The Medical Travel Quality Alliance (MTQUA) has issued its first list of the top ten world’s best hospitals for medical tourists and has named Fortis Hospital in Bangalore (former Wockhardt Hospitals,Bangalore )as the number one hospital in the world. Six of the top 10 world’s best hospitals are in Asia, two in Europe and two in North America.
MTQUA founder Julie Munro says, "Fortis is exemplary in nearly all the criteria we used. The medical traveler’s journey is a complex one and this list helps patients look beyond hospital websites where they can get the full spectrum of care management they need for a successful medical trip. If you cannot get as good or better care abroad than you can at home, you may as well stay home.”
Top ten recognition was given to the hospitals based on MTQUA’s strict assessment criteria of-
1. Medical quality and outcomes 2. International patient management 3. International patient marketing 4. Value for service 5. Patient safety and security 6. Transparency 7. Attention to the unique needs of the medical traveler
The top ten hospitals Globally for Medical Tourism are
1. Fortis Hospital, Bangalore, India 2. Gleneagles Hospital, Singapore 3. Prince Court Medical Centre, Kuala Lumpur, Malaysia 4. Shouldice Hospital, Toronto, Canada 5. Schoen-Kliniken, Munich, Germany 6. Bumrungrad International, Bangkok, Thailand 7. Bangkok Hospital Medical Center, Bangkok, Thailand 8. Wooridul Spine Hospital, Seoul, Korea 9. Clemenceau Medical Center, Beirut, Lebanon 10. Christus Muguerza Super Specialty Hospital, Monterrey, Mexico
Based on the above parameters ,Fortis Hospital Bangalore(former Wockhardt Hospitals,Bangalore) is number one
Medical quality:It has an excellent surgery option for medical travelers seeking joint replacement, particularly hip resurfacing and replacement. It’s also strong in cardiac surgery and neurosurgery.
International patient management:The hospital has a transparent process sensitive to the needs of patients and families for their cultural, language, and religious requirements, their medical needs and emotional support.
International patient marketing:It actively supports web-based social networks, including Youtube, Facebook, and Twitter. It has its own blog.
Value for services:It has a competitive cost structure.
Transparency:The Hospital ensure transparency of care, from cost to outcomes data. Patients receive a portfolio of their medical file and surgery documents including CT scans, MRI and X-rays, and operative notes to take back to their home country.
Centre (from left) Dr. N S Devananda, Consultant Cardiac Surgeon, Fortis Hospitals Bangalore, Dr. Fansisco Collaso, Consultant Cardilogist & Echocardiograher, Goa with Baby Prathamesh and Baby Varad who had undergone cardiac surgery at Fortis Hospitals Bangalore
Fortis Hospitals Bangalore (formerly Wockhardt Hospitals) addresses the media today showcasing the pediatric cardiac scenario in the country and how Goa has been at the forefront in saving many children’s lives by identifying and correcting congenital heart defects at the appropriate time.
Addressing a press conference in Panjim, Dr. N. S. Devananda, Consultant Cardiac Surgeon, Fortis Hospitals Bangalore said, “Our experience in Goa in the pediatric cardiac space over the years has been quite overwhelming. We have seen this state growing from the time when congenital heart disease (CHD) was seen as an evil spell to such a time when people are aware and educated of CHD and confident that this can be treated under proper medical supervision and care at expert hands. We are thankful to all those parents who came to us with immense faith and confidence and helped us marking feat in this field and helped us challenge medical excellence many a times.”
“Goa has been very responsive when it comes to congenital heart defects. This transformation in the mind set of the people has served as a boon to all those children who were suffering from heart defects and had the opportunity to avail treatment at the right time. 60-70 % of infants that came to Fortis Hospitals Bangalore were of very complex nature and the success rate has always been of almost of about 90-95%. With such a huge success rate in correcting CHD amongst which 70% comprised of complex cases definitely poses as a great strength for the surgeons who have performed the surgery. The positive response and the confidence that the Goans have shown in us has immensely build our confidence in our profession and given us the courage to take up the most challenging cases” added Dr. N S Devananda.
