Statement on medical tourism by ACS (American College of Surgeons)

Today, medical tourism is a widely accepted and proven formula for top quality care at low cost. Given the manifold increase in the number of patients traveling overseas for medical and surgical care from the US, the American College of Surgeons (ACS) has recognized that surgical care has become more readily available in a wider global market, and that this phenomenon is here to stay. So, the College recently developed an official "Statement on Medical and Surgical Tourism", which according to ACS is "consistent with the College’s longstanding advocacy position of promoting an environment of optimal care for the surgical patient".

The College has developed several key principles (listed below) for those who choose to seek surgical care abroad. The College:

• encourages patients to seek care of the highest quality and supports their rights to select their surgeons and health care institutions without restriction.


• encourages its Fellows to assist all patients in reaching informed decisions concerning medical care, whether at home or abroad.


• advises patients to consider the medical, social, cultural, and legal implications of seeking medical treatment abroad prior to deciding on a venue of care.


• encourages patients electing to receive treatment abroad to seek care at health care institutions that have met the standards for accreditation established by recognized accrediting organizations.


• encourages patients electing treatment abroad to seek care from surgeons and anesthesiologists certified in their specialties through a process equivalent to that established by the member boards of the American Board of Medical Specialties.


• encourages patients receiving treatment abroad to obtain a complete set of medical records prior to returning home so that the details of their care are immediately available to their physicians and surgeons in the U.S. Follow-up care at home should be organized prior to travel whenever possible.


• encourages patients contemplating medical tourism to understand the special risks of combining long international flights and certain vacation activities with anesthesia and surgical procedures.


• opposes the imposition of provisions for mandatory referral of patients by insurers to health care institutions outside the U.S., unless such provisions are clearly and explicitly stated in the insurance contract and accepted by the subscriber.


• supports the view that payors referring patients for mandatory treatment abroad should be responsible for the coordination and reimbursement of follow-up care in the U.S., including the management of postoperative complications, readmissions, rehabilitation, and long-term care.

Source: Statement on Medical and Surgical Tourism by ACS

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Affordable urinary diversion and reconstruction surgery

Urinary diversion is a way of surgically rerouting or diverting urine flow from its normal pathway in order to treat the condition of diseased or defective ureters, bladder or urethra, either temporarily or permanently. Using the surgical method of urinary reconstruction and diversion a new way is created for the patient to pass urine.

There are three main types of urinary diversion surgeries
• Ileal Conduit Urinary Diversion
• Indiana Pouch Reservoir
• Neobladder to Urethra Diversion

For all of these procedures, a portion of the small and/or large bowel is disconnected from the fecal stream and used for reconstruction.

Ileal Conduit Urinary Diversion: The ileal conduit urinary diversion surgery is used in patients who have had their bladder removed and is usually used in conjunction with radical cystectomy in order to control invasive bladder cancer. In this procedure, the ureters are surgically unattached from the bladder and a ureteroenteric anastomosis is made in order to drain the urine into a detached section of ileum (a part of the small intestine). The end of the ileum is then brought out through an opening (a stoma) in the abdominal wall. The urine is collected through a bag that attaches on the outside of the body over the stoma. The bag must be periodically emptied of urine.

Indiana Pouch Reservoir: The Indiana pouch surgery is used for patients who have had their urinary bladders removed as a result of bladder cancer, pelvic exenteration, bladder exstrophy or who are not continent due to a congenital, neurogenic bladder. In this procedure, a reservoir, or pouch, is created out of approximately two feet of the ascending colon and a portiom of the ileum (a part of the small intestine). The ureters are surgically removed from the bladder and repositioned to drain into the pouch. A piece of small intestine is brought out through a small opening in the abdominal wall called a stoma. Since a segment including the large and small intestines are utilized, also included is the ileal-ceceal valve. This is a one-way valve located between the small and large intestines which normally prevents the passage of bacteria and digested matter from re-entering the small intestine. After a period of several weeks, the body adjusts to the absence of this valve by absorbing more liquids and nutrients. Unlike other urinary diversion and reconstruction techniques, the Indiana pouch has the advantage of not using an external pouch adhered to the abdomen to store urine.

Neobladder to Urethra Diversion: With the Neobladder to Urethra Diversion procedure, the intent is to create a new bladder that mimics the storage function of a normal urinary bladder. The surgery makes a reservoir or pouch by utilizing a small part of the small intestine and connects the pouch to the urethra. The ureters are repositioned to drain into this pouch. As in normal urinary system, urine is able to pass from the kidney, to the ureters, to the pouch, and through the urethra out of the body.

For information about affordable urinary diversion and reconstruction surgery, check out Healthbase.
Healthbase is the trusted source for global medical choices, connecting patients to leading hospitals around the world, through secure and information-rich web portal. To learn more, visit: http://www.healthbase.com Login to get FREE quote. Access is free.

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