SURGERY WEEK 2014

Department of Surgery • Center for Patient Partnership

The Medical City Department of Surgery, inspired with its passion for excellence, is at the forefront of delivering service of greater worth. The department is manned by a distinguished staff of more than 200 surgeons, all of whom are experienced and recognized experts in their various fields of specialization. At the helm, is the chairman, Dr. Jose Antonio Salud.

The department has pioneered robotic-assisted surgeries in the country and has the distinction of doing the most number of laparoscopic surgeries annually in the country.

Surgeries are done at the Surgery Suite providing twelve rooms, well-equipped for various surgeries, staffed with nurses and technicians trained for a specific subspecialty.

Within the operating room is an armamentarium of cutting edge tools such as the Da Vinci surgical robot and the Pentero microscope.

Urologic and colorectal procedures are done at the Center for Endoscopic and Physiologic Studies Center, which is equipped for extracorporeal shockwave lithotripsy (for kidney stones), endoscopy (instrument used to examine the interior of a hollow organ or cavity of the body) and endoanal ultrasound (to evaluate disease of the rectum and anal canal).

Plastic, regenerative and aesthetic surgeries are done at the Wellness Center operating room, a separate facility upholding high surgical standards.

A laparoscopy simulation center is already on its way, providing and invaluable adjunct to traditional laparoscopic skills training.

GENERAL SURGERY RESIDENCY PROGRAM

The Department of Surgery is also proud of its five-year general surgery residency program, which has produced numerous graduates who are now excelling in their respective fields.

During the five dedicated years of training, the residents are exposed to an array of cases along with workshops, examinations, hands-on surgeries, making them safe skillful, competent, surgeons with sound decision-making skills.

The department also opened new highly subspecialized fellowship training programs in breast, hepatobiliary (liver, bile ducts, gallbladder, pancreas), and colorectal subspecialties.

PATIENT-CENTERED APPROACH

Service of greater worth does not begin with the surgery, but with a good relationship between the patient and the surgeon prior to the surgery. This starts with effective communication between the surgeon and the patient and his or her family.

The Medical City Department of Surgery further enhances this commitment between patient and surgeon by providing a multidisciplinary approach (providing all medical and surgical options to the patient in one stop).

Already a standard worldwide, The Medical City has truly led the way in the country by putting up highly specialized multidisciplinary centers of excellence: the Breast Center, Liver Center and another first in the Philippines: Colorectal Center.

Each center has specialized surgeons along with our partners medicine, internists such as gastroenterologists, cardiologists, medical oncologists, radiation oncologists, radiologists specialized in the diagnostic demands the disease condition needs, pathologists, psychiatrists, and nurses specially trained for each condition. This is patient-centered approach at its finest.

The Department always aims to provide world-class service for our Patient Partners, all for greater worth.

We are The Medical City Department of Surgery.

Cutting edge technology combined with our world-class surgeons to give you extraordinary results. Only the best for our Patient Partners.

What is an Appendix?
The appendix is a vestigial organ (an undeveloped and non-functioning organ) attached to the large intestine, near where the small intestine joins the large intestine.
If the appendix becomes blocked (food particles, stool, parasites, illnesses), bacteria inside it grows, causing it to be infected and swollen, which is called acute appendicitis. This condition leads to decreased blood supply to the organ, which then leads to tissue death, then eventually rupture or burst, causing bacteria and stool to release into the abdomen.

APPENDECTOMY
What is appendectomy?
Appendectomy is the surgical removal of an inflamed or diseased appendix. This procedure may be done thru an open technique or a laparoscopic approach.

Although multiple studies have demonstrated the safety and efficacy of both techniques, the open approach is by far the more common procedure done.

In open appendectomy, a small incision (approximately 4-5cm) is done at the right lower abdomen where in the appendix is taken out. In contrast, in laparoscopic appendectomy, the appendix is taken out with the aid of a camera using very small incisions (0.5cm) at the lower abdomen. It provides better cosmetic results and less post operative pain.

Appendectomy in TMC
An average of 500 appendectomy cases is done at The Medical City each year. Ten percent of these cases are done laparoscopically.
With the advent of minimally invasive surgery, our experienced and well-trained surgeons perform laparoscopic appendectomy with ease. The laparoscopic appendectomy cases at TMC have had a less than one percent complication rate for the last 10 years.
It is a very viable alternative to the traditional, open appendectomy approach providing minimal surgical trauma to the patient, as well as decreased hospital costs and faster recovery time. The Medical City is at the forefront of this innovative surgical technique.

