Premature baby saved by groundbreaking NHS surgical team

A “miracle” baby girl has spent her first two nights at home after becoming what her doctors believe is the world’s youngest patient to survive major abdominal surgery.

Abiageal Peters is expected to lead a normal healthy life after being saved in pioneering operation her parents and doctors say was only possible under the NHS.

“She is always going to be our little miracle,” her mother, Louise Peters, said from her home near Esher, Surrey, with the sound of Abiageal gurgling in the background.

Abiageal was born in October 2016 at St Peter’s hospital, Chertsey. She was three months premature, after a gestation of only 23 weeks. Peters was warned her baby had little chance of overcoming a severe gut condition known as perforated necrotising enterocolitis. Her intestine was torn in three places and her stomach had started turning black.

An operation at a specialist neonatal unit at St George’s hospital, London, was Abiageal’s only hope, despite the risk of surgery on such a young and small baby. She weighed just 609g (1lb 5oz).

“She would have been dead without the surgery,” Peters said. “She was deteriorating so badly at that point. She was struggling to breathe and her skin was turning black. We knew she had a day or two left if that, if they didn’t operate.”

Consultant Zahid Mukhtar, who led the operation, said it was extraordinary that Abiageal managed to pull through surgery. “We have trawled the literature and couldn’t find anyone who has been operated on at that early an age and survived. Her story and her recovery has been really remarkable.”

Speaking to the Guardian, he said: “She was smaller than my hand when we operated on her. But it was her prematurity that was so unusual – her organs were so fragile and jelly-like that as soon as you started operating, even with our small instruments, everything started to bleed or fall apart.”

He spoke of the team’s pride in saving Abigail. “It is beyond the craft of surgery, something more has to come into it, to push boundaries like this. It is an amazing achievement for our team, so we are really proud. The fact that four months later she is a really healthy child, with a good brain, is amazing considering how premature she was.”

Peters, a financial analyst who grew up in South Africa, said: “We can’t thank the doctors enough. I don’t know if she could have survived outside the NHS. Some countries don’t even think about helping babies who are less than 25 or 26 weeks. She would have had very little chance.”

“I come from a country where you have to pay for every cent of your medical aid. This country has been phenomenal. I think the NHS is absolutely wonderful.”

Peters and her British husband, David, also have a two-year old daughter, Tara. “My first daughter was such an easy pregnancy that I just took it for granted that my next baby would be as easy,” she said.

Peters added: “The beginning was especially stressful, but my baby is a fighter. Then it was four months of waiting for her come off breathing support and sort out her feeding. There have been lot of hurdles, infections, blood transfusions along the way.

“Other mothers who have this happen to them, should know there is a chance – don’t give up, these little babies are so strong.”

She added: “It has been wonderful to have her home, but there are all the usual niggles of getting a new born to sleep.”

Mukhtar said the success of the operation demonstrated the NHS at its best.

“Despite the financial pressures and morale challenges, the staff working in the NHS are amongst the best in the world,” he said. “They are really pushing the boundaries. Any patient that comes into our system gets the best we can do for them. It is mindset that is different from other places in the world where I have worked. It is a real honour for me to me working in this system.

“Outside the NHS there is no chance she would have survived. Any child in a private hospital born this prematurely would have been transferred to the NHS immediately.”

Mukhtar, who was born in mountain village in Pakistan, said he wanted to become a doctor after his three-year-old sister died from diarrhoea. “From a simple thing like that she died, because there was so little help for sick kids. From then I have tried to never give up on a child and do whatever is possible.”

He added: “I was a village kid with uneducated parents and yet this country gave me the opportunity to follow my dream and now I am able to give back that education and possibility to affect people’s lives so profoundly. It is a real shame that people are so suspicious of people coming here from other countries.”

Premature baby saved by groundbreaking NHS surgical team

Why Cosmetic Surgical procedure Laws Require a Facelift

The Web is packed with surprising ‘Plastic surgical treatment gone incorrect!’ articles meant to baffle as nicely as horrify. Why would any individual go underneath the knife when the benefits are so variable? Well, here’s the answer – plastic surgical treatment is not meant to be like that. The issue, unfortunately, is broad-ranging and goes a whole lot deeper than ‘funny’ photos of horribly mangled faces.

Cosmetic surgery is at present dangerously unregulated – it takes only a extremely fundamental degree to be allowed to perform cosmetic surgical treatment. An infographic regarding the large big difference among a plastic surgeon and a cosmetic surgeon can be located here, and it is downright surprising. But yet individuals carry on to risk their health and even their lives undergoing cosmetic surgical procedure.

One of the most substantial-profile examples of cosmetic surgical treatment gone incorrect comes from America and entails no smaller a title than Kanye West. His mother Donda West went to a cosmetic surgeon for “routine” liposuction and breast reduction, but shortly afterwards died of, in accordance to the coroner’s report, “coronary artery disease and several post-operative aspects due to or as a consequence of liposuction and mammoplasty.” It was unveiled that West had overall health concerns and medical professionals suggested her against undergoing cosmetic surgery she went to a diverse surgeon (with a dubious popularity) to have it carried out as an alternative. The end result, of course, was her death – and elevated scrutiny of the American plastic surgical treatment business. Two years later, Californian Governor Arnold Schwarzenegger signed in a bill requiring any person in the state undergoing plastic surgical treatment to get a bodily examination initial.

Sadly, you could argue that this stage was taken only since of the fame of the individuals concerned. Outdoors of the celebrity world, there is a great deal of concern about the men and women practising cosmetic surgical procedure. In the United kingdom in 2015, the Royal University of Surgeons spoke out about the issues inherent in allowed non-professionals to perform plastic surgical treatment. “Operating outdoors of speciality is a large difficulty in private practice as money is concerned, so we hope to rectify that,” said Stephen Cannon, vice-president of the RSC. “There will be no worries if you are already an established surgeon doing very well. But it’ll stop the basic practitioner doing the nose work, it’ll quit the dermatologist lifting someone’s breasts, it’ll quit all that cowboy behaviour which goes on.”

But change is slow in coming, due to the fact the fact of the matter stays that men and women typically really badly want plastic surgical treatment, and (like Donda West) will go to excellent lengths to get it. Entire body dysmorphic disorder at times plays a part – but even then, patients will frequently undergo procedures and nevertheless discover their BDD not bettering at all. The mental overall health of the patient is an additional factor that needs to be thoroughly checked out before a patient undergoes cosmetic surgery, and yet at the moment, it is not. Stories of ‘plastic surgery addicts’ run rife in the media, but it also rarely seems to question what type of physicians would allow their patients to ruin their lives with surgical procedure and not lift a finger.

Physicians who are paid a lot – but who are also permitted to get away with a lot – is the response there. Cosmetic surgical treatment, rather than currently being observed as a main operation, is now noticed as one thing informal and commonplace that can be fitted in among dropping the youngsters off at college and choosing them up yet again. In 2013, in the middle of the recession, cosmetic surgical procedure was still booming.

