Guanacaste Medical Quote

Plastic Surgery

Surgical Procedure General Description Recommendations for Post Surgical Care Days Stay In Hospital Days Stay In Costa Rica

Rhytidectomy (facelift) with blepharoplasty both superior and inferior

Known as “face lift”. Stretching skin of the face to eliminate wrinkles.

Patient should be kept inside (not exposed to sunlight) and in a low stress environment.

1

7

Abdominoplasty (Tummy Tuck)

Surgical resection of excess abdominal adipose tissue with “stretching” of the skin.

Limited Mobility. Increased risk of deep vein thrombosis.

1

7

Liposuction 2 zones

Removal of adipose tissue with use of specialized equipment that draws in tissue.

Few constraints.

Ambulatory

5

Abdominoplasty with liposuction

Combination of both abdominoplasty and liposuction procedures.

Limited Mobility. Increased risk of deep vein thrombosis.

1

7

Mastopexy (mammoplasty) with implant

Breast lift. Generally involves the placement of an implant.

Associated pain not negligible. Limited mobility, low stress.

1

7

Brachioplasty (arm lift)

Surgical resection of excessive fatty tissue in your arms, or “excess” skin in case of significant loss of weight.

Associated pain not negligible. Limited mobility of upper limbs.

1

7

Breast reduction

Reduction in breast size.

Pain is not negligible. Apart from this there are not many limitations.

1

7

Breast augmentation

Increase breast volume through the placement of implants.

Associated pain is important. Limited mobility.

Ambulatory

7

Rhinoplasty (nose job)

Changing the shape of the nose through surgery.

Nostrils capped by a few days. Do not expose to sunlight.

Ambulatory

7

Rhinoseptoplasty (nose and septum repair)

Combination of both procedures.

Nostrils capped by a few days. Do not expose to sunlight, remain indoors for a few days.

Ambulatory

7

Upper and lower blepharoplasty using general anesthesia

Surgery of the eyelids when they have excess skin.

Few constraints.

Ambulatory

7

Otoplasty (Ear repair)

Surgery of the ears being the intention to change the size, shape, or their prominence

Few constraints.

Ambulatory

7

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Orthopedic

Surgical Procedure General Description Recommendations for Post Surgical Care Days Stay In Hospital Days Stay In Costa Rica

Knee Arthroscopy

Diagnostic and therapeutic procedure for knee injuries.

Variable, depends on findings. Initially, activities do not involve walking. Commonly use crutches later.

Ambulatory

5

Total Knee Replacement

Total replacement of the knee using a prosthesis.

Daily physiotherapy absolutely necessary. Considerable pain and increased risk of deep vein thrombosis.

2

10

Anterior Cruciate Ligament

Knee Arthroscopy in which rupture of the ligament is sutured.

Variable, depends on findings. Initially, activities do not involve walking. Commonly use crutches later.

Ambulatory

6

Shoulder Arthroplasty

Rupture repair of tendon structures of shoulder. Today the gold standard is via arthroscopy.

Pain control may be an issue. Patient can be ambulatory, but not perform actions using the operated on arm.

2

6

Total Hip Replacement

Total replacement of the joint of the hip with a prosthesis. Usually patient in a higher age group. There is considerable risk of bleeding.

Found in elderly patients, and those with common chronic diseases. Increased risk of deep vein thrombosis. Significant ambulatory limitations.

2

10

Finger Claw

Sometimes deformity is bilateral. When it is severe it requires surgical resolution. Surgery is of short duration, usually not very painful.

Procedure does not significantly increases the risk of deep vein thrombosis.

Ambulatory

2

Shoulder Arthroscopy (Bankart)

Diagnostic and therapeutic procedure for injury of the shoulder (Rotator Cuff).

Limitations of mobility in the surgical shoulder. Does not increase the risk of deep vein thrombosis.

1

6

Osteotomy of Tibia

Surgery of the tibia to treat certain diseases (arthritis, arthrosis and genu narus).

Ambulatory limitations. Usually pain is easily controllable.

1

6

Osteotomy Arthroscopy

Combination osteotomy and arthroscopy. Rare.

Equal to arthroscopy and osteotomy.

1

7

Hallux Valgus (Bunion)

Lateral deviation correction first toe.

Ambulatory limitations. There may be considerable pain in the first or second postoperative day. Low risk of deep vein thrombosis unless patient has risk factors.

1

6

Shoulder Arthroscopy

Inspection may require more treatment of some pathology’s of the shoulder via arthroscopy.

