Health Services

A. Cosmetic Surgery

Medical Tourism Experts of Guanacaste offers a wide variety of cosmetic procedures for both men and women.  Cosmetic surgery, including breast augmentation, implants, reductions and lifts are performed in a high quality hospital setting.  Botox injections, facelifts and eyelid surgery are also common procedures performed by experienced Costa Rican doctors, as are rhinoplasty (‘nose jobs’), abdominoplasty (‘tummy tucks’), hair transplants and liposuction.  

Breast Augmentation

Breast augmentation and augmentation mammoplasty are plastic surgery terms for the breast-implant and the fat-graft mammoplasty approaches used to increase the size, change the shape, and alter the texture of the breasts of a woman  Many women prefer to enhance their breast size or shape because they think that their breasts are too small, uneven in size and shape, not firm enough or just unattractive.  In some cases the breasts may have not fully developed or have significantly changed in size or shape after pregnancy, weight loss or aging.

Breast augmentation surgery increases or restores breast size using silicone gel implants, saline implants or in some cases, fat transfer. One of the most popular and frequently performed aesthetic surgery procedures, breast augmentation has a long and successful track record in satisfying women who wish to enhance, regain or restore balance to their figures. It is the most common cosmetic surgery in the US, and there have been significant improvements in surgical methods and breast-implant design and technology. The American Society for Aesthetic Plastic Surgery reports that in 2012, breast augmentation was preformed on 271,369 women. This procedure may be combined with a breast lift to gain full satisfaction. 

For more information regarding augmentation mammoplasty please see: http://www.smartbeautyguide.com/procedures/breast/breast-augmentation

Breast Lift

A breast lift, also known as Mastopexy, is the plastic surgery mammoplasty procedure for raising sagging breasts upon the chest of the woman; by correcting and modifying the size, contour, and elevation of the breasts. Many women lose self confidence of their breast appearance due to pregnancy, breast feeding or aging, which makes their firm breasts sag and droop. In some cases, women find their nipples start to point down or fall below the breast crease. This may even make them feel uncomfortable in wearing certain types of clothes such as swimming suits or summer tops.

The breast-lift correction of a sagging bust is a surgical operation that cuts and removes excess tissues (glandular, adipose, skin), overstretched suspensory ligaments, excess skin from the skin-envelope, and transposes the nipple-areola complex higher upon the breast hemisphere. In surgical practice, mastopexy can be performed as a discrete breast-lift procedure, or as a subordinate surgery within a combined mastopexy–breast augmentation procedure. Depending upon the anatomical factors and needs of the patient, a breast lift can be performed with or without the insertion of breast implants. The American Society for Aesthetic Plastic Surgery reports that in 2012, breast lift surgery was preformed on 127,776 women. Here in Costa Rica, thousands of women undergo successful breast-lift surgery, experience no major problems and are pleased with the results. Results are usually immediate and satisfying.

For more information regarding breast lift surgery please see: http://www.smartbeautyguide.com/procedures/breast/breast-lift.

Breast Reduction

Breast reduction (also reduction mammoplasty) is the plastic surgery procedure for reducing the size of large breasts in order to re-establish a functional bust that is proportionate to the woman’s body.  The goal of breast reduction surgery is to reduce the size of the breasts and reshape them so that they are proportionate to the rest of your body and are no longer a source of physical discomfort.  Discomforts such as back pain, physical burden, uncomfortable bra-bands, sweating, heating and eczemas in the breast folds may be improved. This commonly requested, predictable procedure has the dual benefits of improving your appearance while relieving the physical and emotional burden of overly large breasts. Men also choose to undergo the surgery for the same reason as even they want to reduce physical symptoms and improve the way they look.

For more information regarding breast reduction surgery please see: http://www.smartbeautyguide.com/procedures/breast/breast-reduction.

Eyelid Surgery

Blepharoplasty, more commonly known as eyelid surgery, is presently one of the most popular surgical cosmetic procedures. This surgery revitalizes one’s youthful appearance by removing excess skin, fat or muscle from the upper and lower eyelids. Eyes are considered the most attractive feature of the face and so this procedure corrects wrinkles, sinking upper eyes, puffy bags and heaviness of the lids, giving patients more ‘open’eyes. It can also help treat the medical condition Ptosis (drooping eyelashes).

For more information regarding eyelid surgery please see: http://www.smartbeautyguide.com/procedures/head-face/eyelid-surgery.

Face Lift

A face lift (Rhytidectomy) is a procedure which can reduce visible signs of aging by reducing facial wrinkles. This procedure leaves a person with firmer, fresher and smoother skin, enhancing overall facial appearance with a younger look.  It is the most comprehensive approach to treating facial wrinkles and sagging caused by aging. The surgery varies in range from minimally invasive ‘lunchtime lifts’to more extensive, sophisticated surgery. A facelift removes excess skin, tightens underlying tissues and muscle and redrapes skin on the face and neck. It can correct mid-face sagging, marionette lines, jowls and a double chin, maintaining its reputation as the ‘gold standard’for facial rejuvenation. Every year, thousands of people undergo successful facelift surgery and are pleased with the results.

For more information regarding face lift surgery please see: http://www.smartbeautyguide.com/procedures/head-face/facelift.

Brachioplasty

A brachioplasty, commonly called an arm lift, is a surgical procedure to reshape and provide improved contour to the upper arms and connecting area of chest wall. While “brachioplasty”is commonly used to describe a specific procedure for the upper arms, the term can also be used to describe any surgical arm contouring. Fluctuations in weight, growing older and even heredity can cause your upper arms to have a drooping, sagging appearance. Brachioplasty is often used to address such issues when they do not respond well to diet and exercise. Exercise may strengthen and improve the underlying muscle tone of the upper arm, but it cannot address excess skin that has lost elasticity or underlying weakened tissues and localized fat deposits. It is a common procedure for patients who have experienced significant weight loss.