Generally, cosmetic surgeons are handled like youth and elegance dispensing machines rather than genuine physicians, and it is turn into critically damaging. The marketing behind the sector does nothing at all to dispel the belief that cosmetic surgical treatment is effortless, swift, painless and non-problematic – some clinics that offer Botox have get-1-get-one particular-totally free and loyalty stage schemes. The British Promoting Standards Authority started cracking down on adverts in 2015, banning an advert for plastic surgical procedure in Malaysia which announced “Malaysia is proud to be amid one particular of the only nations inside of the region exactly where health-related tourism is promoted by the government.”

They were proper to, but regardless of this, medical tourism remains enormous – and hugely harmful. In 2014 the CDC issued an alert following four women died and nineteen developed infections whilst looking for plastic surgery in the Dominican Republic. And yet folks continue to risk their lives, and typically drop them, in pursuit of perfection. In 2015, Britain’s ‘most nipped and tucked woman’, Alicia Douvall, appeared on Television to advertise the notion of raising the minimum age to undergo plastic surgery to 21 – and also mentioning that due to her surgical treatment “addiction”, “I cannot smile effectively and cannot breathe through my nose.”

Who can be blamed for all this? However, the finger can’t be pointed at any one individual. Some have blamed celebrity surgeons like Dr. Fredric Brant, the “Baron of Botox” whose own suicide in early 2015 ended up currently being blamed partly on bodily dysmorphic disorder. Other individuals have blamed a culture obsessed with seems to be that drives folks (particularly girls) to plastic surgery in the initial location – celebrity magazine covers and razor-thin models on billboards lead young ladies and older ladies to feel inadequate, creating them get desperate measures to really feel eye-catching. And of course, the cosmetic surgeons the two abroad and at house who deliberately exploit their sufferers deserve to be hit with the total force of the law any time a patient dies under their care.

It is a complex problem, but it’s also important to note that cosmetic and plastic surgical treatment have useful and even essential makes use of, too. People in search of gender reassignment surgical procedure frequently find that cosmetic surgical procedure can make them come to feel much more relaxed with their gender. Ladies who have had to undergo mastectomies can be helped tremendously by plastic surgical treatment that reconstructs their breasts. And men and women who have been badly injured by fire or acid attacks turn to plastic surgical procedure to aid cover up the injuries they’ve sustained and come to feel confident once more.

Sadly, there might be a extended way to go prior to the grimy elements of the market are fixed or removed. Till more laws are signed into result, there will most probably be a excellent quantity more Donda Wests and Alicia Douvalls. But understanding is half the battle – when undergoing plastic surgical treatment, you ought to know your rights as a patient, know your medical doctor is licensed, know that your psychological and physical well being has been checked more than 1st, and (perhaps most importantly) know what you want and why you want it.

Why Cosmetic Surgical procedure Laws Require a Facelift

Bariatric surgical procedure is no cure-all for obesity I know, simply because I have had it | Sharon Bates

‘What issues would bariatric surgical procedure expansion solve? Will it tackle the social and cultural issue of readily available, comparatively low cost food?’ Photograph: Chris Radburn/PA

I am probably one of the few individuals in the United kingdom who is each a extended-phrase bariatric patient and a skilled specialising in the discipline of fat-loss surgical procedure. Fourteen many years in the past, when I was a dimension 32, function and everyday tasks – even getting in and out of the bath – proved challenging. I developed avoidance tactics to minimise bodily discomfort and the resultant sweating, soreness or breathlessness. Supermarket purchasing meant parking as near to an entrance as attainable, and often employing a trolley, basically so I could lean on it. I had sores from my flesh rubbing collectively in the summer time, and at the time I had excess weight-reduction surgical procedure, in 2000, buying outfits online was not an choice, so my selections had been severely constrained.

Last week, new NHS draft tips suggested gastric bands and other bariatric surgical treatment could be made offered to 800,000 further people to aid address the escalating problem of sort two diabetes. This is linked with becoming overweight, and the National Institute for Well being and Care Excellence (Great) has proposed lowering the threshold for bariatric surgical procedure. This would suggest that sort 2 diabetics with a BMI of 30, rather than 35, would potentially be eligible.

Possessing misplaced fat via bariatric surgical procedure, you may anticipate me to be in favour of this. But what difficulties would it fix? Will it deal with the social and cultural concern of readily accessible, fairly low cost foods? It is hardly likely to address the insistent marketing and advertising ploys of huge firms. Will it tackle why some of us are hugely geared to use foods and consuming as a reward, or the production and provision of overly huge portions? Will it quit meals or a huge latte getting consumed on the hoof? Stroll outdoors and note how clear and subliminal triggers connected to food and fluid surround us. We require to alter our culture as nicely.

These of us who have had surgical procedure realise that neither the surgical procedure nor weight reduction offers a easy solution. Surgery does not remedy diabetes, though it may possibly cause remission. Surgical procedure does not cure the practically assured osteoarthritis of people who are considerably obese.

When I stepped into the then practically unknown globe of excess weight reduction surgical treatment, I had the naive belief that fat loss surgery would be an easy, basic, swift and long term way to be thin. I would be asleep, and would wake up as a new man or woman who would rapidly shrink, both unable to eat or not wanting to eat.

It had taken me more than forty many years to turn out to be the shape and dimension I was, and there were numerous motives I had chosen to self-soothe or medicate employing foods. At the time I had no comprehending of the psychological, emotional, bodily and sensible approach that would comply with surgical treatment. I only wished to be thin – and two many years soon after my surgical treatment I had misplaced nine and a half stone.

Weight-reduction surgical treatment alterations your anatomy internally, but it can’t bypass previously learned behaviours. My weight was not the end result of becoming tied down and force-fed I chose to eat as a form of self-soothing, self-medicine and pleasure. I genuinely believed I did not consume massive quantities of foods and was resistant to accepting duty for how I cared for my physique or how I dealt with anxiety and wellbeing. I avoided workout, cooked and ate enormous enormous quantities and had little “me” time – when I was excess fat, I felt I wasn’t well worth my personal time.

To preserve or accomplish a healthy form and dimension, surgery has to be 1 of a selection of approaches, along with other people this kind of as yoga, pilates, counselling, private treatment, dietary assessment, treatment of allergy symptoms and healthcare problems. For me, the approach has mainly involved accepting responsibility for my overall health and wellbeing.

There are new factors to contend with when you alter size and shape. My skin became too massive for my frame and it was my accountability to decide on to whether do anything about it. The NHS may possibly be in a position to fund reconstructive plastic surgery following damage or congenital problems, but it is highly unlikely to fund redundant skin removal following bodyweight-reduction surgical procedure.

To make bariatric operations available to a lot more individuals, the NHS will have to alter. Even now, men and women who fall into the “agreed Wonderful criteria” are unable to accessibility the multi-disciplinary technique required for this surgical treatment to be profitable. There is not enough funding, also few appropriately qualified workers, psychology departments which are overstretched or simply unable to function one to a single for a lot more than a restricted number of sessions. Are we all ready to place our hands into our pockets and make substantially increased nationwide insurance payments?

More contentiously, any treatment method being integrated in a state-financed health method indicates difficult decisions. Do I stand prior to a thirty-yr-old soldier who has misplaced a limb and seeks funding for physio or a prosthesis? Does a tummy tuck come ahead of a skin graft for a kid who has suffered burns?