Lack of adequate knowledge of CHD often results in time lag between diagnosis and referral to a pediatric cardiac centre for treatment and leads to further complication of the child. Also due to lack of awareness facilities available in India to correct congenital heart defects across the spectrum results in higher mortality rate and limited usage of pediatric cardiac expertise available in the country. Heart disease in children is not identified as a health priority by the government in our country. There are no government policies for cardiac care in children. This is perhaps related to the prevailing notion that CHD is uncommon, often fatal and is therefore not worth expanding national resources.
Many families in rural and semi urban parts of India seek advice from unqualified, self-proclaimed “doctors” and quacks because of common beliefs and myths. This further adds to the delay in diagnosis and proper management of the child with CHD. But Goa has stood apart and has set an example for the rest of the states of India. The benefits extended by the government to the families have given an impetus to the pediatric cardiac program at Fortis Hospitals Bangalore to treat many such children and give them a new lease of life.
About Fortis Hospitals (formerly Wockhardt Hospitals)
Wockhardt Hospitals Bangalore, Mumbai and Kolkata which are now christened as Fortis Hospitals are part of the 40 hospitals chain of Fortis Healthcare. This Fortis Hospitals network consists of 11 hospitals focusing on the high end tertiary care around the specialties of cardiac care – adult and pediatric cardiology and cardiac surgery, complex brain & spine surgeries, orthopedics and joint replacement surgery and minimal access surgery. The entity consists of 2 JCI accredited hospitals located in Bangalore and Mulund. Wockhardt Hospitals Bangalore – now a network hospital of Fortis is a 400 bedded Multi specialty hospital with state of the art facility equipped with latest technology and truly World class Clinical Talent dedicated to the whole range of Cardiac, Orthopedic, Neurosciences, Minimal Access Surgery and Women & Child Services. www.wockhardthospitals.net
A team of cardiac experts at Fortis Hospitals Mulund (formerly Wockhardt Hsopitals) performs complex beating heart coronary artery bypass surgery on an infant.
Fortis Hospitals Mulund (formerly Wockhardt Hospitals) marks a feat in the field of pediatric cardio-thoracic surgery by performing a complex beating heart coronary artery bypass surgery on an infant. A team of cardiac experts led by Dr. Suresh Joshi, Consultant Pediatric Cardiac Surgeon, Fortis Hospitals Mulund has successfully corrected a complicated and rare congenital deformity called ALCAPA (Anomalous Left Coronary Artery From the Pulmonary Artery) giving the baby a new lease of life.
Baby Sharon was born with normal delivery without any specific symptoms of heart defect during her birth. However after 4 months she suffered from severe cold and cough and was admitted in a city hospital as she was diagnosed of pneumonia. The baby seemed to suffer from increased breathlessness with a very high heart rate. On further investigation the baby was diagnosed of having an enlarged heart and the parents were advised to consult a pediatric cardiac surgeon.
“Baby Sharon was brought to us in a severe condition where she was suffering from severe breathlessness, excessive crying and was extremely feeble due to poor intake of feed. Upon further investigation we diagnosed her with a congenital heart defect called ALCAPA (Anomalous Left Coronary Artery from the Pulmonary Artery). ALCAPA is a rare birth malformation where the positions of the arteries are switched and the left coronary artery comes out of the pulmonary artery. It occurs in approximately in 1 in 4-5 lakh live births (0.25% - 0.5% of the total birth defects) and if not treated at the appropriate time accounts for 65 % - 85 % of deaths with in 1st yr of life from congestive cardiac failure,” said Dr. Suresh Joshi, Consultant Pediatric Cardiac Surgeon, Fortis Hospitals Mulund.
At the time of birth babies born with such deformities remain active like any normal child but as the child grow the symptoms manifests into breathlessness, inactivity and weak intake of food and they grow very weak and uncontrollable.