For more information regarding brachioplasty surgery please see: http://www.smartbeautyguide.com/procedures/body/upper-arm-lift

Hair Transplant

Many men experience some form of hair loss in their lifetime because of aging, family history, burns or trauma. Even women experience hair loss. In fact, one in five women will experience some degree of hair loss in their lifetime. Some may choose to wear a wig or hair extensions to cover their baldness. Others may use pills and formulas to improve their appearance. Advancements in cosmetic surgery have allowed men and women to regain the appearance of a full head of hair through a treatment called Hair Transplantation. Hair Transplantation is a procedure where hair follicles are transplanted from one site on the body, e.g., neckline or back of the head, to bald or balding areas on the head (scalp). Not only do these hair restoration procedures help individuals to regain a sense of youthfulness, it can also help boost their confidence. Hair transplant is among the more popular cosmetic hair restoration procedures that has been found to be an effective and permanent method of hair restoration.

For more information regarding hair restoration surgery please see: http://www.smartbeautyguide.com/procedures/skin-hair/hair-transplantation.

Liposuction

Liposuction is a type of cosmetic surgery designed to remove excess fat deposits from certain areas of the body. It is an extremely popular surgery, in fact the most common surgical cosmetic procedure performed in the US. The American Society for Aesthetic Plastic Surgery reports that in 2012, liposuction was preformed on 271,369 women and 41, 642 men. Liposuction surgery sculpts your body, eliminating unwanted pockets of diet-resistant fat from the buttocks, hips, love handles, saddlebags, thighs, calves, ankles, breasts (including male breasts), back, arms and neck. Women are more apt to consider liposuction than men, as it helps to improve proportion, body contours, and most importantly, self-image and confidence. Many people, especially those heading toward middle-age, benefit from liposuction treatments that help to rid the body of excess pockets of fat that accumulate around the hips, abdomen, arms and buttocks. Liposuction is often combined with other procedures to create a desired shape, and is one of the safest and most popular cosmetic procedures in Costa Rica.

For more information regarding liposuction surgery please see: http://www.smartbeautyguide.com/procedures/body/liposuction.

Rhinoplasty

Rhinoplasty is a plastic surgery procedure for correcting and reconstructing the form, restoring the functions, and aesthetically enhancing the size or the shape of the nose. In addition, there are often clinical reasons for the procedure, including the opportunity to reduce airway obstruction and improve breathing due to nasal trauma, congenital defect, respiratory impediment, or failed primary rhinoplasty. Besides just adjusting the size and/or correcting a health problem, the nose can be reshaped at the tip and narrowed at the span of the nostrils. A change of angle between the nose and upper lip is also possible. During this surgery, a plastic surgeon creates a functional, aesthetic, and facially proportionate nose by separating the nasal skin and the soft tissues from the osseo-cartilaginous nasal framework, correcting them as required for form and function, suturing the incisions, and applying either a package or a stent to immobilize the corrected nose to ensure the proper healing of the surgical incision. It may take several months for swelling to fully dissipate and up to a year for the outcome of the surgery to fully refine after rhinoplasty surgery.

For more information regarding nose surgery please see: http://www.smartbeautyguide.com/procedures/head-face/nose-surgery.

Tummy Tuck

Abdominoplasty or “tummy tuck” is a cosmetic surgery procedure used to make the abdomen more firm. The surgery involves the removal of excess skin and fat from the middle and lower abdomen in order to tighten the muscle and fascia, creating an abdominal profile that is smoother and firmer. This type of surgery is usually sought by patients with loose or sagging tissues after pregnancy or major weight loss. It can also remove some if not all of the stretch marks in your lower abdomen. It is popular following pregnancy, massive weight loss or whenever a flabby abdomen with weak muscles impairs body contour. Tummy tucks are not a substitute for weight loss or an appropriate exercise program. Also, tummy tuck operations cannot completely correct stretch marks, although these may be removed or somewhat improved if they are located on the areas of excess skin that will be excised, generally the treated areas below the belly button. Most patients report improved self-esteem as a result of this procedure.

For more information regarding abdominoplasty surgery please see: http://www.smartbeautyguide.com/procedures/body/tummy-tuck.

B. Orthopedic Surgery

We provide all major medical treatments and surgeries for different orthopedic procedures. Costa Rica boasts a number of specialist orthopedic surgeons who have made their mark across the world.

Knee Arthroscopy

Knee arthroscopic surgery is a procedure performed through small incisions in the skin to repair injuries to tissues such as ligaments, cartilage, or bone within the knee joint area. The surgery is conducted with the aid of an arthroscope, which is a very small instrument guided by a lighted scope attached to a television monitor. Other instruments are inserted through three incisions around the knee. Technical advances have led to high definition monitors and high resolution cameras. These and other improvements have made arthroscopy a very effective tool for treating knee problems. According to the American Orthopedic Society for Sports Medicine, more than 4 million knee arthroscopies are performed worldwide each year.

Arthroscopic surgeries range from minor procedures such as flushing or smoothing out bone surfaces or tissue fragments (lavage and debridement ) associated with osteoarthritis, to the realignment of a dislocated knee and ligament grafting surgeries. The range of surgeries represents very different procedures, risks, and aftercare requirements. While the clear advantages of arthroscopic surgery lie in surgery with less anesthetic, less cutting, and less recovery time, this surgery nonetheless requires a very thorough examination of the causes of knee injury or pain prior to a decision for surgery.

For more information regarding knee arthroscopic surgery please see: http://www.nlm.nih.gov/medlineplus/ency/article/002972.htm.

Knee Replacement

Knee replacement, or knee arthroplasty, is a surgical procedure to replace a damaged knee with a prosthesis (an artificial joint). It is most commonly performed for osteoarthritis, and also for other knee diseases such as rheumatoid arthritis and psoriatic arthritis. In patients with severe deformity from advanced rheumatoid arthritis, trauma, or long-standing osteoarthritis, the surgery may be more complicated and carry higher risk. Knee replacement surgery can be performed as a partial or a total knee replacement. In general, the surgery consists of replacing the diseased or damaged joint surfaces of the knee with metal and plastic components shaped to allow continued motion of the knee. The operation typically involves substantial postoperative pain, and includes vigorous physical rehabilitation. The recovery period may be 6 weeks or longer and may involve the use of mobility aids (e.g., walking frames, canes, crutches) to enable the patient’s return to preoperative mobility. According to the Agency for Healthcare Research and Quality, more than 600,000 knee replacements are performed each year in the United States.

For more information regarding knee replacement surgery please see: http://orthoinfo.aaos.org/topic.cfm?topic=A00389.

