Surgery in Taiwan

[Visitor]

What is the quality of medical care here in Taiwan as far as surgery goes? I have been told that it is a bit different than the West. Some Taiwanese will go to Japan to have more serious operations. What are your thoughts? In addition, should insurance be purchased, in addition to the NHI coverage, before the operation? Which companies offer policies in English? Thanks.

[Visitor]

I had a hernia operation in Kaohsiung Hospital and it was fine. I had the hernia stictched up the traditional way, that is surgically rather than opting for laprascopic method. The cost was really cheap, compared to if I had it done in Sydney. I had no health insurance at all. But you will need a local friend to help you check in and act as translater. The facilities were good and the Doctor that operated understood English. Well, this was extremely important as I needed to tell him when I was hurting so that he'd stick another needle in to kill the pain. I don't know if the Taipei hospitals do the same thing? So you'll have to check them out yourself. But from personal experience I'll endorse Taiwan hospitals, well, at least the one I went to. I've been told by local friends to avoid the hospitals outside the major cities as they are some times not equiped with good staff if a emergency arises. But check this out yourself.

[Visitor]

As someone who has had quite a bit of medical experience in this country I would say get a couple of opinions before you pick which hospital you have the surgery at. I do not like to give a personal opinion as we all have different experiences but I must for this one. I would say stay clear of the Adventist hospital on Bade Rd. in Taipei. I know loads of foreigners have gone there and been happy. But I went there and after numerous tests they told me I that there was nothing wrong with me. I was actually quite sick. Well, I ended up going to another hospital with my Adventist chart and was told that the only choice left was cancer. Well to make a long story short I did not have cancer but I had the tests. If this was N. America I could have easily sued for malpractice. The experience was drawn out, extremely stressful (always fun waiting to find out if you are going to die or not) and the Adventist doctor was without question the worst medical professional I have ever encountered (more to do with his attitude then his skill, he just did not give a sh**).

So just be careful and I would also stay a zillion miles away from rural hospitals (also from experience).

[Juba]

I had a hernia operation in Kaohsiung Hopspital and it was fine. I had the hernia stictched up the traditional way, that is surgically rather than opting for laprascopic method. The cost was really cheap, compared if I had it done in sydney.

I wonder whether the anonymous person who wrote that is still around to answer these questions:

How much did it actually cost, and how much would it have cost in Australia?

I ask this because I now have a swelling that I think is probably an inguinal (groin) hernia. I haven't gone to see a doctor yet, so I'm not sure. Well, there is a web site belonging to a private clinic in London, the British Hernia Centre, which argues rather persuasively that the method they use (mesh instead of a suture) is the best, and that they are the ones who best know how to do it. On the other hand, I found a document on the web site of the Chung-Hsiao (Zhongxiao) Hospital in Nangang District, Taibei, which suggests that they have been doing mesh surgery for hernias since the early 1990s. If they are really proficient at this, then it would seem silly to go back to London for such a minor operation.

Any experiences with the Chung-Hsiao Hospital, hernia experiences or other opinions?

--------------------
Reference:
American (Pensylvania) page about mesh surgery for inguinal hernia

Chinese (Harbin) page claiming repair to inguinal hernia by support combined with herbal medicine (TCM). (Web page is in simplified Chinese.)


A specialist hernia hospital using traditional Chinese medicine (TCM) in Heze, Shandong Province, China

[jeff]

If you have a GP you trust, go there first to get a diagnosis. Then ask for a referral. If you don't have one you trust, you might still try to get a referral and then ask the specialist what sort of procedure they use.

Mesh is fairly widely used in hernia repair these days, so I'd be surprised if Zhongxiao were the only hospital using it. The procedure of choice probably varies, but they're probably using a tension-free repair, where they cover the abdominal wall defect with mesh. The other common approach would be to sew the defect together; sometimes the wound is closed with sutures and reinforced with mesh, I think. Some centers use laparoscopy, but usually only in select situations as it's more expensive. You might want to look up some treatment guidelines for hernia repair so go for your visit well armed. This Medscape article provides a lot of background information, although you will probably need to register to view it:

Inguinal Hernia: Anatomy and Management CME
Authors: Arthur I. Gilbert, MD, FACS, Michael F. Graham, MD FACS, Walter J. Voigt, MD FACS
http://www.medscape.com/viewprogram/357

Also ask about the rate of recurrent hernias at the hospital--rates vary, but it should probably be <10%.

FWIW, heres an abstract of an article from surgeons at Cathay General:
http://www.ncbi.nlm.nih.gov/entrez/quer ... t=Abstract

[blueulyssess]

hernia...that causes acid reflux right?

yes i hate doctors! they perscribe medications like candy...I've gone through a terrible experience because of that mentality...and if they can't find anything wrong with you , they think you're crazy and perscribe anti depressants...or if you have a not so common side effect from a drug..they dont believe you! they always assume that you are part of the majority and not the minority who can have bad side effects from a drug which are listed in the RX info !

I believe in holistic naturopathic alternatives before ever popping an antibiotic for something minor!! just my two cents i received from my health trip to hell and back!

[Juba]

Thank you for your helpful post, Jeff. Meanwhile, I have dug up one specialist hernia clinic in Tainan.

Ronghui (pinyin) Surgery

[Huang Guang Chen]

blueulyssess

hernia...that causes acid reflux right?

That's a Hiatal hernia. Altogether different to the inguinal hernia Juba's talking about.

As for repairing an inguinal hernia, the laparoscopic method has been around for quite sometime and is a hell of let less painful. As for using mesh or straight repair (suture) I would have thought the mesh offered more strength.

Juba asked about:

pure tissue surgery

I'd assume they mean a suture repair. Basically stitching up the prolapsed area as opposed to stitiching in mesh to support it.

I was a nurse many years ago and used to work in an operating theatre where they pioneered many laporoscopic procedures. As I recall hernia repair was considered very straight forward with a laporoscope. Other ops, such as taking out a gall bladder, were more problematic. In the case of the gall bladder there's always the risk of snipping the hepatic artery.

I don't know what the situation is in the UK but in Australia you would probably wait a good 6 months for this procedure if you didn't have private health insurance.

HG

[Lord Lucan]

In England a doctor asked me (with an entirely straight face) if I'd like to go private or wait six months for an allergy test. For Hay Fever ! Couldn't give me the injection I've had every summer since the age of 16 without waiting 6 months for a "test" (you have my medical records in front of you!)

Straight on a plane back to Northern Ireland, 80mg of Kenalog and two days later, back at work in Berkshire, symptom free. But Northern Ireland is going the way of England. Nine month wait (or GBP800) for an MRI scan. Only two months (or GBP70) for a CAT scan though. Bargain.

In the UK you absolutely have to go private. The NHS is a distant (but pleasant enough) memory. When I was living in the UK (with private medical insurance) I used to joke with the wife that I could always fly out to Taipei for treatment if need be. I was only half joking.

[Sir Donald Bradman]

In the UK you absolutely have to go private. The NHS is a distant (but pleasant enough) memory.

(A bit off topic) but I disagree. After deciding not to delay world travel to wait in New Zealand a year or more for a minor operation, I got it done in 2 months (from GP to leaving the hospital) in England and the quality of care was absolutely excellent.

Brian