“ALCAPA is a serious problem and requires surgery immediately after the birth or as soon as the diagnosis is confirmed. The aim of surgery is to connect the Anomalous left coronary artery with the aorta. The precise surgery depends on the exact location of the Anomalous left coronary artery. Sometimes, it can be moved, along with a button of tissue, from the pulmonary artery and sewn into the aorta. If the Anomalous left coronary artery is located too far away from the aorta to move, a "tunnel" is made from the aorta to the Anomalous left coronary artery or by pass surgery is done by using artery of left arm.”
“Usually to perform such complex surgery heart lung machine is required which is also commonly called On-pump bypass surgery. However in the case of Baby…. we performed the surgery successfully without using heart lung machine, which means, off pump Coronary artery Bypass Graft (CABG) procedure with the self equipped instruments. Off pump bypass surgery are much common in the adult procedure group, but in neonates such procedure till date is only heard off” added Dr. Suresh Joshi, Consultant Pediatric Cardiac Surgeon, Fortis Hospitals Mulund.
The challenges that involve in this surgery were:
1. Grafting vessels on a moving heart which needs small compact stabilizer. Stabilizer for small neonate is not devised till date.
2. Left coronary artery was not appropriate for the graft
3. Poor functioning heart of the baby, Ejection fraction = 25%
Beating heart surgery was performed on the baby to avoid the post operation complication like fluid retention, kidney failure, lung injuries, and acute inflammatory reaction with mild to moderate heart dysfunction, hence helping the baby for the easy & early recovery. The surgery was done without using any stabilizer as such small size stabilizer for newborn babies is not manufactured by any company in the world. It is with the skill of the surgeon who has managed out the surgery without the stabilizer. Baby Sharon’s story showcases the expertise the country has in correcting the most complex congenital defects in the rarest of condition with a combination of skillful hands and technical finesse.
“The diagnosis of Sharon suffering from congenital heart problem came to us as a surprise. When Sharon was not keeping too well, we had the remotest thought of having anything to do with her heart. In fact before this I had very less awareness on congenital heart problems. In our country many kids succumb to faith due to lack of awareness on the defects and availability of expertise to correct such deformities. We need to create more and more awareness on congenital heart disease in India and the facilities provided by hospitals like Fortis Hospitals Mulund to operate upon the most complex cases. We are immensely thankful to Dr. Suresh Joshi and the entire team at Fortis Hospitals Mulund who came to us as saviors and gave a new life to our baby” says Mr. Bonni D’Souza (father of Sharon).
The Bangkok based Medical Travel Quality Alliance (MTQUA) which promotes standards and practices for medical traveler's has recognized Fortis Hospitals, Bangalore (formerly Wockhardt Hospitals) as the most preferred destination in the world for medical tourists from America. The hospital was ranked # 1 in the first list of the top 10 world's best hospitals for medical tourists which was released at a press conference held in Bangkok on January 19, 2010.
According to MTQUA, the top five hospitals are: Fortis Hospitals, Bangalore (formerly Wockhardt Hospital), Gleneagles Hospital, Singapore, Prince Court Medical Centre, Kuala Lumpur, Shouldice Hospital, Toronto and Shoen-Kliniken, Munich.
"It gives us great pride to make India get the top slot as the world's leading destination for International patients" said Mr. Vishal Bali, CEO, Fortis Hospitals Group, India." By providing a strong foundation of quality in all our patient care processes along with affordability we have delivered to both our domestic and International patients' exceptional value" he said.
MTQUA recognized Fortis Hospitals, Bangalore (formerly Wockhardt Hospitals) as the # 1 on its list of Top 10 World's Best Hospitals for Medical Tourists on the following criteria:
1. Medical Quality - The hospital is an excellent surgery option for medical travelers seeking joint replacement, particularly hip resurfacing and replacement. It's also strong in cardiac surgery and neurosurgery. The hospital is internationally accredited by JCI.
2. International Patient Management -Fortis Hospitals has been sensitive to the needs of patients and families for their cultural, language, and religious requirements, their medical needs and emotional support. As the majority of its international caseload is either life-saving or life enhancing procedures, their honesty and integrity provides outstanding case management and better patient understanding.
