General Surgery

General Surgery

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Conventional surgery/ microsurgery

Conventional Surgery is the treatment of injury, deformity, and disease using operative procedures.

Microsurgery is a general term for surgery requiring an operating microscope. The most obvious developments have been procedures developed to allow anastomosis of successively smaller blood vessels and nerves (typically 1 mm in diameter) which have allowed transfer of tissue from one part of the body to another and re-attachment of severed parts. Microsurgical techniques are utilized by several specialties today, such as: general surgery, ophthalmology, orthopaedic surgery, gynaecological surgery, otolaryngology, neurosurgery, oral and maxillofacial surgery, plastic, and paediatric surgery.

Procedures:

No.

entity

Surgical Intervention

Hospitalization

Anaesthesia

1

Incisional Hernia Medium size (5 to 10 cm)

Incisional hernioplasty with
Prosthesis (surgical mesh) (not including the cost of the mesh)

7

General

2

Incisional Hernia Large size (+ 10 cm)

Large hernioplasty (+10 cm diameter) with Incisional prosthesis (surgical mesh not included)

10

General

3

Incisional Hernia Small size (- 5 cm)

Incisional hernioplasty with Prosthesis (surgical mesh) (not including the cost of the mesh)

5

General

4

Varicocele

Spermatic veins ligation

3

Regional

5

Spermatic ducts ligation

Vasectomy

2

Local

6

Uterine Myoma

Myomectomy

7

General

7

Uterine Fibromyoma

Abdominal Hysterectomy

7

General

8

Bicornate uterus (Uterine septum)

Metroplasty

7

General

9

Rectocistocele

Anterior and Posterior Colporrhaphy

5

Regional

10

Rectocistocele with Urinary Incontinence

Anterior and Posterior Colporrhaphy  and Kelly Plication

7

Regional

11

Genital Prolapse

Anterior and Posterior Colporrhaphy. Vaginal Cervical Amputation

3

Regional

12

Uterine Prolapse

Vaginal Hysterectomy

5

Regional

13

High Grade SIL (SIL II)

Conization and curettage

2

Regional

14

Bartholin’s Gland Cyst

Exeresis of Bartholin’s Gland Cyst

0

General

15

Bartholin’s Gland Cyst

Marsupialization of Bartholin’s Gland

1

General

16

up to 12 weeks Pregnancy

Termination of pregnancy

0

General

17

Pregnancy over 12 weeks to 20 weeks

Termination of pregnancy. Therapeutic curettage

4

General

18

Dysfunctional Uterine Bleeding (DUB)

Diagnostic endometrial curettage

0

General

19

Ongoing, deferred or incomplete Abortion

Therapeutic Curettage

0

General

 TheMinimally Invasive Surgery programs includethe following:

-          hospitalizationThe Conventional surgery/ microsurgery programs include the following:

-          doctor fees

-          pre-operative screening

-          basic tests

-          surgical specimen biopsy when indicated

-          right to the operating room

-          right to anesthesia

-          surgical procedure

-          recovery accommodation

The Conventional surgery/ microsurgery programs exclude the following:

-          medicines

-          disposables

-          blood derivatives or substitutes

-          artificial supporting materials when indicated

Minimally Invasive Surgery Programs

In the last decade, the techniques of Minimally Invasive Surgery have taken huge leaps. These procedures involve conducting surgeries through small openings to remove organs and perform several surgical procedures, avoiding large wounds and possible scaring. These techniques have the following advantages:

  • The patient may be discharged early
  • Social life of the patient may restart a few days after surgery.
  • Patients have fewer complications than with traditional techniques.

 Cuba has multidisciplinary medical teams composed of endoscopy surgeons, specialized radiologists, experienced anaesthesiologists, highly trained nursing staff and technicians with expertise and high quality instruments and medical technologies.

 

No.

entity

Surgical Intervention

Hospitalization

Anaesthesia

1

Peptic Ulcer

Vagotomy Post.C. Anterior highly selective Vagotomy

3

General

2

Recurrent peptic ulcer with incomplete Vagotomy

Transthoracic Vagotomy

3

General

3

Splenectomy

Videolaparoscopy with Splenectomy

6

General

4

Hiatal hernia. Gastroesophageal reflux disease

Antireflux Technique (Valvuloplasty
of Nissen or Toupet’s )

3

General

5

Esophageal Achalasia

Heller’s Myotomy of subsequent
with posterior and selective anterior Vagotomy

4

General

6

Varicocele

Ligation of permatic vessels

3

General

7

Appendicitis

Appendectomy

2

General

8

Adrenal gland tumor s

Videoendoscopy.
Adrenalectomy

12

General

9

Recurrent Pneumothorax

Videothoracoscopy.
Resection of bull.
Parietal Pleurectomy.