Thank goodness the proposal is at the moment a draft document, as it raises so several emotive factors. Do people have a “correct” to surgery? Has anybody costed prolonged-term aftercare for surgical individuals? The cost of related metabolic illness down the line? Re-operation, large-dependency bed use? The NHS must consider all these factors into account as well.

Medicare in the US is facing the same dilemma and forecasts that sort two diabetes and the resulting expenses will crush the technique, as predicted in the United kingdom. It has used fat-reduction surgical procedure far more broadly than Britain for many years. Has it really helped? It is well worth noting that I am still as most likely, if not far more very likely, to develop age-connected or weight problems-connected illness this kind of as variety 2 diabetes.

Would I do it again? It’s been a difficult journey but a revealing 1. Understanding how to be a man or woman in a “typical” body has been interesting. I have had counselling and therapeutic input. I have paid for every thing from commence to finish, and am so glad that I did it when I did.

As I walk the puppy four or 5 miles a day, it has taken me all these many years to get out of a fat-lady mind set. I can kayak, take pleasure in lifestyle and food much more than ever.

Paradoxically, obtaining not been diabetic when I had the surgery, I am probably pre-diabetic now. What would Good say about that predicament? I have no “appropriate” to be thin. I accept I may possibly regain some excess weight, and have, and only I can deal with that. There is no fairy godmother waving her magic scalpel for me – I have utilised that one up.

Bariatric surgical procedure is no cure-all for obesity I know, simply because I have had it | Sharon Bates

Time for Informed Consent: The FDA Considers Hazards of Power Morcellators in Fibroid Surgical treatment

Last week, a panel convened by the FDA deliberated over the risks and benefits of using power morcellators in gynecological surgery. In April, the agency issued an alert cautioning providers that the tools could spread malignant cells from an occult malignancy. The panel agreed that there’s no way for a doctor to predict, prior to surgery, if a uterine fibroid is completely benign.

Late last year, a Boston surgeon drew public attention to the potential dangers of the power tools. His wife – an anesthesiologist and mother of six – underwent what was considered a routine operation, as reported by the WSJ. Unfortunately it turned out that a fibroid within her uterus contained malignant cells; it was a leiomyosarcoma. She now age 41, needed an extensive course of chemotherapy to improve her odds of survival.

This case matters because fibroids commonly affect women in their thirties, forties and fifties. These growths of smooth muscle can cause pain, pressure on the bladder or rectum, and bleeding with consequent anemia. Recently the FDA estimated that the risk of a concealed, malignant sarcoma as 1 in 352 among women having surgery for what’s thought to be a benign uterine fibroid.

Hysterectomies and myomectomies to remove fibroids represent a large fraction of gynecological surgery. Power morcellators, which can mince a tumor efficiently, first entered practice in the early 1990s. A surgeon can use this sort of device laparoscopically – potentially and probably reducing a patient’s scar, time in the hospital and complications of a longer surgical procedure.

My first concern is that  Both are precious resources. It’s easier and quicker for a surgeon trained to a power morcellator than to carefully carve out a benign fibroid tumor (or several) from a woman’s uterus. So it may be a matter of economics, rather than what’s best for the patient.

pathology from a uterine leiomyoma (fibroid); PLoS  2012; 7(11) e50058

My second, and possibly greater concern, is that Many hospitals would blow off charges raised by ordinary patients as “hypothetical.” They’d dismiss, or inadequately note, untoward events that are rare but real.

You have to wonder how many side effects of approved devices go unchecked, because of the limits of FDA’s handling capabilities, conflicts of interest, and doctors’ understandable fear of law suits. The FDA encourages doctors to report bad outcomes after use of this sort of device to its MAUDE database, but in general it hasn’t required notification by providers. It’s hard to imagine that most surgeons or hospitals would volitionally report that a device used may have caused a woman’s malignant sarcoma cells to disseminate during a surgical procedure.

The FDA panel hasn’t yet issued a formal statement regarding the use of power morcellators in uterine fibroid surgery. Not surprisingly, gynecologists on the panel challenged the statistic of 1 in 352 – saying that the real risk of cancer was significantly lower than that number. But they agreed that women having the procedure “should sign a written consent form stating they understand the serious risks of laparoscopic power morcellation…”

This is a story about informed consent, and it’s not just about this particular procedure. Rather, it’s about physicians’ knowledge and representation of probable outcomes to patients. In my experience, doctors tend to minimize risks that they haven’t observed in their personal experience or hospital. Given their real time constraints, and the fact – as evident by this case – that not all bad outcomes are reported, physicians may not be aware of a procedure’s potential harms. They may genuinely not believe it to be true, or they may not acknowledge it, due to various biases to which doctors are prone.

The solution involves greater transparency and reducing conflicts of interest at the FDA, and among doctors who perform and prescribe treatments anywhere. It demands rigorous continued medical education of senior physicians in all fields. Ultimately it requires that hospitals and administrators afford surgeons and all physicians time to read, to do their work carefully, and to answer patients’ legitimate questions.

Time for Informed Consent: The FDA Considers Hazards of Power Morcellators in Fibroid Surgical treatment

Must the NHS reduced its gastric band surgical treatment threshold?

10% of the NHS budget is invested on dealing with diabetes, with type 2 – occasionally genetic but normally linked to a man or woman currently being overweight.

Proposals to decrease the threshold for bariatric surgery for folks with newly diagnosed variety two diabetes to a BMI of thirty – the point at which obese is classified as obesity – could see an extra 800,000 individuals referred for abdomen-reducing surgery.

Diabetes Uk believes that surgery need to be a last resort. Simon O’Neill, director of overall health intelligence and expert liaison, said: “Though studies have shown that bariatric surgery can assist with bodyweight reduction and have a optimistic effect on blood glucose levels, it have to be remembered that any surgical treatment carries serious risks.

“Bariatric surgical procedure can lead to dramatic bodyweight loss, which in turn may possibly end result in a reduction in people taking their variety two diabetes medication and even in some folks needing no medicine at all.

“This does not imply, however, that kind 2 diabetes has been cured. These individuals will even now want to eat a healthier balanced diet regime and be physically energetic to handle their diabetes.”

As properly as the risks of surgical procedure, there are presently extended wait lists to join evaluation clinics in which psychologists and other individuals assist individuals to comprehend the consequences of bariatric surgical treatment.

Guardian readers shared their ideas on minimizing the threshold – do you agree? Vote in our poll and share your remarks and experiences in the thread

I’m an hospital dietitian. The first thing you may not realise is a huge portion of my day is spent making an attempt to construct up frail elderly men and women, rather than acquiring obese people down.

You do get your share of folks who tell you all they’ve eaten for three days is a ryvita , and cannot account for the two stone they’ve place on because you final saw them.

The main issues sufferers mention to me are the cheapness and prevalence of low cost crappy meals – several in my spot are minimal cash flow. If they can invest £1 on a pizza that will feed their family members, they will do that rather than purchase a £1 bag of peppers which go rotten inside of a few days.