Shoulder Replacement

Shoulder replacement (arthroplasty) is a surgical procedure in which all or part of the glenohumeral joint is replaced by a prosthetic implant. Such joint replacement surgery generally is conducted to relieve arthritis pain or fix severe physical joint damage. Shoulder replacement surgery is an option for treatment of severe arthritis of the shoulder joint. Arthritis is a condition that affects the cartilage of the joints. As the cartilage lining wears away, the protective lining between the bones is lost. When this happens, painful bone-on-bone arthritis develops. Severe shoulder arthritis is quite painful, and can cause restriction of motion. While this may be tolerated with some medications and lifestyle adjustments, there may come a time when surgical treatment is necessary.

For more information regarding shoulder replacement surgery please see: http://orthoinfo.aaos.org/topic.cfm?topic=A00094.

Total Hip Replacement

Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant. Hip replacement surgery can be performed as a total replacement or a hemi (half) replacement. Such joint replacement orthopedic surgery is generally conducted to relieve arthritis pain or fix severe physical joint damage as part of hip fracture treatment. A total hip replacement (total hip arthroplasty) consists of replacing both the acetabulum and the femoral head while hemiarthroplasty generally only replaces the femoral head. Hip replacement is currently the most common orthopedic operation.

Osteoarthritis of the hip is the most common diagnosis that leads to hip replacement. Osteoarthritis is caused by wear and tear and affects the cartilage surfaces of the ball-and-socket joint of the hip. When the cartilage wears out, pain and stiffness result. Patients with hip arthritis have difficulty walking, climbing stairs and performing routine daily activities. Other conditions that can cause destruction of the hip joint include loss of blood supply to the head of the thighbone, rheumatoid arthritis, previous injury or trauma, infection or developmental abnormalities in the hip.

For more information regarding hip replacement surgery please see: http://orthoinfo.aaos.org/topic.cfm?topic=A00377.

Repair Ulnar Claw

An ulnar claw, also known as claw hand, is an abnormal hand position that develops due to a problem with the ulnar nerve. A hand in ulnar claw position will have the 4th and/or 5th fingers drawn towards the back of the hand at the first knuckle and curled towards the palm at the second and third knuckles.  The ulnar nerve runs from the shoulder to the little finger. If there is damage to the ulnar nerve, it can affect one’s ability to make fine movements and can cause the hand to appear claw-like. Surgery to relieve pressure on the nerve is often the best method to reduce the symptoms of claw hand.

For more information regarding claw hand surgery please see: http://orthoinfo.aaos.org/topic.cfm?topic=A00024.

Bunion Repair

A bunion is one problem that can develop due to hallux valgus, a foot deformity. The term “hallux valgus” is Latin and means a turning outward (valgus) of the big toe (hallux). The bone which joins the big toe, the first metatarsal, becomes prominent on the inner border of the foot. This bump is the bunion and is made up of bone and soft tissue.

Bunion surgery generally involves an incision in the top or side of the big toe joint and the removal or realignment of soft tissue and bone. This is done to relieve pain and restore normal alignment to the joint. Small wires, screws, or plates may be used to hold the bones in place. A regional anesthetic that affects only the foot is commonly used for bunion surgery and a sedative may also be used during the procedure. The procedure usually takes an hour or more, depending on the type of surgery. Bunion repairs are usually done on an outpatient basis. There are over 100 surgeries for bunions. Research does not show which type of surgery is best—surgery needs to be specific to the condition. More than one procedure may be done at the same time.

For more information regarding bunion surgery please see: http://orthoinfo.aaos.org/topic.cfm?topic=a00140.

C. Weight Loss Surgery

Roux-en-Y

“Roux-en-Y” gastric bypass surgery is a procedure where most of the stomach is bypassed and a small stomach pouch is made.  It is the most commonly performed weight loss surgery today, accounting for about 80% of all weight loss surgery in the US

Roux-en-Y gastric bypass surgery has two parts.  First the stomach is divided into a large portion, and a much smaller portion. The small part of the stomach is then sewn or stapled together to make a small pouch (this part is sometimes called “stomach stapling”). The small stomach pouch can only hold a cup or so of food. With such a small stomach, people feel full quickly and eat less. Then the new, small stomach pouch is disconnected from the first part of the small intestine (the duodenum) and reconnected to a portion of intestine slightly further down (the jejunum). This surgical technique is called a “roux-en-Y.”

Roux-en-Y gastric bypass is typically performed laparoscopically (using tools inserted through small incisions in the belly). When laparoscopy is not possible, gastric bypass can be open (laparotomy). This involves a large incision in the middle of the belly. The procedure is performed under general anesthesia.  After gastric bypass surgery, people typically stay in the hospital for two to three days and return to normal activity in two to three weeks. Weight loss after gastric bypass surgery is often dramatic. On average, patients lose 60% of their extra weight. For example, a 350-pound person who is 200 pounds overweight would lose about 120 pounds.

For more information regarding Roux-en-Y gastric bypass surgery please see: http://www.webmd.com/diet/weight-loss-surgery/gastric-bypass.

Laparoscopic Adjustable Gastric Banding Surgery

Laparoscopic gastric banding is the second most common weight loss surgery, after gastric bypass. Using laparoscopic tools, the surgeon places an adjustable silicone band around the upper part of the stomach. Squeezed by the silicone band, the stomach becomes a pouch with about an inch-wide outlet. After banding, the stomach can only hold about an ounce of food. A plastic tube runs from the silicone band to a device just under the skin. Saline (sterile salt water) can be injected or removed through the skin, flowing into or out of the silicone band. Injecting saline fills the band and makes it tighter. In this way, the band can be tightened or loosened as needed. This can reduce side effects and improve weight loss.

Laparoscopic adjustable gastric banding leads to loss of about 40% of excess weight, on average. For example, someone who is 200 pounds overweight could expect to lose an average of 80 pounds after gastric banding. However, these results vary widely. Gastric banding is considered the least invasive weight loss surgery. It is also the safest. The procedure can be reversed if necessary, and in time, the stomach generally returns to its normal size. Gastric banding surgery also has a low complication rate.

For more information regarding laparoscopic gastric banding surgery please see: http://www.obesitylapbandsurgery.com/tecmain.html.

