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Kamis, 10 Januari 2008

Re: [surfacehippy] Re: MIS

Great news!!! May your recovery continue to go
smoothly,
jackie
pre-op sf
--- Leslie <coskater64@yahoo.ca> wrote:

> I had Mr Treacy as my surgeon, he said it would be
> about 35-45 minutes for me, I was a
> difficult case. I think he has a very well oiled
> team?? I am unsure though as I was under
> GA..... Currently, I am 3 months and almost 2 weeks
> out and so far everything is fine. I
> am doing the sport I love again and just taking my
> time and enjoying the chance to learn
> it all over again.
>
> Leslie
> RBHR Treacy
> 10/2/07
> --- In surfacehippy@yahoogroups.com, John &/or
> Jacqueline Hullar <jhullar@...> wrote:
> >
> > Thanks for this interesting post, Vicky.
> >
> > I just wonder how Treacy does his so darn
> fast....!
> > jackie
> > sf pre-op
> > --- vicky4vi <vickymm@...> wrote:
> >
> > > http://www.surfacehippy.info/misapproachbose.php
> > >
> > > Dr. Bose explanation of MIS
> > >
> > > "Yes, it is true that minimally invasive
> approach
> > > has been proven not
> > > to have great benefits over a conventional
> incision
> > > in terms of blood
> > > loss, pain , or speed of recovery in the same
> > > surgeons hands. It is
> > > only of cosmetic value.
> > >
> > > All studies to investigate this have been done
> on
> > > two groups of
> > > patients in which a single surgeon employs the
> two
> > > approaches in the
> > > diff groups. When a surgeon who is capable of
> doing
> > > a minimally
> > > invasive approach does a conventional approach
> it is
> > > logical that the
> > > conventional technique will be only marginally
> > > bigger and therefore
> > > advantages do not show up in studies. However,
> if a
> > > minimally
> > > invasive approach of a surgeon is compared with
> a
> > > conventional
> > > approach of another surgeon who never does
> minimally
> > > invasive or
> > > never makes an attempt to reduce his incision
> size
> > > (within comfort
> > > levels)- the differences will show up.
> > >
> > > When one compares an incision which is 5 cms for
> a
> > > particular
> > > procedure with another which is 50 cms for the
> same
> > > procedure - the
> > > differences will show up without any doubt.
> However
> > > to see objective
> > > difference between an incision which is 5 cms
> and 8
> > > cms it is
> > > difficult This is a question of degree.
> > >
> > > MIS approach has been accused to be just a
> marketing
> > > trick which has
> > > caused more harm than good. This is true in many
> > > instances however
> > > one must be careful not to confuse MIS surgery
> with
> > > the concept of
> > > minimizing incision size When surgeons are
> focused
> > > on doing a surgery
> > > with a pre- determined incision size like say 10
> cms
> > > - they are hell
> > > bent on doing this through this incision even
> though
> > > they are
> > > struggling and probably getting many things
> wrong in
> > > the deep bone
> > > work. This is certainly not good. Scientific
> papers
> > > enumerating
> > > surgical disasters when this is employed is
> common
> > > place
> > >
> > > The other side of the coin is when surgeons chop
> up
> > > patients to
> > > extraordinary lengths. Certainly it is equally
> wrong
> > > to cut up
> > > tissues unnecessarily when the same can be
> > > accomplished to the same
> > > degree of accuracy by employing a much smaller
> > > incision. In other
> > > words it is certainly the duty of the surgeon to
> > > minimize the length
> > > of incision of any elective procedure but
> ensuring
> > > that he is
> > > comfortable and deep bony work is not
> compromised in
> > > any way. There
> > > should not be any predetermined length but the
> > > surgeon must
> > > consciously reduce incision size as a guiding
> > > principle. Undoubtedly
> > > a hip incision that goes all the way to the knee
> > > will have many other
> > > bad effects apart from the scar.
> > >
> > > Therefore there is no doubt that surgeons must
> be
> > > constantly striving
> > > to reduce incision size without compromising any
> > > other factor.
> > > However trying to work with a pre-determined
> > > incision size is
> > > frequently a recipe for disaster. It is also
> well
> > > accepted that
> > > revolutionary techniques like the two incision
> > > technique for THR in
> > > which the surgeons previous experience with THR
> is
> > > rendered
> > > completely useless is very risky when compared
> > > evolutionary
> > > techniques in which surgeons reduce incision
> size
> > > progressively.
> > >
> > > Surgical speed is another interesting topic. The
> > > fastest hand that I
> > > have seen wield the scalpel is undoubtedly Ronan
> > > Treacy who can
> > > finish a resurfacing in 20-25 minutes. However
> Mr.
> > > McMinn who
> > > invented resurfacing and who of course trained
> Mr.
> > > Treacy still takes
> > > close to two hours. The turnover time will be 3
> hrs.
> > > I still take
> > > close to two hrs for a resurfacing with a
> turnover
> > > time of 3 hrs.
> > > There are so many steps and no matter how fast
> you
> > > do them it takes
> > > that amount of time to do all the steps. The
> neck
> > > capsule
> > > preservation that I do takes extra time as well.
> > > Attempting to reduce
> > > incision size and using subcuticular absorbable
