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Experiences with Building an Endourology Service in Belize
Dr Victor Lizarraga BCM Urology
Experiences with Building an Endourology Service in Belize Dr - - PowerPoint PPT Presentation
Experiences with Building an Endourology Service in Belize Dr - - PowerPoint PPT Presentation
Experiences with Building an Endourology Service in Belize Dr Victor Lizarraga BCM Urology BCM Urology and Belize A long healthy relationship Over 10 years of regular visits Many patients served in the OR and in clinic Many
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BCM Urology and Belize
- A long healthy relationship
- Over 10 years of regular visits
- Many patients served in the OR
and in clinic
- Many urology residents exposed
to surgery and urology in an unforgettable setting
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Key indicators
Population – 350000 full time residents Per Capita income - $ 8,000 Percent of Population with medical insurance – 10%* Number of Full time urologists - 2
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Urologist : Population Ratio
USA 1:30,000 Belize 1:150,000
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Barriers
- 1. Equipment
- cost, import duties, power needs
- 2. Supplies
- if you need it, you better have brought it
- Saline, Sterile water, catheters, stents, wires…
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Barriers
- 3. Referrals
- weak referral system
- 4. Limited diagnostics
- ultrasound readily available, though quality variable
- CT – older technology
- 5. Cost constraints
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Building the Service
- Step 1
- Equipment
- Holmium laser
- Flexible/rigid ureteronephroscopes
- Flexible/rigid cystoscopes
- Lights/Cameras
- Step 2
- Supplies
- Build ‘kits’ – distill supply needs to the true basics
- Sterilization, tubing, drapes
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Building the Service
- Step 3
- Referrals
- Educate – hospital staff
- Educate – patients
- Step 4
- Keep costs low
- Keep working
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Results thus far – in the first 12 months
Procedure Patients Cystoscopy with ureteral stent placement 3 Ureteroscopy with laser lithotripsy 3 Removal of encrusted ureteral stent 1 Ureteroscopy with removal of misplaced stent 1 Diagnostic cystoscopy 9
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Outcomes
- All laser lithotripsy patients stone free on ultrasound at 3 months
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It made the news in Belize
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