privacy – I’ve done my best to crop the patient ‘bits’ from the photo.)
Spent some time last week with Dr. Alberto Martinez of Med-Sports Orthopedic Clinic here in Bogotá. Dr. Martinez specializes in arthroscopic surgery of the hips, knees and shoulders. As we talked about before, shoulder surgery is its own subspecialty in orthopedics due to the increased complexity of this joint.
We talked a bit about hip arthroscopy,which is still a relatively new procedure in orthopedics and the fact that one two surgeons in Bogota are currently performing this procedure.
Arthroscopy is the orthopedic minimally invasive counterpart to general surgery’s laparoscopy or thoracic surgery’s thoracoscopy. It involves insertion of a camera and several tools through small (1 cm) incisions in the skin. Arthroscopy itself has been used in orthopedics for many years but it is just now making inroads in hip procedures.
I’ll be publishing an upcoming article based on my observations over at ColombiaReports.com
For more information
Rath E, Tsvieli O, Levy O. (2012). Hip arthroscopy: an emerging technique and indications. Isr Med Assoc J. 2012 Mar;14(3):170-4.
The authors found that 16% of patients in their study eventually required hip replacement after hip arthroscopy during seven years follow-up.
Spent part of yesterday back in the operating room with Dr. Sergio Abello. Dr. Abello is an orthopedic surgeon who specializes in foot and ankle surgery. (He also have a specialized computer system in his office for truly customized orthodics).
Dr. Sergio Abello de Castro, Foot & Ankle Center
It was a chance meeting in the hallway, but as always, with the gracious and genial surgeon – it led to the operating room. He apologized, “it’s just a small case,” but everything went perfectly.
Dr. Sergio Abello (right) with orthopedic resident, Dr. Juan Manuel Munoz
Patient was prepped and draped in sterile fashion, with no breaks in sterile technique. Case proceeded rapidly (previous surgical pins removed).
The was no bleeding or other complications.
Yvonne (left), surgical nurse
Anesthesia was managed beautifully by Claudia Marroqoon, RN – with a surgical apgar of 10. The patient received conscious sedation and appeared comfortable during the procedure. There was no hemodynamic instability or hypoxia. Oxygen saturation 100% for the entire duration of the case.
I would like to thank Dr. Francisco Cabal – an orthopedic surgeon and director of Clinica del Country/ Hospital de la Mujer. A few nights ago, a Colombian friend was seriously injured in a motorcycle accident – and the worried family asked me for help, so I called Dr. Cabal.
He was absolutely fantastic in making sure the family was up-to-date on the status of their loved one while she was in surgery, addressing all of their concerns and helping to relieve some of their anxiety.
I wanted to be sure to thank him on this (semi-public) forum, because I want readers to realize that medicine here is very different from the United States, in that – most often, if you ask for help; people will go out of their way to provide it. (I suspect given the time of day when I contacted Dr. Cabal – he was probably enjoying a nice supper or time with his family) but he had information for the family in just a few minutes..
Sometimes, at home, (the USA), there is a barrier, or ‘gatekeeping’ that keeps us from our providers – and can make situations like this more difficult. But here in Colombia, as I’ve said before – the doctors give you their cell phone numbers and emails because they want you to call if you have questions or concerns..
And when you do call – you are getting their personal phones, so you won’t be routed to a secretary or left on hold for twenty minutes.. [the only exception is during surgery].
Does this privilege get abused at times? Certainly, which is what makes it more impressive that these doctors stay accessible to their patients. [We’ve all encountered obnoxious customers in all lines of work – medicine and health in no exception.]
I have published several Images of Surgery in Colombia to the web to give outsiders a glimpse into the operating rooms here in Bogota. But since Yahoo! has overhauled their site – I will publish images here for readers, including photos from some of my other travels (Mexico, Medellin).
However, please do not use/ copy/ alter these images without my express written permission. (All photos by K. Eckland)
Dr. Victor Lizcano, Chief of Orthopedics
Spent the day with several surgeons from the Department of Orthopedics at Clinica San Rafael – which has a city-wide reputation for excellence.
Dr. Victor Lizcano, MD is the charming Chief of Orthopedics who opened his busy, 11 surgeon department to me. I watched surgeries, talked to patients, reviewed films, and interviewed the surgeons in his department, with free rein.
Orthopedics surgical team; two instrumentadors and 4th year resident (center)
Dr. Maria Angela Gomez, MD, a busy surgeon who nevertheless took the time to talk to me; manages dual practices; both as a plastic surgeon (at Clinica de Marly) and an orthopedic (hand) surgeon. She’s currently involved in a very interesting research project – tell you more about it later… A very fascinating lady.
Dr. Martha Pincon, MD an orthopedic surgeon specializing in foot and ankle surgery, also a very interesting and enjoyable surgeon.
Dr. Martha Pincon, during a complex case at Clinica San Rafael
There’s a lot more to tell – but I have another interview in a few minutes..
The rest of Bogota may be quiet for the Easter holidays (la semana santa) but the operating rooms were busy at Unidad Medica Cecimin.
Dr. Mauricio Largacha, Shoulder and Elbow surgeon
I spent an interesting and enjoyable morning in the operating room with Dr. Mauricio Largacha, MD for an arthroscopic Rotator Cuff Repair. Dr. Largacha is a natural teacher, and did an excellent job at explaining different aspects of the procedure, expected post operative outcomes, and specialized equipment – since I am less familiar with shoulder and elbow surgery than other surgical procedures. (Unsurprising since as I mentioned previously, he is an expert in this area, and the author of several chapters in multiple orthopedic surgery textbooks on elbow, shoulder and ankle surgery).
Dr. Mauricio Largacha (left) and author
Surgery went beautifully, and surprisingly quick.. No intraoperative complications.
Dr. Mauricio Largacha is an orthopedic surgeon specializing in shoulder and elbow surgery including arthroscopy, rotator cuff repair and joint replacement. I’ll be following him to the operating room this weekend – so check back in for more details..
For readers unfamiliar with orthopedic surgery – ankle and shoulder joint surgeries are a particular sub-specialty only practiced by a few orthopedic surgeons. Luckily for readers here – Dr. Largacha is the author of several of the most heavily used textbooks (and chapters in American medical textbooks) on both ankle and shoulder surgery.