Sleeve Gastrectomy

Sleeve gastrectomy is a surgical weight-loss procedure in which the stomach is reduced to about 25% of its original size by surgically removing a large portion of the stomach along the greater curvature. This results in a sleeve or tube like structure. The procedure permanently reduces the size of the stomach and is irreversible, although there could be some dilatation of the stomach later on in life. Sleeve Gastrectomy may also cause a decrease in appetite. In addition to reducing the size of the stomach, Sleeve Gastrectomy may reduce the amount of “hunger hormone” produced by the stomach which may contribute to weight loss after this procedure. A sleeve gastrectomy is generally performed laparoscopically. This involves making five or six small incisions in the abdomen and performing the procedure using a video camera and long instruments that are placed through these small incisions.

Sleeve gastrectomy was originally performed as a modification to another bariatric procedure, the duodenal switch, and then later as the first part of a two-stage gastric bypass operation on extremely obese patients for which the risk of performing gastric bypass surgery was deemed too large. The initial weight loss in these patients was so successful it began to be investigated as a stand alone procedure.

Today sleeve gastrectomy is the fastest growing weight loss surgery option in North America and Asia. In many cases, but not all, sleeve gastrectomy is as effective as gastric bypass surgery, including weight independent benefits on glucose homeostasis. The precise mechanism(s) that produce these benefits is not known. The procedure takes one to two hours to complete and is performed under general anesthesia. 

For more information regarding sleeve gastrectomy surgery please see: http://www.womenfitness.net/vertical_gastrectomy.htm.

Duodenal Switch

The duodenal switch procedure, also known as biliopancreatic diversion with duodenal switch, is a weight loss surgery procedure that is composed of a restrictive and a malabsorptive aspect. The restrictive portion of the surgery involves removing approximately 70% of the stomach along the greater curvature. The malabsorptive portion of the surgery reroutes a lengthy portion of the small intestine, creating two separate pathways and one common channel. The shorter of the two pathways, the digestive loop, takes food from the stomach to the common channel. The much longer pathway, the biliopancreatic loop, carries bile from the liver to the common channel. The common channel is the portion of small intestine, usually 75-150 centimeters long, in which the contents of the digestive path mix with the bile from the biliopancreatic loop before emptying into the large intestine. The objective of this arrangement is to reduce the amount of time the body has to capture calories from food in the small intestine and to selectively limit the absorption of fat. As a result, following surgery, these patients only absorb approximately 20% of the fat they intake.

The primary advantage of duodenal switch surgery is that its combination of moderate intake restriction with substantial calorie malabsorption results in a very high percentage of excess weight loss for obese individuals, with a very low risk of significant weight regain. Type 2 diabetics have had a 98% “cure” (i.e., became euglycemic) almost immediately following surgery which is due to the metabolic effect from the intestine switch. The results are so favorable that some surgeons are performing the surgery on non-obese patients for the benefits of curing the diabetes. The following observations were reported on the resolution of obesity related comorbidities following the duodenal switch: type 2 diabetes 99%, hyperlipidemia 99%, sleep apnea 92%, and hypertension 83%.

Because the pyloric valve between the stomach and small intestine is preserved, people who have undergone the duodenal switch do not experience the dumping syndrome common with people who’ve undergone the Roux-en-Y gastric bypass surgery. Much of the production of the hunger hormone, ghrelin, is removed with the greater curvature of the stomach. Diet following duodenal switch surgery is more normal and better tolerated than with other surgeries. The malabsorptive component of the duodenal switch is fully reversible as no small intestine is actually removed, only re-routed. The procedure takes one to two hours to complete and is performed under general anesthesia. 

For more information regarding duodenal switch surgery please see: http://www.duodenalswitch.com

D. General Surgery

Inguinal Hernia Repair

Inguinal hernia repair is surgery to repair a hernia in the abdominal wall of the groin. A hernia is tissue that bulges out of a weak spot in the abdominal wall. During hernia repair, this bulging tissue is pushed back in. The abdominal wall is then strengthened and supported with sutures (stitches), and sometimes mesh. The procedure is typically performed under general anesthesia (asleep and pain-free) or spinal anesthesia. If the hernia is small, the patient may receive local anesthesia, and be awake but pain-free. The surgery is performed either laparoscopically or as an open surgery.  Laparoscopic surgery may not be recommended for larger or more complicated hernias, or for growing hernias on both sides.

For more information regarding  surgery please see: http://en.wikipedia.org/wiki/Inguinal_hernia.

Colectomy

A colectomy is a surgical procedure to remove all or part of the colon. The colon, also called the large intestine, is a long tube-like organ at the end of your digestive system. Colectomy may be necessary to treat or prevent diseases and conditions that affect the colon. These include Crohn’s disease, colon cancer tumors, or severe constipation, called colonic inertia. There are various types of colectomy operations: a total abdominal colectomy is the removal of the large intestine from the lowest part of the small intestine (ileum) to the rectum. After it is removed, the end of the small intestine is sewn to the rectum.  A partial colectomy involves removing part of the colon and may also be called subtotal colectomy. A hemicolectomy involves removing the right or left portion of the colon. A proctocolectomy involves removing both the colon and rectum.  For these surgeries, the patient receives general anesthesia. 

For more information regarding colectomy surgery please see: http://www.privatehealth.co.uk/private-operations/general-surgery/colectomy-total-and-ileostomy/.

Diagnostic Laparoscopy

A diagnostic laparoscopy is a procedure that allows the doctor to look directly at the contents of a patient’s abdomen or pelvis. This procedure is done in the hospital under general anesthesia (while you are asleep and pain-free). Very rarely, this procedure may also be done using local anesthesia. This numbs only the area affected by the surgery and allows the patient to stay awake.

A diagnostic laparoscopy involves a surgeon making a small cut below the belly button (navel) and inserting a needle into the area. Carbon dioxide gas is passed into the abdomen to expand the area. This gives the surgeon more room to work, and helps the surgeon see the organs more clearly. Then a tube is placed through the cut in the abdomen. A tiny video camera (laparoscope) goes through this tube and is used to see the inside of the pelvis and abdomen. More small cuts may be made if other instruments are needed to get a better view of certain organs. If it is a gynecologic laparoscopy, dye may be injected into the cervix area so the surgeon can better see the fallopian tubes.  Our partners at Hospital Clinico San Rafael Arcangel have recently installed the most modern and sophisticated laparoscopy equipment available today.

For more information regarding diagnostic laparoscopy please see: http://www.webmd.com/digestive-disorders/laparoscopy-16156.