8

General

10

Uterine diseases of various causes

Laparoscopic Assisted Vaginal
Hysterectomy

7

General

11

Paraovarian Cyst

Exeresis of the Cyst by Laparoscopic unilateral

3

General

12

Polycystic Ovaries

Section of ovaries by laparoscopy

3

General

13

Ovarian tumor

Unilateral Oophorectomy

3

General

14

Pelvic Endometriosis

Contrasted Videolaparoscopy.
Vaporization of the Endometrium foci by Argon plasma

3

General

15

Castration

Bilateral Oophorectomy

3

General

16

Unilateral Hydrosalpinx

Unilateral Salpingectomy

3

General

17

Bilateral Hydrosalpinx

Bilateral Salpingectomy

3

General

18

Tubal Infertility

Contrasted Videolaparoscopy
with unilateral tubal plasty surgery

3

General

19

Previous Tubal Ligation (Reversal)

Contrasted Laparoscopy.
End-to-end tubal anastomosis by
microsurgery

7

General

20

Multiparity

Sterilization by laparoscopy

2

General

21

Tubal pregnancy

Salpingectomy

2

General

 

Ectopic pregnancy

Videolaparoscopy with Unilateral
Salpingostomy

3

General

22

Study of infertility in female

contrasted Videolaparoscopy

5

General

23

Study of infertility in male

Ambulatory

 

General

       

The Minimally Invasive Surgery programs include the following:

-          hospitalization

-          doctor fees

-          pre-operative screening

-          basic tests

-          surgical specimen biopsy when indicated

-          right to the operating room

-          right to anesthesia

-          surgical procedure

-          recovery accommodation 

The Minimally Invasive Surgery programs exclude the following:

-          medicines

-          disposables

-          blood derivatives or substitutes

-          artificial supporting materials when indicated

Pregnancy termination:

This program includes:

  • Specialized Medical Consultation in Gynecology
  • Laboratory tests which includes the following:

-          Hemoglobin test

-          Hematocrit test

-          Erythrocyte sedimentation rate

-          Differential white blood cell count

-          Determination of blood type and RH factor test

-          Quantitative serology test

-          Venereal Disease Research Laboratory test (VDRL)

-          HIV test

-          Cyturia test

-          Glycemia test

-          Creatinine test

  •  Microbiological tests which includes the following:

-          Vaginal discharge

-          Endocervical exudate

  • Imaging investigations which includes:

Gynecological ultrasound

  • Surgical procedure which includes:

-          Interruption of Pregnancy

-          Right of operating room (minor surgery)

-          Right to anesthesia and post-operative resuscitation.

Female infertility:

Female infertility refers to infertility in female humans. It affects an estimated 48 million women with the highest prevalence of infertility affecting people in South Asia, Sub-Saharan Africa, North Africa/Middle East, and Central/Eastern Europe and Central Asia. Infertility is caused by many sources, including nutrition, diseases, and other malformations of the uterus. Infertility affects women from around the world.


The Female infertility Program includes the following:

  • 10 Nights of hospitalization. (The Hospitalization will include accommodation, nursing care and medical assistance, as well as three course meals).
  • Laboratory Tests which includes:

-          Erythrocyte sedimentation rate.

-          Differential white blood cell count

-          Blood type and RH factor Complete coagulation test

-          CBC test

-          Quantitative serology test

-          Venereal Disease Research Laboratory (VDRL) test

-          HIV test

-          Cyturia test

-          Glycemia test

-          Creatinine test

-          FSH (Follicle Stimulating Hormone) and LH (Lutenizing Hormone) Estrogen test

-          Progesterone and prolactin test

  • Other tests: Vaginal discharge and vaginal cytology. Sperm penetration test and cervical Test
  • Imaging studies: Hysterosalpingography. Skull and Sella radiography. Transvaginal ultrasound.
  • Instrumentation and diagnostic examination: Contrasted Laparoscopy.

Male infertility:

Male infertility refers to a male's inability to cause pregnancy in a fertile female. In humans it accounts for 40-50% of infertility. Male infertility is commonly due to deficiencies in the semen, and semen quality is used as a surrogate measure of male fecundity.

The Evaluation of male infertility program includes the following:

  • 10 nights in hospital (as companion). (Accommodation and meals).
  • Cultures and antibiograms tests
  • Testosterone Tests
  • Spermatic vein Doppler examination
  • Semen analysis.

Male sexual dysfunction

Sexual dysfunction  or  sexual malfunction  is difficulty experienced by an individual or a couple during any stage of a normal sexual activity, including physical pleasure, desire, preference, arousal or orgasm. According to the DSM-5, sexual dysfunction requires a person to feel extreme distress and interpersonal strain for a minimum of 6 months (excluding substance or medication-induced sexual dysfunction). Sexual dysfunctions can have a profound impact on an individual's perceived quality of sexual life.

This program can also be performed as an outpatient service.

This Evaluation of male sexual dysfunction program includes the following:

  • 4 nights of hospitalization (The Hospitalization will include accommodation in a private room, nursing care and medical assistance, evaluation and preparation of medical history, as well as three course meals).
  • Specialized medical Interconsultation of psychology
  • Clinical laboratory studies:

-          Hemoglobin

-          Hematocrit

-          Erythrocyte sedimentation rate (ESR).

-          differential Leucogram

-          quantitative serology

-          HIV

-          Glycemia

-          Cholesterol

-          Triglycerides

-          Testosterone

-          Follicle stimulating hormone  (FSH)

-          Luteinizing Hormone (LH)

-          Prolactin

-          Penile-brachial index at rest and after exercise

-          Penile Doppler with prostaglandin

conduction velocity of dorsal penile nerve