GALVESTON, Texas — Performing surgery on a pregnant patient is a delicate matter. Risks to both mother and baby must be carefully weighed in every decision a surgeon makes. Recently, at the University of Texas Medical Branch at Galveston, a surgeon performed a groundbreaking robotic laparoscopic procedure on a 35-year-old pregnant patient whose cervix was too short to sustain a pregnancy.
Dr. Sami Kilic, chief of minimally invasive gynecology and research at UTMB, is the first surgeon in the world reported to have used robotically assisted, ultrasound-guided laparoscopic surgery to successfully tighten a pregnant patient’s incompetent cervix. The procedure is explained in a new paper now online in the Journal of Minimally Invasive Gynecology. When performed traditionally, abdominal cerclage surgery requires a large incision and a long period of recovery. Kilic’s new procedure left the patient with only three tiny abdominal scars. [read more]
Teenage gamers are better at performing robotic surgery than medical professionals because of their superior hand-eye coordination skills. According to research by UTMB, high school and college students outmatched medical residents when performing technologically advanced robotic surgeries. Dr. Sami Kilic, lead author and professor at UTMB, said, “The inspiration for this study first developed when I saw my son, an avid video game player, take the reins of a robotic surgery simulator at a medical convention. With no formal training, he was immediately at ease with the technology and the type of movements required to operate the robot.” He added, “As we see students with enhanced visual-spatial experience and hand-eye coordination that are a result of the technologically-savvy world they are immersed in, we should rethink how best to teach this generation.” The news is receiving widespread coverage and appears in ECN Magazine, Science Daily and Science Newsline.
Dr. Ana M. Rodriguez of the Department of Obstetrics and Gynecology recently took top honors for a research poster presented at the joint annual meeting of the American Congress of Obstetrics & Gynecology and the Texas Association of Obstetrics & Gynecology. Dr. Rodriguez, whose areas of interest include family planning /contraception, minimally invasive gynecology and robotic surgery, is one of the nation's most experienced gynecologists in the area of hysteroscopic sterilizations. Her first-place poster, Analysis of Tubal Patency after Essure ™ Placement, summarized an analysis of 203 patients who had undergone the Essure ™ procedure. In the analysis, which compared results with earlier studies, researchers led by Dr. Rodriguez found a slightly higher failure rate in certain patients, which they theorize could be associated with higher BMI (obesity) or prior intrauterine device use. More research will be necessary. The work presented was conducted with Drs. Daniel Breitkopf and Russell R. Snyder.
By Ana M. Rodriguez
Americans receive only about half of the preventive services and screening tests recommended to promote health and wellness, which is crucial in the prevention of developing diseases. The good news is that the Affordable Care Act is increasing women’s access to services that promote their health. This new access to preventive services and screening tests is expected to fill the gaps in current women’s access to comprehensive medical care.
Different barriers still exist against the promotion of public health and the establishment of preventive practices that are a fundamental part of medical care in any population. One of these barriers is certainly the financial aspects involved with people undergoing recommended preventive services. By removing the financial barriers to these services through this Act, our women are being offered the opportunity to access needed preventive care.
On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act, Public Law 111-148 into law, creating new reforms that increase access to affordable health coverage for everyone and protect consumers from abusive insurance company practices. The Health Care and Education Reconciliation Act, Public Law 111-152, was enacted on March 30, 2010 (collectively known as the “Affordable Care Act”). This law establishes the creation of an office to be known as “The Office of Women’s Health,” which aims to coordinate activities related to disease prevention, health promotion, service delivery and research for issues of particular concern to women throughout their lifespan.
Beginning Aug. 1, 2012, under the Affordable Care Act and the new Office of Women’s Health, it will be required that most private health plans cover preventive services for women without having to pay a co-payment or a deductible. Some of these preventive services include:
Public insurance programs, such as Medicare, on Jan. 1, 2011, started to cover without cost-sharing an annual wellness visit that includes a health-risk evaluation and a customized prevention plan based on individual needs. Similarly, in 2013, state Medicaid programs will have incentives to eliminate co-payments for preventive services and screening tests.
It is now our role, as health care providers, to educate our communities on the importance of looking for these preventives services and to help to increase the number of women having mammograms, colonoscopies, Pap smears, tobacco-use counseling and the other preventive services available without cost-sharing or co-payments.
The implementation of these services and the facilitation of access to the no co-payment screening tests will continue moving prevention as the main source of health in women and communities. Prevention and early detection of disease continue to be the fundamental actions to improve the health of our individuals, communities and nation. Therefore, it is vital for health care providers and community leaders to get involved in this new initiative.
As a gynecologist at the University of Texas Medical Branch, I have a strong commitment to women’s health and am pleased that we provide many of these services through our new Comprehensive Women's Health Care Center. The Center’s principal role will be to address all aspects of women’s health, treating for common medical illnesses and promoting wellness. This clinic will be co-located with the current women’s health clinics in both Galveston and Bay Colony.
Let’s start, everybody, making our female patients, friends, neighbors and family members aware of the new preventive services and tests available at no cost and their importance in women’s health.
Dr. Ana M. Rodriguez is an assistant professor in the Department of Obstetrics and Gynecology at UTMB. This article was published in various Texas newspapers in September 2012.
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