Laparoscopic Gall Bladder Removal

Gallbladder removal is one of the most commonly performed surgical procedures in the United States. Today, gallbladder surgery is performed laparoscopically. The medical name for this procedure is Laparoscopic Cholecystectomy. Gallbladder problems are usually caused by the presence of gallstones: small hard masses consisting primarily of cholesterol and bile salts that form in the gallbladder or in the bile duct. It is uncertain why some people form gallstones and there is no known means to prevent them.  Gallstones do not go away on their own. Some can be temporarily managed with drugs or by making dietary adjustments, such as reducing fat intake. This treatment has a low, short-term success rate. Symptoms will eventually continue unless the gallbladder is removed. Surgical removal of the gallbladder is the time honored and safest treatment of gallbladder disease.

For more information regarding gallbladder surgery please see: http://en.wikipedia.org/wiki/Cholecystectomy.

Laparoscopic Splenectomy

A laparoscopic splenectomy is the extraction of the spleen through laparoscopic surgery. Numerous case reports have repeatedly demonstrated the safety (mortality rates <1%) and efficacy of this technique. Indeed, it is now considered standard of care for most elective normal size spleens. The spleen is removed while the patient is under general anesthesia (asleep and pain-free). Depending on the situation, the surgeon may do either an open splenectomy or a laparoscopic splenectomy. Some conditions that may require spleen removal include an abscess or cyst in the spleen, cirrhosis of the liver, certain disorders of blood cells (e.g., idiopathic thrombocytopenia purpura), lymphoma, Hodgkin disease, or leukemia, and trauma to the spleen.

For more information regarding laparoscopic splenectomy surgery please see: http://www.webmd.com/digestive-disorders/splenectomy.

Laparoscopic Salpingectomy

A laparoscopic salpingectomy refers to the surgical removal of a Fallopian tube. The fallopian tubes are part of the reproductive system in women and form the needed connection between the ovaries and the uterus. Sometimes disease is present in one or both of the tubes, or other conditions like fluid build-up or ectopic pregnancy damages a single tube. In these instances and in other circumstances, salpingectomy could be considered. Occasionally it’s necessary to remove both tubes, which is called a bilateral version of the procedure.

The basic procedure for a salpingectomy is to use laparoscopy. This creates a tiny incision, which allows removal of the tube. Under certain circumstances, a larger incision is required, and laparotomy or stomach incision is necessary instead. Patients can’t always know ahead of time what incision to expect since a doctor may have to change his/her mind based on conditions found during surgery. It is fair to state that laparoscopic removal is more common, however, and that some women might expect to go home on the day of their surgery or could spend a few days in the hospital recovering first. A laparoscopic salpingectomy is normally done in the hospital under general anesthesia. Very rarely, this procedure may also be done using local anesthesia. This numbs only the area affected by the surgery and allows the patient to stay awake.

For more information regarding salpingectomy surgery please see: http://emedicine.medscape.com/article/1848581-overview.

Vasectomy

A vasectomy prevents the release of sperm when a man ejaculates and is considered a permanent method of birth control. During a vasectomy, the vas deferens from each testicle is clamped, cut, or otherwise sealed. This prevents sperm from mixing with the semen. An egg cannot be fertilized when there are no sperm in the semen. The testicles continue to produce sperm, but the sperm are reabsorbed by the body (this also happens to sperm that are not ejaculated after a long while). Because the tubes are blocked before the seminal vesicles and prostate, the patient will still ejaculate about the same amount of fluid.  It usually takes several months after a vasectomy for all remaining sperm to be ejaculated or be reabsorbed. As a result, the patient must use another method of birth control until a semen sample test shows a zero sperm count.

For more information regarding a vasectomy please see: http://en.wikipedia.org/wiki/Vasectomy.

Transurethral Resection of the Prostate (TURP)

A TURP is a type of prostate surgery done to relieve moderate to severe urinary symptoms caused by an enlarged prostate, a condition known as benign prostatic hyperplasia (BPH). During TURP, a combined visual and surgical instrument (resectoscope) is inserted through the tip of the penis and into the tube that carries urine from your bladder (urethra). The urethra is surrounded by the prostate. Using the resectoscope, the doctor trims away excess prostate tissue that’s blocking urine flow and increases the size of the channel that allows the bladder to empty. This method is one of the most compelling options for treating urinary symptoms caused by BPH and has a long history as an effective treatment with low mortality.  However, there are a number of newer highly efficient methods that have recently become popular. To determine whether TURP or another treatment is the right choice, the doctor will consider how severe are the symptoms, and what other health problems the patient may have, and the size and shape of the prostate.

For more information regarding TURP surgery please see: http://www.mayoclinic.org/tests-procedures/turp/basics/definition/prc-20020214.

Transurethral Vaporization of the Prostate (TUVP)

A TUVP is a prostate surgery using advanced laser methods to perform a prostatectomy. A telescope is placed into the urethra up to the prostate, and then the doctor uses a laser to vaporize prostate tissue that is obstructing flow of urine from the bladder. During the process, the small blood vessels in the prostate are sealed off. There is less bleeding during and after this procedure than there is with the TURP. As a result, patients can leave the hospital the same day or next morning. Laser Prostatectomy is done under general or spinal anesthesia as an outpatient procedure. Most patients keep a foley catheter for less than 24 hours. Other benefits include long-lasting relief of BPH symptoms, the ability to stop BPH medications, and faster return to normal activities.

For more information regarding TUVP surgery please see: http://www.mayoclinic.org/tests-procedures/prostate-laser-surgery/basics/definition/prc-20013285.

Radical Prostatectomy

A radical prostatectomy is a surgical procedure that removes the prostate gland and attached seminal vesicles. Lymph nodes near the prostate can be removed at the same time. Radical prostatectomy is one treatment option for men with localized prostate cancer. This operation may be done by open surgery, or by laparoscopic surgery through small incisions. In open surgery, the surgeon makes an incision to reach the prostate gland. Depending on the case, the incision is made either in the lower belly or in the perineum between the anus and the scrotum. When the incision is made in the lower belly, it is called the retropubic approach. The surgeon may also remove lymph nodes in the area so that they can be tested for cancer. When the incision is made in the perineum, it is called the perineal approach. The recovery time after this surgery may be shorter than with the retropubic approach. If the surgeon wants to remove lymph nodes for testing, he or she must make a separate incision. If the lymph nodes are believed to be free of cancer based on the grade of the cancer and results of the PSA test, the surgeon may not remove lymph nodes.

