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 urology residents exposed to surgery and urology in an unforgettable setting

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

Urologist : Population Ratio USA 1:30,000 Belize 1:150,000

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…

Barriers 3. Referrals - weak referral system 4. Limited diagnostics - ultrasound readily available, though quality variable - CT – older technology 5. Cost constraints

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

Building the Service • Step 3 • Referrals • Educate – hospital staff • Educate – patients • Step 4 • Keep costs low • Keep working

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

Outcomes • All laser lithotripsy patients stone free on ultrasound at 3 months

It made the news in Belize

Learn more victor.lizarraga@bcm.edu