As for bariatric surgical treatment, the individuals have to go by means of rigorous ‘selection’. They should give up smoking, consuming in most cases and display a prolonged phrase dedication to fat loss – I am asked to supply a supporting letter/reference in numerous instances. The individuals truly have to have lost some bodyweight just before they’re considered and the entire method takes about a year from referral to surgical procedure – so its not exactly handed out with impunity. They’re underneath a psychologist to make confident they can take care of the truth they’re unlikely to consume a total portion once again. In addition – there is a large risk of dying on the table.

When I recognized I was practically getting to be crippled due to my fat I made a decision I would drop bodyweight at any value. Yes, I considered one particular of the gastric bypass surgeries, but in the end there had been a couple of items that stored me from it:

1. I just didn’t want to have surgical treatment.
two. I did not want the challenge of living with a stomach “pouch” that holds only a few ounces of food.
three. If a man or woman has to lose twenty lbs or so prior to the surgical treatment, then definitely that indicates a individual can lose much more. So which is what I established to do.

As I get closer to a typical bodyweight I am fearful about gaining it back.

The bottom line is that I am not on a diet regime. The way I eat now is the way I will always eat. I weigh every single single day, even though I hate to. If I never I worry I could effortlessly achieve it back and that would be a nightmare for me.

Oh, and I swim a great deal. And I will often need to do some kind of vigorous exercising if I expect not to acquire excess weight again.

Dropping this 70 lbs has modified my lifestyle in many approaches and there is no doubt that if I am able to keep it off, I will have saved myself and my society a good deal of funds in well being care expenses. (I’m in the U.S.). And my quality of existence now has some high quality to it.

This need to be signifies tested. These who can afford it need to shell out for it themselves. There are usually remarks on these threads about how it is just ‘poor’ folks that grow to be obese, but I know loads of very financially cozy, middle-class individuals who are obese, and who could well afford to pay out for this process.

As a medical professional I think this sends out totally the incorrect message. I’m afraid there is no magic to fat loss – it is hard, but it just quantities to calories in versus calories out.

We want to be empowering folks and encouraging private obligation, educating individuals correctly about wholesome residing, not selling them the lie that surgery – important, difficult surgical treatment – is the panacea.

Not everyone who is overweight due to overeating and laziness.
I had a routine op on my bladder eight years ago, and a never was broken in my groin. This has lead to me unable to walk quite far, and when I do walk I am quite slow – and any walking is incredibly agonizing.

In the 8 many years considering that that operation, I have put on just above five stone and have a BMI of 34.

I have been seeing a dietitian for last year and lost less than half a stone. Even the dietician agrees that I couldn’t consume any significantly less than I am and nevertheless be healthy.
No, I am not a secret eater. I when invested 3 weeks in hospital with each morsel measured and logged – 1000 calories a day -and I did not get rid of an ounce. I have substantial blood stress and now recently been diagnosed with diabetes two.

At the moment a BMI of 34 is as well low to qualify for gastric surgical treatment, but creating me wait until my BMI is substantial enough to qualify below current criteria, is only going to make the situation worse.

Need to the NHS lower its gastric band surgery threshold?

Must the NHS reduced its gastric band surgical treatment threshold?

NHS anti-obesity plans could lead to sharp rise in gastric band surgical procedure

Wonderful is proposing reducing the entire body mass index threshold for contemplating gastric band surgical procedure in instances of newly diagnosed variety 2 diabetes. Photograph: Anthony Devlin/PA

Much more than 800,000 further folks could be considered for gastric bands or other surgery to restrict their eating beneath fresh NHS draft suggestions.

The guidance from Wonderful, the Nationwide Institute for Wellness and Care Excellence, aims to help the escalating numbers of individuals with kind two diabetes. About ten% of the NHS budget is invested on dealing with diabetes, with kind two – occasionally genetic but generally linked to a individual being obese – the chief cause.

Nice is proposing decreasing the threshold for thinking about bariatric (abdomen-minimizing) surgical procedure for folks with newly diagnosed type 2 diabetes to a BMI of thirty, which is the stage at which obese commences to be classified as weight problems. Till now, it has mentioned that people with type two diabetes could be deemed for a gastric band at a BMI of 35.

If the alter in advice is confirmed, it would mean a huge rise in the numbers who could be referred for evaluation and potentially surgical treatment if their doctors feel it acceptable. There has been a substantial enhance in the numbers of individuals getting stomach-reducing surgery above the past five or six years to about 8,000 in 2012-13, in accordance to the health and social care information centre’s most current report this year.

But experts calculate that the new advice could imply that a lot more than 800,000 men and women in England and Wales could be eligible if their medical professionals consider they are appropriate.

Wonderful says the alter would be very expense efficient. “Far more than half of folks who undergo surgical treatment have more manage over their diabetes following surgical procedure and are significantly less probably to have diabetes-related illness. In some cases, surgery can even reverse the diagnosis,” said Professor Mark Baker, director of Nice’s Centre for Clinical Practice.

But Diabetes Uk still believes that surgery need to be a last resort. “Even though scientific studies have shown that bariatric surgery can aid with weight loss and have a optimistic effect on blood glucose ranges, it have to be remembered that any surgical treatment carries serious dangers. Bariatric surgical treatment should only be considered as a last resort if severe attempts to lose fat have been unsuccessful and if the individual is obese,” stated Simon O’Neill, director of health intelligence and expert liaison.

“Bariatric surgical treatment can lead to dramatic fat reduction, which in flip might end result in a reduction in folks taking their variety 2 diabetes medication and even in some folks needing no medication at all.

“This does not imply, even so, that kind 2 diabetes has been cured. These people will still need to have to consume a healthful balanced diet plan and be physically active to handle their diabetes.”

Diabetes United kingdom is at present supporting a trial of a extremely low-calorie diet plan for people with type 2 diabetes, followed by long-phrase excess weight management. “If a quite low-calorie diet plan can be utilised inside of routine GP care to deliver about and keep fat reduction and variety two diabetes remission, it could in the end be of massive benefit to millions of individuals living with the issue,” stated O’Neill.

“But the complete final results will not be available until 2018. Till we have the evidence that this strategy is more effective than the existing ideal-available treatment, we do not advise that men and women with type two diabetes try to shed excess weight this way.”

Nice’s advice also suggests that these extremely reduced-calorie diets, where people eat fewer than 800 calories a day, ought to not be routinely utilised and suggested only for individuals who urgently require to lose fat – for instance, ahead of joint substitute surgical treatment.

If the abdomen surgical treatment recommendations are confirmed, there will be strain on hospitals. There are currently lengthy waits to join the assessment clinics the place psychologists and other folks support patients to realize the consequences of bariatric surgical procedure, which involves everlasting change to the sorts of meals as well as the quantities men and women can eat.

NHS anti-obesity plans could lead to sharp rise in gastric band surgical procedure

Going underneath the knife: surgical procedure access should be offered to all

Two billion men and women in the world do not have accessibility to simple surgical treatment. Photograph: Gemunu Amarasinghe/AP

A quiet alter is sweeping over global overall health. Surgery, previously an unique service for rich urban dwellers, is now currently being acknowledged as a human right. It is an thrilling time for international surgeons. The neglected stepchild of worldwide public health is gradually but surely becoming accepted into the major healthcare family.