For more information regarding radical prostatectomy please see: http://www.privatehealth.co.uk/private-operations/urology/prostatectomy/.

Varicocele Repair

Varicocele is an abnormal enlargement of the pampiniform venous plexus in the scrotum. This plexus of veins drains the testicles. The testicular blood vessels originate in the abdomen and course down through the inguinal canal as part of the spermatic cord on their way to the testis. Upward flow of blood in the veins is ensured by small one-way valves that prevent back-flow. Defective valves, or compression of the vein by a nearby structure, can cause dilatation of the testicular veins near the testis, leading to the formation of a varicocele.

Most men diagnosed with a varicocele have no symptoms, but varicoceles are important for several reasons. Approximately 40 percent of cases of primary male infertility and 80 percent of cases of secondary male infertility are believed to be due to varicoceles. Varicoceles can be discovered through self-examination or during routine physical examination. They may look or feel like a mass in the scrotum, and they have been described as having a “bag of worms” both because of their appearance and the way they feel. Surgical intervention of varicoceles is an appropriate consideration in patients with infertility, pain or testicular atrophy. Surgical repairinvolves ligation (obstructing) of the spermatic veins thus interrupting blood flow in the vessels of the pampiniform venous plexus. The surgical approaches include open surgical repairs performed through a single 1 inch incision with or without the use of optical magnification. Laparoscopic varicocele repair which utilizes telescopes passed through the abdominal wall are advocated by some. The open procedures are performed under a variety of anesthetics, from local to general anesthesia, whereas the laparoscopic approach is uniformly performed under a general anesthetic agent. With the advent of smaller incisions, which avoid muscle transection, the open procedures are becoming closer to the laparoscopic techniques in both speed of recovery and postoperative pain.

For more information regarding varicocele repair please see: http://www.urologyhealth.org/urology/index.cfm?article=116.

Urethral Sling

Urethral sling surgeries to treat urinary incontinence involve placing a sling around the urethra  to lift it back into a normal position and to exert pressure on the urethra to aid urine retention. The sling is attached to the abdominal (belly) wall. The sling material may be muscle, ligament, or tendon tissue taken from the woman or from an animal, such as a pig. It may also be composed of synthetic material such as plastic that is compatible with body tissues or of absorbable polymer that disintegrates over time.

For more information regarding urethral sling surgery please see: http://www.mayoclinic.org/diseases-conditions/urinary-incontinence/in-depth/urinary-incontinence-surgery/art-20046858.

Transurethral Resection of the Bladder     

Transurethral resection (TUR) of the bladder is a surgical procedure that is used both to diagnose bladder cancer and to remove cancerous tissue from the bladder. This procedure is also called a TURBT (transurethral resection for bladder tumor). General anesthesia or spinal anesthesia is often used. During TUR surgery, a cystoscope is passed into the bladder through the urethra. A camera lens at the end of the cystoscope will send pictures from the inside of the bladder to a monitor. The surgeon will look at these images on the monitor to locate the unusual growth or tumors on the bladder wall. Using a special wire loop, he or she will cut away the tumor and a border of healthy tissue around it. The surgeon may also pass an electric current down the wire loop to seal the wound. He or she will then take the cystoscope out and pass a thin, flexible tube (catheter) into your urethra. This will be left in place for about 24 hours. The tissue removed in the procedure will be sent to a laboratory for testing. The operation can take between 15 and 40 minutes.

For more information regarding a transurethral resection of the bladder please see: http://www.cancer.org/cancer/bladdercancer/detailedguide/bladder-cancer-treating-surgery.

E. Dental Transformations

Medical tourists who seek dental care outside their national borders have a single focus in mind: money. In Canada, the US, and many European countries, dental care is expensive, especially if extensive reconstructive or cosmetic work is required. In the US, only the most rudimentary dental care is covered by health insurance plans, which is why more than 150 million Americans are without dental coverage.

We provide several dental packages. However, these will be based on the requirements of the person and their holiday needs. In order to understand the dental services provided by MTEG, we have prepared a list of dental procedures available here in Guanacaste:

Dental Bridges

A dental bridge is a false tooth or teeth, known as a pontic, which is fused between two porcelain crowns to fill in the area left by a missing tooth or teeth. The two crowns holding it in place that are attached onto your teeth on each side of the false tooth. This is known as a fixed bridge. This procedure is used to replace one or more missing teeth. Fixed bridges cannot be taken out of your mouth as you might do with removable partial dentures.

In areas of your mouth that are under less stress, such as your front teeth, a cantilever bridge may be used. Cantilever bridges are used when there are teeth on only one side of the open space. Bridges can reduce your risk of gum disease, help correct some bite issues and even improve your speech. Bridges require your commitment to serious oral hygiene, but will last as many ten years or more.

For more information about tooth crowns please see:

http://www.aboutcosmeticdentistry.com/procedures/tooth_crowns/index.html

Dental Crowns

Veneers, porcelain or dental bonding, are placed over the front teeth to change color shape of the teeth. Veneers are ideal for teeth that are too small, too big, or have uneven surfaces. It is very common for people to have imperfect teeth, either oddly shaped teeth, chipped teeth, crooked teeth, teeth with small holes in them, or an inappropriate sized tooth or teeth that have an odd appearance. Veneers solve such irregularities and create a durable and pleasing smile.

For more information about dental crowns please see:

http://www.aboutcosmeticdentistry.com/procedures/dental_crown.html

Dental Fillings 

Most of us have had amalgam fillings (silver) or gold filling restorations. Some amalgam fillings were what we have called mercury fillings, as some amalgam fillings contained mercury. Metal fillings were effective, but very conspicuous and tended to blacken in color over time.

Composite resin dental fillings were created as an alternative to traditional metal dental fillings. Tooth fillings colored to look like a natural tooth are known as Composite Resin Dental Fillings, are made of a plastic dental resin. Composite Resin Dental Fillings are strong, durable, and make for a very natural looking smile. Many dental insurance plans cover their use.  