CHOLECYSTECTOMY
What is cholecystectomy?
Gallbladder stone is a common condition seen in a wide number of our population. When this becomes symptomatic, removal of the gallbladder, known as cholecystectomy, is the first line management to alleviate this condition.
Since the 1800’s, open cholecystectomy has been the gold standard in terms of surgical management. However, with the changing times and innovations in surgery, the minimally invasive approach is fast becoming the gold standard as well as the more popular method of treatment.
Laparoscopic surgery provides the benefit of having smaller incisions, less post operative pain, shorter hospital stay and higher accuracy rate by providing better visualization of the internal organs involved.

What is a Mastectomy?

Mastectomy is a surgical procedure that removes the diseased breast tissue. It is done to treat cancers of the breast.
Breast cancer remains the leading cause of cancer in Filipino women. The Philippines also has the highest rate of breast cancer in Southeast Asia.
Breast conservation surgeries and innovations in breast surgery are now being offered at The Medical City. Such procedures include lumpectomy, skin-sparing mastectomy and sentinel lymph node biopsy.
Lumpectomy is only partial removal of the breast to treat breast cancer coupled with radiation treatment. Sentinel lymph node biopsy is a specialized procedure which determines whether the lymph nodes are involved in the cancer and removal if they are.
Because of this, the lymph nodes in the armpit may be saved if they are cancer-free. Skin-sparing mastectomy is a removal of the breast while preserving breast skin.

What is Breast Reconstruction?
Breast reconstruction, which may be done immediately after the mastectomy, is an option offered to our patients. It entails placement of a prosthetic tissue expander or implant, or use of the patients’ own excess tissues from the abdomen (a TRAM- transverse rectus abdominismyocutaneousflap) or back (a latissimusdorsi flap.) Following standards worldwide, these procedures help make the patient feel whole again.

Mastectomy and Breast Reconstruction in TMC
Since the inception of The Medical City Breast Cancer Unit in 2007, The Medical City has paved the way in state of the art breast cancer diagnosis and treatment.
Options such as a lumpectomy, skin-sparing mastectomy and sentinel lymph node biopsy are now being offered at The Medical City. This is at the forefront of breast cancer management, resulting to less morbidity for the patient. These breast surgeries along with breast reconstructions have steadily increased over the years.
Since 2007, almost 700 mastectomies were performed at The Medical City, 15-20% of which skin-sparing mastectomies with immediate breast reconstructions.

Robot-assisted Laparoscopic Radical Prostatectomy at The Medical City

What is Radical Prostatectomy?
Radical prostatectomy is an established treatment modality for localized prostate cancer. Prostate cancer remains a significant health problem worldwide and one of the most common cancer affecting men. Prostate cancer is a form of cancer that develops in the prostate, a gland in the male reproductive system.

Robot Assisted Radical Prostatectomy in TMC
The first robot-assisted radical prostatectomy in the Philippines was performed in June of 2010. It was performed by TMC Urologists using the 4-arm Da Vinci-S surgical robot.
From July 2010 to December 2012, a total of 40 patients diagnosed with prostate cancer underwent robot- assisted radical prostatectomy. Among the 40 patients, only 7% had blood transfusion intra-operatively. The conversion rate to open surgery is a low 2.5%.
Compared to the older technique the advantages of robotic surgery for prostate cancer is less scaring, less post operative pain, less post operative pain medicine and narcotics, shorter hospital stay, decreased intraoperative blood loss, reduced time for indwelling urine catheters, and improved ability to avoid erectile dysfunction.
The Medical City has certainly proven itself the pioneer in this advanced and life-changing treatment for our patients with prostatic cancer.

What is Bariatric Surgery?

The surgical treatment of the morbidly obese individual, that is, those with weights equal to or exceeding 100 lbs. beyond their ideal, is known as bariatric (or weight loss) surgery and provides perhaps the last resort for those who have seriously attempted to lose weight but have continuously failed. Bariatric surgery has been shown to provide effective & sustained weight loss for such unfortunate individuals.