Mild to moderate pain. Limitation to use the surgical upper limb. Patient can walk around without difficulty

Ambulatory

3

Notes

  1. All procedures include comprehensive laboratory exams (hemogram, coagulation, electrolytes, blood sugar), respiratory function tests, electrocardiogram and chest x-ray.
  2. All procedures include the fees for the preoperative assessment.
  3. Total knee and hip replacement include full set of postoperative laboratory tests.
  4. Replacement of hip includes 2 units of patient specific packed cells.
  5. Cost of knee replacement was estimated taking into account prosthesis Genesis II of Smith & Nephew (Eurociencias provider).
  6. Amount of hip replacement was made taking into account is ANTHOLOGY prosthesis of Smith & Nephew (Eurociencias provider).
  7. Cost of replacement (Arthroplasty) shoulder was made taking into account prosthesis.
  8. Amount of Hallux Valgus was carried out taking into account screws Acutrak 3.0/2.0, total 3 screws (provider Acumed).
  9. In hip replacement PROSTHESIS is not CEMENTED TAPERLOC XL (BIOMET). Price may vary according to the prosthesis that is needed for each procedure.

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General

Surgical Procedure General Description Recommendations for Post Surgical Care Days Stay In Hospital Days Stay In Costa Rica

Open Inguinal Hernioplasty

Hernia repair, can include mesh. Severe cases (giant hernia) may have higher costs.

No effort for the first month. First week almost complete bed rest, subsequently increasing activities gradually. OK to fly after 4 days postop in healthy patients, could be more in patients with increased risk of deep vein thrombosis. It may be necessary to stay longer for medical treatment.

1

5

Open Colectomy

Total or partial removal of the colon by open procedure, not laparoscopic.

No efforts for the first month. First 10 days almost absolute rest, subsequently gradual increase in activities. Ok to fly at least 8 days postop in healthy patients, could be more in patients with increased risk of deep vein thrombosis. Patient will require thromboprophylaxis.

2

10

Diagnostic Laparoscopy

Laparoscopy in which there is done a visual examination of the abdominal cavity and its contents.

Normal activity the second postoperative day. No extreme sports. Healthy patients without increased risk of deep vein thrombosis can air travel after a few days.

Ambulatory

5

Gastric sleeve

Laparoscopic surgery that removes a portion of the stomach with purpose of decreasing its size. “Gold Standard” of bariatric surgery today.

They are obese patients. There is increased risk of deep vein thrombosis (need to provide preventative measures as well as medical treatment). Strict liquid diet for a month. Patient must remain in Costa Rica least 8 days prior to travel. Normal activities after a few postoperative days.

1

10

Laparoscopic cholecystectomy

Surgical removal of the gallbladder by means of laparoscopy.

Healthy patients have minimal risk of deep vein thrombosis. Normal activities OK a few days postoperative. Acceptable to fly within a few days. Prophylaxis for deep vein thrombosis in patients at risk.

1

5

Laparoscopic Splenectomy

Surgical removal of the spleen by means of laparoscopy.

Healthy patients have minimum risk of deep vein thrombosis. Normal activities OK within a few days. Acceptable to fly within a few days. Provide deep vein thrombosis prophylaxis in patients at risk. Will require implementation of vaccine against pneumococcus for life.

1

8

Notes

  1. All procedures include comprehensive laboratory exams (hemogram, coagulation, electrolytes, blood sugar), Respiratory Function Tests, Electrocardiogram and Chest X-ray for the preoperative workup.
  2. All the procedures have included the fees for the preoperative assessment.
  3. Cholectomy and Splenectomy include post-operative laboratory tests.
  4. Laparoscopic cholecystectomy with disposable material.
  5. The cost of the LigaSure (TM) vessel sealing technology is included in medicines and supplies of laparoscopic splenectomy.
  6. In the Splenectomy procedure, the cost of the linear stapler is $800.
  7. The Gastric Sleeve cost includes the hospital stay, medical assessment, etc. Does not include nutritional or psychological evaluations pre or post op.

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Gynecology

Surgical Procedure General Description Recommendations for Post Surgical Care Days Stay In Hospital Days Stay In Costa Rica

Laparoscopic salpingectomy

Surgical removal of fallopian tubes by laparoscopy.

Minimum 2 -3 days relative rest. No extreme activities. Low risk of deep vein thrombosis.

Ambulatory

5

Open salpingectomy

Surgical removal of fallopian tubes open procedure.

Minimum 6 days relative rest. No extreme activities. Low risk of deep vein thrombosis.

Ambulatory

7

Hysteroscopy

Internal inspection of uterus. Transvaginal procedure, for which there is no external scars, and little pain. Designed to take biopsies and dry masses.

Minimum relative rest 5 days. No extreme activities. Low risk of deep vein thrombosis.