For more information about dental fillings please see:

http://www.aboutcosmeticdentistry.com/procedures/dental_fillings/index.html

Dental Implants

Dental implants are fixtures of titanium which are surgically screwed into your jaw bone. The dental implant is an anchor for a naturally-appearing false tooth or a set of false teeth. The success rate of dental implants depends on where the implants are placed and their purpose. They are typically best placed in the front portion of your lower jaw. Implants are great for replacing missing teeth. It is important that you have enough bone in the area of the missing teeth for the implants to be attached to. Implants are not only used to replace one tooth, but rather people missing most, if not all, of their teeth benefit greatly as well. Dental implants are increasingly being used to replace certain types of bridges and removable partial dentures.

For more information about dental implants please see:

http://www.aboutcosmeticdentistry.com/procedures/dental_implants/index.html

Dentures 

Dentures are removable replacements for missing teeth typically made out of an acrylic resin which at times incorporate porcelain or metal for additional structural support. There are two main types of dentures. Both Complete Dentures and Partial Dentures are finely crafted, custom-fitted. If you properly maintain your dentures they will appear natural and provide a perfect smile. Additionally, dentures help strengthen muscles controlling your expressions that require the support of your teeth, rid you of pronunciation problems caused by missing teeth and aid with chewing.

For more information about dentures please see: http://www.aboutcosmeticdentistry.com/procedures/dentures/index.html.

Root Canals

There are tiny canals within your tooth that may become infected. This leads to the pulp inside your tooth also becoming infected as well. Either your dentist or an endodontist to remove any infection performs the root canal procedure. The canals are cleaned and then filled and the tooth receives either a filling or a crown. 

For more information about root canals please see:

http://www.aboutcosmeticdentistry.com/procedures/tooth_root_canal.html

Teeth Whitening 

Whitening of teeth is performed for patients who desire a brighter smile. Teeth whitening can be performed to reduce discoloration and staining, or simply to provide the patient with whiter, brighter teeth. Teeth are usually whitened before placing porcelain crowns or porcelain veneers which will be color matched to the whitened teeth. Also in dental bonding treatment whitening first is desired.

For more information about teeth whitening please see:

http://www.aboutcosmeticdentistry.com/procedures/teeth_whitening/index.html

Tooth Contouring and Reshaping 

Tooth reshaping, or contouring, is one of few instant treatments now available in cosmetic dentistry. Dental reshaping and contouring is a procedure to correct crooked teeth, chipped teeth, cracked teeth or even overlapping teeth in just one session.

The dental contouring procedure can even be a substitute for braces under certain circumstances. It is also a procedure of subtle changes. A few millimeters of reduction and a few millimeters of tooth-colored laminate can create a beautiful smile when performed by a cosmetic dentist, with no discomfort to you. Tooth reshaping, or dental contouring, is commonly used to alter the length, shape or position of your teeth.

For more information about dental contouring please see:

http://www.aboutcosmeticdentistry.com/procedures/dental_contouring/candidate.html

Tooth Veneers

Veneers, porcelain or dental bonding, are placed over the front teeth to change color shape of the teeth. Veneers are ideal for teeth that are too small, too big, or have uneven surfaces. It is very common for people to have imperfect teeth, either oddly shaped teeth, chipped teeth, crooked teeth, teeth with small holes in them, or an inappropriate sized tooth or teeth that have an odd appearance. Veneers solve such irregularities and create a durable and pleasing smile.

For more information about tooth veneers please see:

http://www.aboutcosmeticdentistry.com/procedures/porcelain_veneers/candidate.html

Dental Bonding

The dental bonding procedure utilizes a composite resin and is used for a variety of structural as well as cosmetic purposes. One can draw a parallel between dental bonding materials and a sculptor’s clay. By using dental composite resin bonding your dentist can restore chipped or broken teeth, fill in gaps and reshape or recolor your smile. To learn more about the dental bonding procedure, choose from the selections below, or simply click the “Continue” arrow to begin.

For more information about dental bonding please see: http://www.aboutcosmeticdentistry.com/procedures/dental_bonding.html.

F.        Well Patient Check-ups

Basic Medical Check-Up for Women

Hospital Clínico San Rafael Arcángel offers a complete basic check-up for women.

In consultation with a medical specialist in Internal Medicine, the check-up includes an interview, a complete medical evaluation, clinical history and report of your health conditions based on the results obtained from the following tests and procedures:

Laboratory

  • Full Hemogram (red blood cells, white blood cells, platelets count, hematocrit and hemoglobin).
  • Glucose
  • Total Cholesterol (cholesterol, HDL, VLDL, COL/HDL, LDL, triglycerides)
  • Urea nitrogen
  • Creatinine
  • Uric Acid
  • Gamma glutamyl transpeptidase
  • General Urine Test

Imaging Diagnostics

  • Mammogram
  • One View Chest X-Ray
  • Bone Densitometry (osteoporosis)
  • Full Abdominal Ultrasound (upper abdomen and pelvis)

Cardiology

  • Electrocardiogram

The patient will have a bi-lingual individual to guide her through the process.  The program also includes free breakfast and parking.

Advanced Medical Check-Up for Women

Hospital Clínico San Rafael Arcángel offers a complete advanced check-up for women.

In consultation with a medical specialist in Internal Medicine, the check-up includes an interview, a complete medical evaluation, clinical history and report of your health conditions based on the results obtained from the following tests and procedures:

Laboratory

  • Full Hemogram (red blood cells, white blood cells, platelets count, hematocrit and hemoglobin).
  • Glucose
  • Total Cholesterol (cholesterol, HDL, VLDL, COL/HDL, LDL, triglycerides)
  • Creatinine
  • Uric Acid
  • Urea Nitrogen
  • Gamma glutamyl transpeptidase
  • TSH
  • Total T3
  • Free T4
  • General Urine Test

Imaging Diagnostics

  • Mammogram
  • One View Chest X-Ray
  • Bone Densitometry (osteoporosis)
  • Full Abdominal Ultrasound (upper abdomen and pelvis)

Cardiology

  • Electrocardiogram

The patient will have a bi-lingual individual to guide her through the process.  The program also includes free breakfast and parking.

Comprehensive Medical Check-Up for Women

Hospital Clínico San Rafael Arcángel offers a comprehensive medical check-up for women.