> > > stitches all add up
> > > the time taken for surgery. If I don't do all
> these
> > > i probably can
> > > finish in an hour. If I should finish a
> resurfacing
> > > within half an
> > > hour there is no doubt I will be skipping steps.
>
> > >
> > > Vijay Bose.
> > > Consultant Orthopaedic Surgeon
> > > Apollo Hospital
> > > chennai
> > > www.hipresurfacingindia.com "
> > >
> > > Vicky
> > > LBHR Dr. Bose Dec 01 05
> > >
> > > --- In surfacehippy@yahoogroups.com, "Dennis
> Albee"
> > > <dalbee@>
> > > wrote:
> > > >
> > > > Does anyone know how the other big name OS's
> feel
> > > about minimally
> > > > invasive surgeries (Gross, Amstutz, Mont, Su,
> > > Bose)?
> > > >
> > > > Thanks,
> > > >
> > > > Dennis (scheduled for late April - HSR)
> > > >
> > > > -----Original Message-----
> > > > From: surfacehippy@yahoogroups.com
> > > [mailto:surfacehippy@yahoogroups.com]
> > > > On Behalf Of ps2_sfca
> > > > Sent: Thursday, January 10, 2008 12:46 AM
> > > > To: surfacehippy@yahoogroups.com
> > > > Subject: [surfacehippy] Re: Attention
> California
> > > Hippies with blue
> > > > shield
> > > >
> > > > Thanks for the information. The jury is out on
> > > minimal invasive
> > > being
> > > > good or bad at this moment. There are no long
> term
> > > studies pointing
> > > > either way with HSR or THR. I just want my
> fees
> > > reimbursed if
> > > possible.
> > > >
> > > > Congrats on your appeal. I had to appeal BSCA
> > > decision not to
> > > preapprove
> > > > benefits last Jan 07. Luckily, it didn't go as
> far
> > > as the Ca dept of
> > > > Managed care because I would have lost for
> sure
> > > because my company
> > > is
> > > > self insured and BSCA only administers the
> > > benefits(CA has no
> > > > jurisdiction for self insureds).
> > > >
> > > > Dr. Gross performed my HSR and my experiences
> > > mirrored yours. My
> > > > surgical wound was completely healed when I
> took
> > > the bandages off
> > > in ten
> > > > days, and I have not needed any pain
> medication
> > > post op. The nurses
> > > gave
> > > > me tylenol during my two and a half day
> hospital
> > > stay and I have not
> > > > taken any since. My hip is pain free.
> > > >
> > > > --- In surfacehippy@yahoogroups.com
> > > > <mailto:surfacehippy%40yahoogroups.com> ,
> > > "rodwindle" <rodwindle@>
> > > > wrote:
> > > > >
> > > > > No, Dr. De Smet wants to see what he is
> doing
> > > and get the
> > > > prosthesis located properly.
> > > > > I'm firmly in his camp: make the incision as
> big
> > > as you want,
> > > > just get the metal aligned
> > > > > perfectly. You don't want to have to do it
> > > again.
> > > > > I have a nice 8 inch incision from my
> surgery
> > > three weeks ago. I
> > > > would caution against the
> > > > > (logical) conclusion that smaller incision
> > > equals faster and
> > > > easier recovery. I have had no
> > > > > need for post-op medication and my incision
> was
> > > completely closed
> > > > after nine days. I am
> > > > > feeling amazingly normal (WAY better than
> before
> > > surgery). I
> > > > believe the skill of the
> > > > > surgeon is of critical importance, no matter
> how
> > > large the
> > > > incision is. Dr. De Smet thinks
> > > > > that the 'minimally invasive' approach is no
> > > good for resurfacing
> > > > and will lead to trouble.
> > > > > He was not at all happy with some of the
> > > techniques he saw at the
> > > > 1'st 'annual' resurfacing
> > > > > conference back in November.
> > > > > If you're interested in BSCA appeals, go to
> this
> > > website:
> > > >
> > >
> >
>
http://www.dmhc.ca.gov/dmhc_consumer/pc/pc_imrdec.asp
> > > >
> > >
> >
>
<http://www.dmhc.ca.gov/dmhc_consumer/pc/pc_imrdec.asp>
> > >
> > > > > to see how cases have been decided.
> > > > > --rod
> > > > > LBHR De Smet 12/18/07
> > > > >
> > > > > --- In surfacehippy@yahoogroups.com
> > > > <mailto:surfacehippy%40yahoogroups.com> ,
> > > "ps2_sfca" <ps2_sfca@>
> > > wrote:
> > > > > >
> > > > > > Does Dr. DeSmet use the minimally invasive
> > > surgerical
> > > > procedure? If
> > > > > > so, did BSCA cover it? I looking for any
> info
> > > on minimally
> > > > invasive
> > > > > > for BSCA appeal purposes.
> > > > > >
> > > > > > --- In surfacehippy@yahoogroups.com
> > > > > > <mailto:surfacehippy%40yahoogroups.com> ,
> > > "rodwindle"
> > > <rodwindle@>
> > > > wrote:
> > > > > > >
> > > > > > > Thanks for the accolades, Alan. However,
> I
> > > don't think I'm
> > > > the
> > > > > > first...
> > > > > > > I know that Kani Rowland got reimbursed
> by
> > > Blue Shield Alaska
> > > > last
> > > > > > year for his
> > > > > > > bilateral surgery with Koen. In any
> event, I
> > > will do all that
> > > > I can
> > > > > > to help others succeed with
> > > > > > > their insurance companies. BTW, I've
> enjoyed
> > > your posts since
> > > > I
> > > > > > first started lurking on the
> > > > > > > site a few years ago.....
> > > > > > >
> > > > > >
> > > > >
> > > >
> > >
> > >
> > >
> >
> >
> > jacqueline collins hullar
> > 3954 washington street
> > san francisco, ca 94118
> > 415-379-3715 home
> > 415-609-4591 cell
> > 415-379-3745 fax
> >
>
>
>
>

jacqueline collins hullar
3954 washington street
san francisco, ca 94118
415-379-3715 home
415-609-4591 cell
415-379-3745 fax

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