In 2009, I worked as a medical officer in a principal health centre in rural India. On a bright Saturday afternoon, a lady was brought in with significant stomach ache and fever. With the constrained resources I had, I made a probable diagnosis of acute appendicitis and referred her urgently to a bigger hospital, found 5 hrs away. Regrettably, the rains had washed away the roads and she could not be transported. The lady died from a totally treatable situation. I will in no way forget how annoyed I felt that day, particularly knowing that this was a frequent story in rural regions globally.

The World Overall health Organisation (WHO) estimates that about 2 billion individuals do not have access to surgery. According to a report published in 2008, only 3.5% of all surgeries carried out around the world have been on the poorest 35%. The burden of disease triggered by treatable surgical conditions amounts to 401 million disability-adjusted life many years (DALYs, a measurement of the burden of the disease), far more than that triggered by malaria, tuberculosis and HIV/Aids collectively (214 million DALYs). Given that DALYs signify the variety of healthy years misplaced due to disability or death, these figures translate into massive economic losses.

In 2007 WHO director-general Dr Margaret Chan included vital and emergency surgical treatment in her agenda to enhance main healthcare. Ever given that, international surgical treatment has been gaining ground. This was most clear in January 2014, when World Bank president Dr Jim Yong Kim outlined the need for globalisation of surgical treatment, calling it the “indivisible, indispensable component of healthcare”.

There is resistance to contemplating surgical treatment a component of vital well being solutions, largely due to a perception that it is complex and pricey to create and practice. No doubt the initial value of establishing a surgical practice is substantial. Even so, a number of research globally have confirmed that vital surgery is one particular of the most value-successful health interventions offered. In reality, in some nations it has been estimated that the value per year of a lifestyle saved through surgical treatment is comparable to that saved by the measles vaccine. So the financial benefits alone can outweigh the original investment. Pioneering setups this kind of as that in Narayana (Hrudalaya) Overall health Groups in India, established by Dr Devi Shetty, have repeatedly demonstrated that unit expenses come down the a lot more surgical treatment is practiced.

The other major barrier in globalisation of surgery is lack of human assets. Surgical instruction is prolonged and labour-intensive. As soon as surgeons are educated, most of them establish their practices in urban areas or leave the nation altogether, generating a vacuum that is frequently filled by unskilled pros. This can be partly addressed by scaling up training, incentivising surgeons to perform in places with the most want and by delegating straightforward procedures to non-physicians. In 2005 WHO established the Worldwide Initiative for Emergency and Crucial Surgical Care, with the goal of minimizing essential surgical treatment-connected morbidity and mortality. It has made available toolkits, reports, and manuals, organised instruction workshops, and set minimal standards and technologies essential to establish surgical treatment as a part of major healthcare practice.

Moulding evidence-based mostly practices into achievable and sustainable goals at the neighborhood degree is the key step. Pilot projects that can be scaled up have been the backbone of all public well being practices. Global surgery will be no exception. Now what is essential is for governments and donors worldwide to recognise and invest in national wellness programs to integrate essential and surgical healthcare into main care practices.

With the appropriate will, the correct policies, right analysis and a multi-sectoral strategy, providing safe and good quality surgery as a principal overall health service is an achievable objective globally.

Sristi Sharma is a physician from India and a graduate from Johns Hopkins Bloomberg School of Public Overall health. Follow @sristi on on Twitter.

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Going underneath the knife: surgical procedure access should be offered to all

Patients not told the reality about heart surgical procedure

Writer Dr Aseem Malhotra, a London cardiologist, said US studies involving a lot more than four,000 this kind of patients discovered the costs of mortality and heart attacks had been the identical between these offered the surgical procedure as amongst individuals who had been only offered medication.

He said patients ought to be given more details about the function of surgery, which ought to only be provided to individuals with lively signs of heart condition.

Creating in Jama Inner Medicine, Dr Malhotra, consultant clinical associate to the Academy of Health care Royal Colleges,says: “What we require is definitely transparency in the consent method whereby sufferers are created entirely conscious that elective stenting will not minimize their danger of a heart attack or death. This must be made “mandatory” in the consenting for method approach.”

He explained the procedure could support individuals suffering from angina, reducing the amount of chest ache, but stated also typically individuals had been provided an impression it would achieve far much more.

“Of program elective stenting has an essential function in the therapy of sufferers with limiting angina to boost the top quality of life when medical therapy is inadequate but number of individuals are explicitly told that stent won’t stop a heart assault or prolong life,” he writes.

The review by the Division of Cardiovascular Medicine, Division of Medication, State University of New York, examined 5 trials involving 4064 patients with steady heart condition, and concluded that stenting was not connected with a reduction in death or in heart attacks which have been not fatal.

Dr Malhohtra also cites separate investigation suggesting that up to half of stenting procedures carried out in the US were both “inappropriate” or of “uncertain” appropriateness.

Robert Henderson, a advisor cardiologist from Nottingham University Hospitals stated: “This is a debate that we have been wrestling with for years. It is fairly significantly unanimous that where there has been a heart attack, stenting is proper, but when it comes to other instances, there is still an terrible good deal of variation in practice across the United kingdom, which can’t be appropriate.”

Patients not told the reality about heart surgical procedure

Virtual Surgical procedure: doctors employing Google Glass

Dr. Selene Parekh is element of a tiny group of surgeons who have begun testing Google Glass in operating rooms.

He explains how physicians wearing Glass can instantaneously deliver health care records, x-rays and MRIs into see.

It can broadcast live video of uncommon operations and even use virtual-actuality-sort applications to allow a remote expert help with a difficult surgery.

Virtual Surgical procedure: doctors employing Google Glass

Star sings through surgical treatment to conserve her voice

31-yr-previous Alama Kante, who is a skilled singer, underwent throat surgical procedure in France to get rid of her thyroid gland which was a cancer danger.

“I met with the anaesthetist to know how it would go and they called me afterwards to say ‘No we are not going to do it simply because you have a expert occupation with your vocal cords, we cannot consider the danger of sending you to rest and carry out such an operation’.

So they proposed hypnosis so that I sing, so the medical doctor knows in which to locate the vocal cords that he must not touch,” she explained.

Medical hypnosis permits the patient to stay awake and respond throughout the operation.

Supply: ITN

Star sings through surgical treatment to conserve her voice

Wide Range In Cancer Danger From Radiation In Children Undergoing Heart Surgical procedure

Kids with heart ailment are at elevated danger for establishing cancer later on in life due to their exposure to radiation for the duration of imaging procedures. Since an ever-increasing amount of young children with heart ailment now reach adulthood, this may possibly turn into an more and more essential public well being problem.

A new study published in Circulation offers some reassurance in locating that for most youngsters the elevated danger is lower or negligible. But for some youngsters who undergo far more complicated procedures, the increased chance is substantial.

Jason Johnson and colleagues calculated the radiation dose received by 337 kids who underwent 1 of seven cardiac surgical treatment procedures at Duke University. The median quantity of radiation-producing imaging procedures obtained by the children was 17. The median cumulative powerful dose was two.7 mSv, much less than the yearly background exposure of three.0–3.5 mSv in the U.S.

