Help sought for ‘keyhole’ surgery at Bustamante Hospital

CONSULTANT PAEDIATRIC surgeon at the Bustamante Hospital for Children (BHC), Dr Sarah Marshall Niles, is leading the charge for minimally invasive surgery (MIS) to be offered to children who depend on the public health services. She believes it is an achievable venture, and that the benefits will be game-changing.

MIS, which is also called’ keyhole’ or ‘scarless’ surgery, refers to surgery performed through small incisions using surgical telescopes and specially designed instruments. This is in contrast to open surgery, which involves large incisions using the surgeon’s hands directly. MIS is now routine practice in paediatric surgical centres worldwide and is offered to adults at many centres in Jamaica.

The BHC is the only specialist paediatric hospital in the Englishspeaking Caribbean. With a bed capacity of 279, BHC caters to patients from birth to 12 years, providing a comprehensive range of diagnostic, preventive, curative, rehabilitative, and ambulatory services in paediatric medical and surgical specialities and sub-specialities. The Bustamante Hospital caters to patients from across Jamaica and neighbouring Caribbean countries.

“It is our vision at the Bustamante Hospital to be the provider of world-class medical services. Currently, minimally invasive, or laparoscopic, surgery has become the standard in surgical units worldwide,” the consultant says.

SAVINGS

The introduction of minimally invasive surgery at Jamaica’s only children’s hospital would greatly benefit the young patients. These benefits include a faster return to routine activities and participating in extracurricular activities; better aesthetic outcomes (smaller scars); a faster return to work for family members/caregivers; and decreased risk of overall complications and readmissions.

The establishment of MIS would also lead to savings in the public health sector. Dr Niles estimates that surgery for appendicitis alone using minimally invasive procedures would shorten hospital stay by as much as three nights per patient, saving the Government over $30,000 per patient. A conservative average of four patients per month would mean savings of $120,000 each month, or $1.44 million per year. These figures are quite conservative and do not take into consideration other conditions that are amenable to MIS, and savings from decreased admissions for complications.

Niles is collaborating with Dr Claudine Desouza, paediatric surgeon; Dr Michelle-ann Richards-dawson, senior medical officer of the BHC; Head of Surgery Dr Colin Abel; and consultant surgeon Dr Noel Mclennon.

Dr Richards-dawson said: “Having observed the benefits that laparoscopic surgery offers to our adult patients, it is only fitting that we should offer this to our paediatric patients. Our patients and their families would benefit immensely from the earlier recovery, and earlier return to home and school. The desire of all parents to not have big scars left on their children’s tiny bodies can come true with the introduction of MIS at the BHC.”

Heading the list of procedures being targeted for laparoscopic surgery is the appendectomy. This surgery removes an infected appendix, and is the most common emergency surgical procedure performed at the Bustamante Hospital for Children.

“Another key procedure that will be done laparoscopically is the removal of the gallbladder, or cholecystectomy. We will also be able to perform diagnostic laparoscopies for trauma patients, or for elusive illnesses where a diagnosis is uncertain and imaging cannot give answers,” Dr Niles said.

This procedure comes at a cost – $16.1 million, or just about US$105,000 – which is the amount needed to acquire the equipment. Ongoing costs for disposables and maintenance will not be significant. “The savings that we would gain by doing laparoscopic surgery and decreasing the length of hospital stay for these patients would outweigh any ongoing cost that this type of surgery would incur,” she said.

RECEIVING SUPPORT

The project is receiving support from private-sector partners, including the Loshusan family, who have already donated US$10,000, and the Friends of Bustamante Hospital for Children (FBHC).

Orane Lake, chairman, and Henry Anglin, member of the FBHC executive and former BHC administrator, are in full support of this initiative. Anglin said that “the FBHC welcomes this opportunity to again partner with and support the dedicated medical team in their effort to further improve the services offered by the introduction of life-saving laparoscopic surgery. FBHC, therefore, is happy to call on our corporate entities, and fellow Jamaicans at home and worldwide, to partner with us and the hospital to make this a reality by opening their hearts and wallets to this worthy cause”.

For further information or to report a donation, please contact Dr Richards-dawson at the BHC 876968-0300-9.