In consultation with a medical specialist in Internal Medicine, the check-up includes an interview, a complete medical evaluation, clinical history and report of your health conditions based on the results obtained from the following tests and procedures:

Laboratory

  • Full Hemogram (red blood cells, white blood cells, platelets count, hematocrit and hemoglobin).
  • Glucose
  • Total Cholesterol (cholesterol, HDL, VLDL, COL/HDL, LDL, triglycerides)
  • Creatinine
  • Uric Acid
  • Urea Nitrogen
  • Gamma glutamyl transpeptidase
  • TSH
  • Total T3
  • Free T4
  • General Urine Test

Imaging Diagnostics

  • Mammogram
  • One View Chest X-Ray
  • Bone Densitometry (osteoporosis)
  • Full Abdominal ultrasound (upper abdomen and pelvis)

Endoscopy

  • Upper GI (Gastroscopy)
  • Urease Test (for Helicobacter pylori)
  • Lower GI (Complete Colonoscopy)

Cardiology

  • Exercise Stress Tolerance Test

In addition, the comprehensive medical check-up for women includes one-on-one consultations with an ENT Specialist who will conduct an audiometric exam, a Nutritionist who will provide nutritional advice and consultation, and an Optometrist who will perform a thorough eye exam.

The patient will have a bi-lingual individual to guide her through the process.  The program also includes free breakfast and parking.

Basic Check-Up for Men

Hospital Clínico San Rafael Arcángel offers a complete basic check-up for men. In consultation with a medical specialist in Internal Medicine, the check-up includes an interview, a complete medical evaluation, clinical history and report of your health conditions based on the results obtained from the following tests and procedures:

Laboratory

  • Full Hemogram (red blood cells, white blood cells, platelets count, hematocrit and hemoglobin).
  • Glucose
  • Total Cholesterol (cholesterol, HDL, VLDL, COL/HDL, LDL, triglycerides)
  • Creatinine
  • Uric Acid
  • Urea Nitrogen
  • Gamma glutamyl transpeptidase
  • Prostate-specific antigen
  • TSH
  • Total T3
  • Free T4
  • General Urine Test

Imaging Diagnostic

  • One View Thoracic x-ray
  • Bone Densitometry (osteoporosis)
  • Upper and lower abdominal ultrasound

Cardiology Electrocardiogram

The patient will have a bi-lingual individual to guide him through the process.  The program also includes free breakfast and parking.

Complete Executive Check-Up for Men with Hospitalization

Hospital Clínico San Rafael Arcángel offers a complete executive check-up for men.  Because the thoroughness of the exam, the patient will have the opportunity for a one night stay in a private room at the hospital. The exam will include consultation with a medical specialist in Internal Medicine, who will conduct an interview, a complete medical evaluation, and a clinical history and report of your health conditions based on the results obtained from the following tests and procedures:

Laboratory

  • Full Hemogram (red blood cells, white blood cells, platelets count, hematocrit and hemoglobin).
  • Glucose
  • Lipid profile (cholesterol, HDL, VLDL, COL/HDL, LDL, triglycerides)
  • Creatinine
  • Uric Acid
  • Urea Nitrogen
  • Gamma glutamyl transpeptidase
  • Prostate-specific antigen
  • TSH
  • Total T3
  • Free T4
  • General Urine Test

Imaging Diagnosis

  • One View Thoracic x-ray
  • Bone Densitometry (osteoporosis)
  • Upper and lower abdominal ultrasound

Endoscopy

  • Upper GI (Gastroscopy)
  • Urease Test (for Helicobacter pylori)
  • Lower GI (Complete Colonoscopy)

Cardiology

  • Electrocardiogram

The patient will have a bi-lingual individual to guide him through the process.  The program also includes one night lodging in a private room with one companion. Moreover, free breakfast and parking.

Comprehensive Executive Plan Afor Men over 45

Hospital Clínico San Rafael Arcángel offers a complete executive check-up geared specifically for men over the age of 45 years. In consultation with a medical specialist in Internal Medicine, the check-up includes an interview, a complete medical evaluation, clinical history and report of your health conditions based on the results obtained from the following tests and procedures:

Laboratory

  • Full Hemogram (red blood cells, white blood cells, platelets count, hematocrit and hemoglobin).
  • Glucose
  • Lipid profile (cholesterol, HDL, VLDL, COL/HDL, LDL, triglycerides)
  • Creatinine
  • Uric Acid
  • Urea Nitrogen
  • Gamma glutamyl transpeptidase
  • Prostate-specific antigen
  • General Urine Test

Imaging Diagnosis

  • One View Thoracic x-ray
  • Bone Densitometry (osteoporosis)
  • Upper and lower abdominal ultrasound

Endoscopy

  • Upper GI (Gastroscopy)
  • Urease Test (for Helicobacter pylori)

Cardiology

  • Cardiac Stress Test

In addition, the comprehensive medical check-up for men includes one-on-one consultations with an ENT Specialist who will conduct an audiometric exam, a Nutritionist who will provide nutritional advice and consultation, and an Optometrist who will perform a thorough eye exam.

The patient will have a bi-lingual individual to guide him through the process.  The program also includes free breakfast and parking.

Comprehensive Executive Plan Bfor Men over 45

Hospital Clínico San Rafael Arcángel offers a complete executive check-up geared specifically for men over the age of 45 years. In consultation with a medical specialist in Internal Medicine, the check-up includes an interview, a complete medical evaluation, clinical history and report of your health conditions based on the results obtained from the following tests and procedures:

Laboratory

  • Full Hemogram (red blood cells, white blood cells, platelets count, hematocrit and hemoglobin).
  • Glucose
  • Lipid profile (cholesterol, HDL, VLDL, COL/HDL, LDL, triglycerides)
  • Creatinine
  • Uric Acid
  • Urea Nitrogen
  • Gamma glutamyl transpeptidase
  • Prostate-specific antigen
  • General Urine Test

Imaging Diagnosis

  • One View Thoracic x-ray
  • Bone Densitometry (osteoporosis)
  • Upper and lower abdominal ultrasound

Endoscopy

  • Upper GI (Gastroscopy)
  • Urease Test (for Helicobacter pylori)

     Complete colonoscopy and preparation for colonoscopy

Cardiology

  • Cardiac Stress Test

In addition, the comprehensive medical check-up for men includes one-on-one consultations with an ENT Specialist who will conduct an audiometric exam, a Nutritionist who will provide nutritional advice and consultation, and an Optometrist who will perform a thorough eye exam.

The patient will have a bi-lingual individual to guide him through the process.  The program also includes free breakfast and parking.