There was a broad variation in radiation publicity. For five of the seven procedures (atrial septal defect, ventricular septal defect, arterial switch operation, tetralogy of Fallot, and atrioventricular canal defect), the median yearly dose ranged from .9 to . 29 mSv, which the authors stated was “reassuringly minimal.” But children who underwent the most complex operations obtained a lot greater amounts of radiation: the median dose was twenty.08 mSv for youngsters who underwent the Norwood operation and 42.54 for people who underwent cardiac transplantation.

Even though cardiac catheterization represented only a small percentage (1.five%) of all imaging procedures, it was responsible for a majority (60%) of the complete radiation exposure.

The lifetime attributable chance for cancer due to radiation was little for the less complex procedures, ranging from a median of six-twenty instances per a hundred,000 exposed. But the danger was much far more elevated for the Norwood procedure (799 instances per one hundred,000) and cardiac transplantation (1677 per a hundred,000). Since of the anticipated affect of radiation on breast and thyroid cancer, women had a considerably higher boost in danger than boys.

The authors create that their findings can be used in clinical practice: “To decrease lengthy-phrase cancer danger, companies ought to target reducing radiation publicity in the highest-risk cohorts, like individuals young children who will call for repetitive large-exposure imaging and females simply because of their improved cancer danger. Companies can think about our relative exposure estimates when picking among numerous radiation-generating imaging modalities.”

Wide Range In Cancer Danger From Radiation In Children Undergoing Heart Surgical procedure

Cancer charity claims older patients are currently being denied lifestyle-saving surgical treatment

The charity has mentioned sufferers are assessed for remedy bassed on age alone in some instances. Photograph: Naomi Harris

Older lung cancer individuals are becoming denied existence-conserving surgical procedure, a charity has mentioned. Those aged 75 or in excess of who are otherwise in excellent overall health and whose cancer has not spread are 5 times much less likely to be provided lifestyle-extending surgery than younger sufferers, Macmillan Cancer Assistance stated.

England and Wales have the worst five-year lung-cancer survival rates in Europe among the above 75s, a spokesman explained.

The United kingdom carries out significantly less lung cancer surgery on older individuals than in other European nations, he additional.

In some situations, sufferers are assessed for remedy based on age alone and not total fitness, the charity mentioned.

“I just cannot comprehend why healthful, older lung cancer patients are provided less daily life-saving surgical procedure than younger individuals, regardless of the fact that numerous could survive for many years afterwards,” explained Ciaran Devane, chief executive at Macmillan Cancer Assistance.

“It is deeply sad that our survival charges in this age group carry on to lag behind Europe. We should not send the message to older cancer individuals that it is Ok to discriminate.”

Cancer charity claims older patients are currently being denied lifestyle-saving surgical treatment

Surgical "robot hands" could execute operations on unborn infants with defects

Professor Sebastien Ourselin who is major the analysis stated: “Working on infants in the womb is not undertaken lightly and is reserved for just a handful of the most significant defects. Really few procedures can be done safely in the fetus making use of keyhole surgical treatment, and more complicated ones need opening the uterus, which puts both the mother and unborn child at chance. Less than one,000 procedures a yr have been attempted at various specialised clinics all around the globe.

“Our aim is to combine less invasive surgical technologies with stem cell and gene therapies to deal with a wide range of ailments in the womb, with significantly significantly less danger to both mother and infant.”

At present surgery in unborn infants can only be carried out when the foetus is 26 weeks previous. According to the Observer the task will aim to make it achievable to operate on foetuses at a significantly earlier stage of growth.

It is envisaged that the ‘robot hand’ will involve a thin, flexible probe that would be inserted into the womb. The probe’s head would have a single strand fitted with a small camera that would produce a 3D photograph within the womb. The photographs could then be utilized to guidebook the probe to its target.

In the case of a foetus with spina bifida, the probe’s other arms would be fitted with instruments which would carry a piece of gel or patch that would then be inserted in excess of the gap in the baby’s spine.

In addition to working on surgical imaging techniques, the analysis will create new instruments to increase surgical procedure on unborn babies, as properly as producing adaptations to the delivery of stem cell therapies to unborn infants.

Surgical "robot hands" could execute operations on unborn infants with defects

Pensioner "shot himself dead" in Surrey doctor"s surgical treatment

“The surgery is constantly throwing stuff out so hearing the bang of a bin is quite widespread but this was louder.

“I went about the corner and there were lots of folks and police autos about – it was chaotic.

“I did consider the noise was much louder than the typical bin noise and it sounded like a gun shot.”

Employees at The Mane Street barbers opposite the surgical procedure mentioned they have been told a guy had shot himself dead in the lavatories.

A female member of workers, who asked not to be named, mentioned: “The first issue we heard was the police sirens screaming as the initial of nine vehicles sped up.

“Then there were armed police swarming about, the doctor’s surgical procedure was closed and no person was allowed in.

“I didn’t hear a gunshot myself but an elderly couple who had been in the surgical treatment at the time said a man had shot himself.

“An ambulance turned up outdoors soon right after the police but was turned away, which makes me believe it is proper that the gentleman died.

“Everybody in the surgery had to give statements to the police before they could depart.

“From what I’ve heard the man shot himself in the toilet or the reception area, not in an appointment.”

Staff at the surgery, which has been sealed off, refused to comment on the incident.

Surrey Police confirmed they had been referred to as to reports of a “sudden death”.

A police officer was stationed by a silver Ford Focus ST parked just 25 yards from the surgery entrance, believed to be the dead man’s auto.

A spokesman said: “Surrey Police was known as to a doctor’s surgery in Station Road, Frimley just just before 11am this morning (Monday, 2 June) following reports of a sudden death.

“Officers and other emergency providers attended the spot after reports that a firearm had been discharged within the building.

“The entire body of a guy, believed to be in his 80s, was discovered at the scene, the place he was pronounced dead.

“Officers are carrying out a thorough investigation into the conditions surrounding the death but at this stage there is no indication of any third get together involvement or wider danger to the local local community.

“A publish mortem examination will take spot in due course.”

Adam Wicks, who operates at Vickery and Co estate agents in Frimley Higher Street, which is in the up coming street, said police officers had asked to see the firm’s CCTV footage.

Mr Wicks, from Camberley, Surrey, stated: “I did not hear anything at all myself as we’re too far away but there was a great deal of commotion at the surgical procedure.

“There are about 6 or 7 police automobiles all about the doctor’s surgery.

“The police came in asking about our CCTV but we never have any and they would not tell us anything.”

Pensioner "shot himself dead" in Surrey doctor"s surgical treatment

GPs to vote on charges for visits to surgical procedure

The movement, place to conference by the agenda committee and set to be proposed at the Nearby Healthcare Committees Conference in York, suggests general practice is “unsustainable in its current format” and that “it is no longer viable for standard practice to give all sufferers with all NHS services free at the level of delivery”, Pulse Today trade magazine reported.

The motion, from Wiltshire LMC, concludes: “That conference… calls on GPC to investigate national charging for general practice providers with the United kingdom governments.”

