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Re: LSH was UAE Option From: RModugno@aol.com Fri Aug 27 07:50:29 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: RModugno@aol.com: "Jury indicts woman in pregnancy scam" Previous message: Braun, R. Daniel: "Re: Switching patients**41 plus" Next in thread: Richard Chudacoff, MD: "Re: LSH was UAE Option" Reply: Richard Chudacoff, MD: "Re: LSH was UAE Option" Reply: Garry E. Siegel, M.D.: "Re: LSH was UAE Option" In a message dated 8/26/2004 6:38:44 PM Eastern Daylight Time, ENDODOK@aol.com writes: >I inform the patient of all options  including "doing nothing". When I >compare a  "one hour-home the same day-  treat other associated conditions (endo?)- >resume 95-99% ALL ACTIVITIES,  including sex, in 5-7 days, LSH" to UAE ( cost, >pain, continuation of periods)  the vast majority of patients choose LSH. I >had to deal with 2 post-embolization  syndrome patients ( pain, chills fever >etc) and have so informed the  interventional radiologists that they MUST  deal >with these  problems, not the primary gynecologist. >    Kaiser in Santa Monica recently compared costs of  LSH vs TAH. >LSH=$5000. TAH= $9000. LSH the hysterectomy procedure of choice in Kaiser   >San Diego >hospitals. No way can UAE compete cost wise. >    The MRI -controlled focused ultrasound  ("ExAblate"?) procedure developed >in Israel reportedly destroys fibroids without  pain, or surgical >intervention. The company has applied for FDA approval here in  USA. This might put gyn >surgeons out of business. > >J.Glenn Bradley MD > Interesting post Glenn.I assume, however that most general gynecologists cannot complete a LSH in one hour. I also assume that many general gynecologists could do a TAH or TVH within an hour or thereabouts. The reimbursement rate in Georgia for hysterectomies of all types ( excluding radicals), is about 850 to 950 dollars. Soooo... it may be cost effective for the physician to do the procedure they are most adept at, in the shortest time, rather than a "foreveroscopy". At our institution we have to present proof of a training session in the use of the power morcellator - as you know these injuries never occur with TAH or TVH. Some technical questions: 1)What do you use to amputate the uterus in LSH? 2)Do you suture the cervical stump? 3) How do you secure the uterine artery pedicles? Robert Modugno MD MBA FACOG Marietta, GA http://www.novaobgyn.yourmd.com Next message: RModugno@aol.com: "Jury indicts woman in pregnancy scam" Previous message: Braun, R. Daniel: "Re: Switching patients**41 plus" Next in thread: Richard Chudacoff, MD: "Re: LSH was UAE Option" Reply: Richard Chudacoff, MD: "Re: LSH was UAE Option" Reply: Garry E. Siegel, M.D.: "Re: LSH was UAE Option"

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