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New prostate surgery not necessarily better: study

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New prostate surgery not necessarily better: study

Men who have less invasive prostate cancer surgery — often done robotically — are more likely to be incontinent and have erectile dysfunction than men who have conventional open surgery, U.S. researchers said on Tuesday.

Many men, especially those who are wealthy and highly educated, favor minimally invasive surgery because they assume the high-tech approach will yield better results, but the evidence on that is mixed, the team reported in the Journal of the American Medical Association.

“We found men undergoing minimally invasive versus open surgery were more likely to have a diagnosis of incontinence and erectile dysfunction,” Dr. Jim Hu of Brigham and Women’s Hospital in Boston said in a telephone briefing.

Hu said use of minimally invasive surgery has taken off since the introduction and heavy marketing of robot-assisted surgery, such as the da Vinci system made by Intuitive Surgical Inc.

The system consists of robotic arms, controlled from a console, that allow surgeons to perform less invasive surgeries. Hospitals advertise the systems as being able to reduce trauma, blood loss, risk of infection, scarring and often pain.

Hu said so far, there have been few studies that compare minimally invasive surgery with open surgery.

To do that, he and colleagues used billing data from the Medicare insurance program for the elderly on procedures done from 2003 to 2007. During that time, use of minimally invasive surgery for prostate cancer increased fivefold.

While both approaches fared equally well as a cancer treatment, they found that men who got the minimally invasive approach had shorter hospital stays, were less likely to need blood transfusions, and had fewer breathing problems after surgery than those who got conventional surgery.

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Healthy Meals, No Cooking

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Healthy Meals, No Cooking

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Men’s Health magazine’s Matt Bean showed Maggie Rodriguez healthy meal options on-the-go.

No cooking required.

At the of the creation of the World Health Organization (WHO), in 1948, Health was defined as being “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity”.

This definition invited nations to expand the conceptual framework of their health systems beyond issues related to the physical condition of individuals and their diseases, and it motivated us to focus our attention on what we now call social determinants of health. Consequently, WHO challenged political, academic, community, and professional organizations devoted to improving or preserving health to make the scope of their work explicit, including their rationale for allocating resources. This opened the door for public accountability

Only a handful of publications have focused specifically on the definition of health and its evolution in the first 6 decades. Some of them highlight its lack of operational value and the problem created by use of the word “complete.” Others declare the definition, which has not been modified since 1948, “simply a bad one.”

In 1986, the WHO, in the Ottawa Charter for Health Promotion, said that health is “a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities.” Classification systems such as the WHO Family of International Classifications (WHO-FIC), which is composed of the International Classification of Functioning, Disability, and Health (ICF) and the International Classification of Diseases (ICD) also define health.

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Surgical Operation surgery

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Surgical Operation surgery

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A patient undergoing coronary artery surgery.

The chest has been opened and the heart exposed. A heart-lung machine will take over the vital job of circulating oxygenated blood to the body while the heart is temporarily stopped.

During this period, blockages in the coronary arteries will be bypassed using sections of vein taken from the patient’s legs.

A patient with ischaemic heart disease is having the blocked coronary artery bypassed using a section of vein taken from her leg.

During the procedure, the circulation of oxygenated blood to the body and brain has been taken over by a heart-lung machine.

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