A survey by Pulse of 440 GPs final July showed that just over half of GPs are in favour of the NHS charging a little charge for program appointments, with several believing it is the only way of managing their workload and curbing rising patient demand.

Well being policy experts have stated the flat rate, which could incorporate exemptions for groups like the elderly and unemployed, would bring British well being care in line with effective methods in France, Germany and Scandinavia.

Last 12 months, Andrew Haldenby, director of the Reform consider tank, mentioned payments for GP appointments were frequent elsewhere in Europe, which includes France exactly where the costs are recognized as “responsibility payments”.

“The thought is that individuals are a lot more responsible about the want to pay a visit to their doctor,” he stated. “Of program it seems practically like an unthinkable move, but in the current circumstances it is realistic to think the unthinkable.”

But some top medical professionals advised the measure could put off individuals with a genuine want for assist, and could “hinder the doctor-patient romantic relationship”.

Dr Chaand Nagpaul, chairman of the BMA’s GP Committee, mentioned in July: “I entirely sympathise with the disappointment GPs have with feeling their workload is unmanageable and demand is exceeding their capability to give care … but we believe charging individuals is not the remedy.”

GPs to vote on charges for visits to surgical procedure

Man undergoing minor surgical treatment given vasectomy by blunder

The believe in say this is only their 2nd “in no way event” – a health-related blunder that must never occur – since 2011. The other incident involved a patient who had the wrong teeth eliminated.

Dr Peter Williams, the health care director, stated: “We can verify a patient who was scheduled to have a distinct small urological method was wrongly offered a vasectomy.

“We have apologised unreservedly to the patient and we are giving him our complete help. We tremendously regret the distress this has brought on him.

“It is our duty, in the best interests of the patient to uphold their confidentiality, for that reason we are not able to offer any further detail without having their agreement.

“This is a severe incident and we are investigating this totally to realize why it occurred and how we can guarantee it does not happen once more.”

A vasectomy is a surgical procedure in which the tubes that carry sperm from a man’s testicles to the penis are lower, blocked or sealed.

In most cases, it is much more than 99% successful and although it can be reversed, NHS England figures present that the good results fee is only around 55%.

Ian Cohen, clinical negligence attorney at Slater &amp Gordon, explained the error could value the believe in a six-figure sum.

He explained: “This is a genuinely shocking and worrying case. From what we know there has been a catastrophic breakdown in process, as straightforward checks developed to guarantee the proper operation is carried out on the right patient look to have failed.

“In a worst-case situation – sterility in a younger guy with no kids – the trust may be liable for a figure in extra of £100,000 in compensation.”

Hospital bosses admitted the error throughout a Royal Liverpool and Broadgreen University Hospitals NHS Trust board meeting.

Chief executive Aidan Kehoe stated it appeared the Planet Health Organisation (WHO) surgical security checklist had not been followed when the operation occurred in February.

Hospital Chairman Judith Greensmith asked for assurances more than the use of the checklist, which has also been raised by England’s well being watchdog, the Care Top quality Commission.

The GP-led Liverpool Clinical Commissioning Group board, which monitors patient security incidents, explained the situation involved “wrong site surgical treatment”.

Dr Williams stated: “We take any incident such as this extremely critically and report them at the highest level in the trust and to our regulators …

“We care for around 90,000 inpatient and day-situation individuals a 12 months and carry out over 25,000 surgical procedures. Since 2011 we have had one other never ever event.”

Union bosses have claimed that staffing cuts and elevated stress on their members could be partly to blame for the error.

Louise Ellman, Liverpool Riverside MP, stated: “Obviously this is a matter of great concern for the individual concerned.

“This need to be followed up by the hospital and action taken to make sure it doesn’t come about once more.”

Hospitals are now required to publish a quarterly checklist detailing their never events so that performances amongst distinct hospitals can be in contrast.

In the 12 months till September final 12 months there have been 299 never ever events in NHS hospitals across the country, such as operations on the wrong side of the physique and health-related instruments left within a patient following the process.

Man undergoing minor surgical treatment given vasectomy by blunder

Sufferers ought to get fiscal advice at GP surgical procedure, watchdog says

Mr Selbie highlighted a scheme in Derbyshire, in which Citizens Guidance have set up clinics in practically 100 GP surgeries. They evaluate the economic guidance they give to offering sufferers a flu jab.

He stated: “In Derbyshire, there are 102 GP practices, of which 98 have a weekly clinic operated by the Citizens Suggestions Bureaux to guarantee individuals have access to support, which can resolve nerve-racking issues this kind of as housing, employment and advantages troubles or any other matter obtaining in the way of their excellent overall health.”

The chairman of the Royal College of GPs stated patients could be left feeling that fiscal solutions had been being “forced on them” when they wished healthcare help.

Dr Maureen Baker mentioned monetary tips in surgeries was not one thing that the occupation “could or should” be expected to offer.

She stated: “Doctors are skilled and skilled to diagnose and treat illness this is what our individuals rely on and expect from us, and it is important that this remains our principal priority.

“GPs are already struggling to cope with ever-growing workloads while funding for common practice is at an all-time lower. Some medical professionals are seeing upwards of 60 sufferers a day, and it would not be feasible or proper for them to consider on an extra function as economic advisers.

“We would also be concerned about economic representatives operating from GP surgeries if they have been for-revenue. The partnership between patient and physician is one of trust and confidentiality, and this could be broken if sufferers felt that GPs were forcing other services on them.”

Referring to the Derbyshire scheme, Mr Selbie said: “We know that not getting enough cash to dwell on, or somewhere respectable to dwell are barriers to people’s very good wellness and wellbeing, and we have the voluntary sector, council and CCGs [clinical commissioning groups] functioning collectively in a way which implies men and women have assistance via early intervention guidance services and staying away from the possible require for high-priced wellness care later on.”

In accordance to the Workplace for National Statistics, kids in the richest areas in Britain can count on to reside an energetic lifestyle for up to 20 years longer than their counterparts in the poorest neighbourhoods.

In a survey by StepChange, a charity offering debt guidance, practically 3- quarters of men and women explained that debt worries impacted their sleep, whilst six in ten recommended that mood modifications relating to debt concerns impacted their behaviour.

A spokesman for the British Health-related Association explained it was unlikely that the vast majority of GP practices would have the sources to provide this kind of a support.

Sufferers ought to get fiscal advice at GP surgical procedure, watchdog says

Patients should get financial suggestions at GP surgical treatment, watchdog says

Mr Selbie highlighted a scheme in Derbyshire, where Citizens Advice have set up clinics in almost 100 GP surgeries. They compare the financial advice they give to offering patients a flu jab.

He said: “In Derbyshire, there are 102 GP practices, of which 98 have a weekly clinic operated by the Citizens Advice Bureaux to ensure people have access to help, which can resolve stressful issues such as housing, employment and benefits problems or any other matter getting in the way of their good health.”

The chairman of the Royal College of GPs said patients could be left feeling that financial services were being “forced on them” when they wanted medical help.

Dr Maureen Baker said financial advice in surgeries was not something that the

profession “could or should” be expected to provide.