3. International Patient Marketing - The Hospital actively supports web-based social networks, including Youtube, Facebook, and Twitter. It has its own blog. The hospital has a dedicated team of men and women available 24/7 with access to treating physicians who can respond to qualified patient inquiries.
4. Value For Services - India's hospitals are positioned to provide value for services and will continue to do so because the number of hospitals in India seeking the American or international patient market nurtures a competitive cost structure.
5. Patient Safety And Security - The Hospital wraps the traveling patient from America in a security blanket. From the initial hospital response, Fortis assigns dedicated staff representatives to the patient throughout their hospital stay and a treating physician who directly discusses procedures and outcomes before the patient leaves their home country. Communication with the patient's family physician is encouraged. Patients may stay in the hospital for their full recovery period to avoid moving to a hotel.
6. Transparency - Every effort is extended to ensure transparency of care, from cost to outcomes data. Patients receive a portfolio of their medical file and surgery documents including CT scans, MRI and X-rays, and operative notes to take back to their home country.
7. Attention To The Unique Needs Of The Medical Traveler - According to reports, more than 50% of Hospital's international patients are Americans. It offers prompt scheduling of pre-surgery preparation. It provides exemplary follow up care and services to monitor American medical travelers once they return home.
MTQUA's top 10 list of the World's best hospitals has 6 hospitals out of Asia, 2 from Europe and 2 from North America.
The various procedures which can be done on the Short Stay basis for Urology are
Cystoscopy
This is a diagnostic procedure to check the Urethra and the Bladder. A small telescope ( Cystoscope ) is passed through the urinary pipe to have a look as well as carry out any procedures such as treating the Urethral Stricture, removal of small Bladder Tumours, removing any small stones in the Bladder. The insertion or removal of the Double 'J' stents can also be done during this procedure.
Lower Ureteric Stones:
The stones in the lower part of the Ureter can be treated on a Short stay basis. After passing the Ureteroscope, the stones can be broken by the Lithotripsy and extracted with the help of the Basket. A Double 'J' stent may be inserted after the procedure, which will be removed at the later date.
Varicocele:
The dilatation of the veins around the Testes is called Varicocele. It can cause pain and discomfort in the scrotum. The other significant effect of Varicocele is on the Male Infertility. The ligation of Varicocele is carried out as a Day-Case procedure involving two small cuts in the groins and carefully ligating the dilated veins with the help of a microscope.
Circumcision, Vasectomy
These are the other procedures ideally suitable on a short stay basis. There is minimum disturbance in the patient's routine and they can get back to work quickly.
After a surgery, hospital stay often becomes a tedious task for the patient and his visitors. Not only does it take the patient time to adjust to his new surroundings, it is often noted as a discomfort. Every surgery has its own healing time and requires the patient to rest adequately before he can be sent home. However, there are some surgeries where the patient is operated and sent home that very same day!
Short Stay Surgery has been defined by the Royal College of Surgeons as when the surgical day case patient is admitted for investigation or operation on a planned non-resident basis and who nonetheless requires facilities for recovery.
This definition excludes upper and lower GI endoscopies, outpatient procedures such as flexible cystoscopy, and minor superficial surgery under local anaesthetic, none of which require full day case facilities for recovery. Currently the Short Stay Surgery has a specialized dedicated team, functioning only at Cunningham Road, Bangalore.