Ambulatory

6

Open hysterectomy

Uterus resection through an open transabdominal wound with or without its annexes (fallopian tubes and ovaries).

1 Month of relative rest, first 10 days are vital at rest. Minimum Activities in this period and low stress. There is low to moderate risk of TVP.

1

10

Laparoscopic hysterectomy

Resection of uterus with or without its annexes (fallopian tubes and ovaries) through laparoscopic surgery. Uterus is removed through the vagina.

1 Month of relative rest, first 10 days are vital at rest. Minimum Activities in this period and low stress. There is low to moderate risk of TVP.

1

10

Notes

Hospitalization includes outpatient admission, use of surgical room, laparoscopic tower, recovery room, blood testing, EKG, chest x-ray, and a pre-operative assessment.

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Urology

Surgical Procedure General Description Recommendations for Post Surgical Care Days Stay In Hospital Days Stay In Costa Rica

Orchiectomy

Surgical removal of one (unilateral) or both (bilateral) testicles. It occurs in patients with prostate cancer and testicular torsion.

Normal activity within a few days. No sports or significant effort for 3 to 4 weeks. Consider risk deep vein thrombosis if a carrier of malignancy.

Ambulatory

6

Vaporization of Prostate

Transurethral Resection of the Prostate with specialized equipment which vaporizes tissue. Minimal blood loss and is safer for the patient.

Normal activity within a few days. No sports or significant effort for 3 to 4 weeks. Patient can sometimes be left with a Foley catheter (urinary catheter) for a few days. Assess risk of deep vein thrombosis.

1

7

Trans Urethral Resection Prostate

Transurethral Resection of the Prostate with resectoscope. There is a major risk of bleeding.

Normal activity within a few days. No sports or significant effort for 3 to 4 weeks. Patient can sometimes be left with a Foley catheter (urinary catheter) for a few days. Assess risk of deep vein thrombosis.

1

8

Trans Urethral Resection Bladder

Transurethral Resection of Bladder with intervesicular mass.

Normal activity within a few days. No sports or significant effort for 3 to 4 weeks. Patient can sometimes be left with a Foley catheter (urinary catheter) for a few days. Assess risk of deep vein thrombosis.

1

7

Radical Prostatectomy

Open major surgery aimed at removing the prostate for malignant disease. Will include lymph node dissection. There are multiple biopsies.

Almost absolute bed rest for at least 10 postoperative days, with little activity (only basic needs) for a month after surgery. Significant risk of deep vein thrombosis. Very common associated co-morbidities.

3

10

Urethral Sling

Surgical procedure of low invasiveness to treat / control urinary incontinence.

Patient can return to normal activity within a few days. Minimal Risk of deep vein thrombosis in healthy patients. Assess risk of deep vein thrombosis in patients with comorbidities.

Ambulatory

5

Varicocelectomy Unilateral

Ligation of dilated veins of the spermatic cord.

Patient can return to normal activity within a few days. Minimal Risk of deep vein thrombosis in healthy patients. Assess risk of deep vein thrombosis in patients with comorbidities.

Ambulatory

4

Vasectomy

Surgical ligation of the vas deferens.

Return to normal activity within a few days. Low risk of deep vein thrombosis in healthy patients.

Ambulatory

3

Notes

  1. All procedures include comprehensive laboratory exams (hemogram, coagulation, electrolytes, blood sugar), Respiratory Function Tests, Electrocardiogram and Chest X-ray for the preoperative workup.
  2. All procedures include the fees for the preoperative assessment.
  3. Vaporization of the prostate, TUR prostate, TUR bladder and radical prostatectomy include a complete set of postoperative laboratory tests.
  4. Radical prostatectomy includes 2 units of type specific packed cells.
  5. Urethral Sling procedure performed by Dr. Vladimir Gonzalez only.
  6. For the Urethral Sling, the Ophira Mini Sling System (TRI D.M. Provider) was used with a margin of 25% and a price of $875.
  7. In the Urethral Sling, anesthesia fees are included in the fees for the gynecologist ($1,000-$400)

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Dental

Dental Procedure General Description Days Stay In Costa Rica
Porcelain Crown Crowns are placed over the front teeth to change color shape of the teeth. 5
Zirconium Crown Crowns are placed over the front teeth to change color shape of the teeth. 5
Implant Surgery This surgery requires to trips to Costa Rica about four months apart. 2 days  for each of 2 trips.
Root Canal Fees range depending on the number of roots. 1
Extraction   1
Surgical Extraction   1
Whitening Typically conducted over three sessions. 5
Crown on Implant Fees range depending on the material used and size of the crown. 5
Endodontic Post   1
Partial Prosthesis Fees range depending on the material used. 5
Total Prosthesis   5

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