She said: “Doctors are skilled and trained to diagnose and treat illness; this is what our patients rely on and expect from us, and it is important that this remains our main priority.

“GPs are already struggling to cope with ever-increasing workloads whilst funding for general practice is at an all-time low. Some doctors are seeing upwards of 60 patients a day, and it would not be feasible or appropriate for them to take on an additional role as financial advisers.

“We would also be worried about financial representatives operating from GP surgeries if they were for-profit. The relationship between patient and doctor is one of trust and confidentiality, and this could be damaged if patients felt that GPs were forcing other services on them.”

Referring to the Derbyshire scheme, Mr Selbie said: “We know that not having enough money to live on, or somewhere decent to live are barriers to people’s good health and wellbeing, and we have the voluntary sector, council and CCGs [clinical commissioning groups] working together in a way which means people have support through early intervention advice services and avoiding the potential need for expensive health care later on.”

According to the Office for National Statistics, children in the richest areas in Britain can expect to live an active life for up to 20 years longer than their counterparts in the poorest neighbourhoods.

In a survey by StepChange, a charity providing debt advice, almost three- quarters of people said that debt worries affected their sleep, while six in 10 suggested that mood changes relating to debt issues affected their behaviour.

A spokesman for the British Medical Association said it was unlikely that the vast majority of GP practices would have the resources to provide such a service.

Patients should get financial suggestions at GP surgical treatment, watchdog says

NHS sufferers are missing out on existence-saving robot surgical procedure

A gynaecologist uses a robot. Photograph: Jean-Paul Chasse/Alamy

New life-saving surgical techniques are not being adopted quickly enough in British hospitals. That is the stark conclusion of a report by the Royal College of Surgeons (RCS) which warns this week that patients are missing out on new procedures because the NHS is failing to set up programmes to promote their use in the UK.

The report, Innovation to Adoption: Successfully Spreading Surgical Innovation, stresses the need to find ways to introduce new surgical techniques as quickly as possible, thus saving lives and helping the NHS to save money.

New surgical techniques – involving robotics, 3D-imaging and lasers – have been developed in recent years, but in many cases have only been introduced in a haphazard manner in British hospitals. This failure to act coherently is now causing concern among surgeons.

“Many patients are not benefiting from ground-breaking procedures, even when surgeons firmly believe that they can save or extend lives. This cannot continue,” said Professor Norman Williams, the RCS president. “We cannot afford to neglect the kind of surgical innovation that has made such a difference to survival and recovery, such as keyhole surgery and advancements in transplant surgery.” He added that the NHS, the government and doctors had to understand how to accelerate innovative surgical practices in the UK.

The point was backed by David Neal, professor of surgical oncology at Cambridge University. “The NHS is the perfect place to test new technologies,” he said. “It covers the whole country and gives us an ideal platform for showing the worth of a new surgical technique. Unfortunately, this is not being done. The NHS does not seem to be able to tackle this sort of thing. Instead, we are relying, in many cases, on tests being done in the US, where there are commercial pressures involved.”

Neal has been involved in using a semi-automated technique known as robot-assisted radical prostatectomy (Rarp) to treat prostate cancer in the UK. “The technique greatly improves a human surgeon’s performance,” said Neal. “Using current methods, a patient is typically in hospital for around five days, while around 20% of them need blood transfusions. With Rarp, they can leave the next day and only about 1% of patients need a transfusion.”

About 200 prostate cancer patients are now being treated every year using the new technique. “That is far to low a figure,” Neal added. “We need to introduce the technique to enough hospitals to treat around 10,000 patients a year, but that is not happening.” He added that the UK needed a network of about 10-15 hospitals where new medical techniques would be taught to surgeons.

The need to promote robots in medicine is seen as being particularly important in future. The first robot procedure was offered to NHS patients in 2004, but the NHS has yet to fund the purchase of a single surgical robot and has relied instead on charities and endowments to provide cash to buy them.

A programme to help surgeons learn keyhole colorectal surgery for patients with bowel cancer and other conditions was set up in 2007. Mark Coleman, a consultant at Plymouth Hospital involved in creating the programme, said: “In 2008, 10% of operations on the colon involved keyhole surgery. Now that figure has reached 50% and the saving for the NHS over that period has been calculated as being around £11m.”

NHS sufferers are missing out on existence-saving robot surgical procedure

NHS individuals are missing out on life-saving robot surgical treatment

A gynaecologist uses a robot. Photograph: Jean-Paul Chasse/Alamy

New life-saving surgical techniques are not being adopted quickly enough in British hospitals. That is the stark conclusion of a report by the Royal College of Surgeons (RCS) which warns this week that patients are missing out on new procedures because the NHS is failing to set up programmes to promote their use in the UK.

The report, Innovation to Adoption: Successfully Spreading Surgical Innovation, stresses the need to find ways to introduce new surgical techniques as quickly as possible, thus saving lives and helping the NHS to save money.

New surgical techniques – involving robotics, 3D-imaging and lasers – have been developed in recent years, but in many cases have only been introduced in a haphazard manner in British hospitals. This failure to act coherently is now causing concern among surgeons.

“Many patients are not benefiting from ground-breaking procedures, even when surgeons firmly believe that they can save or extend lives. This cannot continue,” said Professor Norman Williams, the RCS president. “We cannot afford to neglect the kind of surgical innovation that has made such a difference to survival and recovery, such as keyhole surgery and advancements in transplant surgery.” He added that the NHS, the government and doctors had to understand how to accelerate innovative surgical practices in the UK.

The point was backed by David Neal, professor of surgical oncology at Cambridge University. “The NHS is the perfect place to test new technologies,” he said. “It covers the whole country and gives us an ideal platform for showing the worth of a new surgical technique. Unfortunately, this is not being done. The NHS does not seem to be able to tackle this sort of thing. Instead, we are relying, in many cases, on tests being done in the US, where there are commercial pressures involved.”

Neal has been involved in using a semi-automated technique known as robot-assisted radical prostatectomy (Rarp) to treat prostate cancer in the UK. “The technique greatly improves a human surgeon’s performance,” said Neal. “Using current methods, a patient is typically in hospital for around five days, while around 20% of them need blood transfusions. With Rarp, they can leave the next day and only about 1% of patients need a transfusion.”

About 200 prostate cancer patients are now being treated every year using the new technique. “That is far to low a figure,” Neal added. “We need to introduce the technique to enough hospitals to treat around 10,000 patients a year, but that is not happening.” He added that the UK needed a network of about 10-15 hospitals where new medical techniques would be taught to surgeons.

The need to promote robots in medicine is seen as being particularly important in future. The first robot procedure was offered to NHS patients in 2004, but the NHS has yet to fund the purchase of a single surgical robot and has relied instead on charities and endowments to provide cash to buy them.

A programme to help surgeons learn keyhole colorectal surgery for patients with bowel cancer and other conditions was set up in 2007. Mark Coleman, a consultant at Plymouth Hospital involved in creating the programme, said: “In 2008, 10% of operations on the colon involved keyhole surgery. Now that figure has reached 50% and the saving for the NHS over that period has been calculated as being around £11m.”

NHS individuals are missing out on life-saving robot surgical treatment