Some of the Short Stay Surgery Procedures
1. Orchidopexy 2. Circumcision 3. Inguinal hernia repair 4. Excision of breast lump 5. Anal fissure dilatation or excision 6. Haemorrhoidectomy 7. Laparoscopic cholecystectomy 8. Varicose vein stripping or ligation 9. Transurethral resection of bladder tumour 10. Excision of dupuytren's contracture 11. Carpal tunnel decompression 12. Excision of ganglion 13. Arthroscopy 14. Bunion operations 15. Removal of metalware 16. Extraction of cataract with/without implant 17. Correction of squint 18. Myringotomy 19. Tonsillectomy 20. Sub Mucous resection 21. Reduction of nasal fracture 22. Operation for bat ears 23. Dilatation and curettage/hysteroscopy 24. Laparoscopy 25. Termination of Pregnancy
Benefits of Short Stay Surgery 1. Pre-booked date and less likely to be cancelled 2. Shorter waiting lists and lesser uncertainty of a long wait 3. Easier domestic arrangements 4. Earlier mobilisation 5. Minimal disruption of patient's personal life 6. Earlier return to normal environment 7. Reduced risk of cross-infection 8. Avoidance of disruptive nights in hospital wards 9. Less loss of time at work 10. Less psychological disturbances in children 11. Lesser chances of cancellation due to pressures of emergency surgeries in a dedicated day care facility.
To find out if you are a candidate for short stay surgery, pls email enquiries@wockhardthospitals.netor sms short to 56767
~Martin undergoes a rare cardiac surgery at Wockhardt Hospitals Mulund-Now a network of Fortis~
A team of cardiac experts led by Dr. Ajay Chaughule, Consultant Cardiac Surgeon, Wockhardt Hospitals Mulund( Now a Network of Fortis Hospitals) performed a major tricuspid valve repair on 32 year old Martin from Republic of Rwanda.
Martin was suffering from breathlessness, swelling on face, extremities and abdomen since last 4 -5 years. Martin had history of Rheumatic fever at the age of 8yr. Doctors in Rwanda diagnosed as having Rheumatic fever and treated him with Injection -penicillin for several years (from age of 9 yrs to age of 15 yrs). However nothing gave relief to Martin of his fever. Soon Martin realized this was not getting him anywhere and he failed to receive the right kind of treatment he decided to venture out to the neighbouring countries in search of treatment. He went to Tanzania, Uganda showed to expert doctor, but there as well no one was able to give a proper diagnosis to his problem. They concluded that Martin was suffering from poor liver function and put him on medication. As a last hope Martin went to Nairobi (Kenya) where investigation revealed that he was suffering from Valvular heart diseases and was advised to undergo Valve Surgery.
“Martin had a very a rare and uncommon valve defect which is called the Rheumatic Isolated Predominant Tricuspid Stenosis of Heart" and required to undergo a valve repair surgery. The heart has four valves – Mitral, Aortic, Pulmonary and Tricuspid. In most common cases the mitral, aortic valves gets affected as the primary pathology and the patient needs to undergo a valve repair or replacement procedure. Tricuspid valve getting affected as isolated one is very rare. In Martin’s case this valve had defect and he needed immediate surgery to correct the problem” said Dr. Ajay Chaughule, Cardio-Thoracic & Vascular Surgeon.
Due to the defect in the Tricuspid wall his heart had formed thrombus or cloth which was of 6 cm in size on the right atrium for which the blood flow was restricted and the thickness of the right atrium became 3 cm whereas in normal condition the size is about 2 -3 mm. His heart condition led to many other issues in his system like his liver had enlarged up to the umbilicus and liver function was deranged. He had severe carditus (inflammation of the heart) which led to adhesion of his heart which means his heart was stuck to the surrounding tissue.
“The Echocardiography confirmed the diagnosis Tricuspid valve stenosis with osifice of 0.8cm normal being 5.8cm. Then we decided to go ahead with immediate surgery as his condition was deteriorating.”
“I had to travel from one place to another in search of the right kind of treatment for my problem. With years my condition worsened and it restricted my physical mobility as I was suffering from severe fatigue and breathlessness at slightest physical activity I used to conduct. My physical ill-health perturbed me to quite an extent and I used to feel terrible when all my friends of my age led a healthy life and could do anything they wanted” said Martin. “But once my diagnosis was confirmed in Kenya I made up my mind to go ahead with the surgery as I definitely craved for a healthy life.
However the treatment cost there was too high and there were no expert cardiac surgeon available in Kenya. That’s when my elder brother who is a film director came to know from his colleague about treatment option available in India and the expertise at Wockhardt Hospitals Mulund in the cardiac space and he referred us to fly down to India for my surgery. This experience had given me a new meaning to life and I am extremely happy and consider my self to be fortunate enough to have received such marvelous treatment here. Dr. Ajay Chaugle has almost given me a new life and I would definitely like to make the most of it now. I thank Doctor and Wockhardt Hospitals for the phenomenal treatment offered to me” said Martin.
A team of cardiac experts led by Dr. N S Devananda, Consultant Cardiac Surgeon, Wockhardt Hospitals,Bangalore (now a Fortis Hospitals Network ) has performed a major open heart surgery on a 2 year old baby from Nigeria. Baby Brendan was suffering from congenital heart defect called – Tetralogy of Fallot or complex blue baby syndrome.
“Baby Brendan was brought to us in a condition which was complicated and need surgical intervention to correct the anomaly. In this syndrome the pure and impure blood gets mixed in the heart and the amount of blood flow to the lungs is decreased. It is the most common complex heart defect, representing 55-70%, and the most common cause of blue baby syndrome. It can prove fatal if it is not treated in time,” said Dr. N S Devananda, Consultant Cardiac Surgeon, Wockhardt Hospitals.
The other bigger challenge which came before the surgery was the fact that the baby’s parents belonged to the Jehovah Witness community and as per their religious belief they oppose to any form of transfusion of blood and any blood products however they could accept other from of treatment. This made the case all the more complicated.
“Babies with Tetrology of Fallout have two treatment options – the first is palliative where no open heart surgery is done and the defect is treated with shunt operation. The second is complete repair – which is definitive treatment where the patient undergoes an open heart surgery with a heart lung machine. In the case of Baby Brendan we obviously chose the second option due to its curative value. But the problem we faced was that the heart lung machine requires 500 ml of blood by itself to drive away the air and still haemoglobin at acceptable level. The challenge was with the baby weighed only 11 kgs and his blood volume was 800 – 900 ml and to conduct an open heart proved difficult without additional usage of blood” said Dr. Devananda.
The team devised many things technically to make operative time shorter and do the best possible ways so that re-operation or re-exploration can be avoided and the ICU stay is reduced. The heart lung machine circuit was modified in such a way that total priming volume was reduced to the least possible; the haemo-filteration technique was used in such a way that excess water from the body is removed and it gives back the RBC’s to the body. We also had to reduce the sampling to the least possible for various tests.
“We did everything technically possible to reduce the requirement of blood. With all these modifications the baby underwent the open heart surgery and was out of ICU within 24 hours and is flying back to his native on the 7th post operative day. In an era where a lot of talking is happening around blood transfusion and adults have been undergoing surgery without blood transfusion, the same thing on a child is quite complicated. However with technical modification and surgical skills it is definitely possible and should be encouraged so that no child from the community remains untreated” said Dr. Devananda.
Brendan can live an active life like any other child of his age as this is a one time complete correction and his post op ECHO is satisfactory.
Brendan’s mother Ettieh’s faith in Jehovah has strengthened after this incident. She says, “Everybody should give proper attention to their child and keep monitoring the health of the baby time and again. Till one year when Brendan was not keeping too well and was not gaining weight we got very concerned and kept taking to the local physicians in Nigeria. However nobody could give us a proper answer to his continuous ill health until last year August, 09 Brendan complained of breathlessness and pain on his left chest.
A thorough examination indicated that my baby has some heart complication which needed to be treated immediately. Being a member of the Jehovah Witness community our challenge was to take Brendan to the right hands where surgery was possible without using blood transfusion. That’s when one of our friends at Nigeria who knew about Wockhardt Hospitals and their expertise in performing surgery without blood transfusion suggested us and we finally decided to fly Brendan down here for treatment. Initially when we decided to come to India for treatment I was engulfed with mixed feelings, but with the kind of care and response we received here I was quite confident that I have brought my baby to the right place.”