Medical history has again been made in Jamaica with a local team, led by Dr Roger Hunter, carrying out a complex spinal surgery – SEXTANT Percutaneous Lumbar Fusion; the first such procedure to be done in the island.

The surgery was done on December 23, 2014 at the Mandeville-based Hargreaves Memorial Hospital, which has been forging ahead into new horizons with advanced cutting-edge technological medical procedures.

Utilising the minimally invasive or keyhole-surgery technique, Hunter and his team proposed a controlled spinal surgery under nerve monitoring for 92-year-old retired senior registered nurse Myrtle Gordon.

Gordon was suffering from lumbar instability, with severe nerve compression, and underwent surgery which lasted 14 hours.

Nine years earlier, Gordon underwent a traditional open surgery – laminectomy – here in Jamaica, but after one year, was left with excruciating, debilitating pain and scores of tablets which offered only momentary, fractional relief.

Another open surgery was deemed too dangerous at her age, and there was no option for correction as no one was available locally who was trained in Percutaneous Keyhole Lumbar Fusion.

Minimally invasive keyhole spinal surgery describes surgical procedures that are performed on the spine with minimal disturbance or injury to soft tissues around the spine.

The incisions are around one sixth the size of those of the traditional open-back surgery, and it allows the patient to recover more quickly, experience less pain and blood loss and a faster return to normalised living without the need for a back brace.

According to Hunter, Gordon was standing and walking approximately three hours after surgery, without any more leg pain, having tea, and was able to go home three days after the operation.

Though a less-invasive surgery, the complexities required greater detail, technical applications and expertise, hence the long duration of the operation.

“Her age proved a far greater challenge, as she had multiple degenerate joints (shoulders, neck, left knee), which made positioning much lengthier – taking three times as long,” explained Hunter. “Her badly twisted spine made screw placement and Sextant rod passage much more challenging,” he added.

The new procedure has corrected Gordon’s ailment and has set her back on her feet in quicker time. “Her hospital stay has been more than cut in half, with no need for a blood transfusion or the usual copious cocktails of heavy doses of potent painkillers. Typically, patients can return to non-physical work seven days after surgery, well within the average time for typical fully paid sick leave and, overall, a much faster return to better productivity,” said Hunter.

Hunter is a consultant neurosurgeon and spinal surgeon at Hargreaves Memorial Hospital. He graduated from medical school in 1996 with a MBBS Honours Degree, gaining both the Allenbury Prize in Medicine and the Glaxo Clinical Award for the top performance in the clinical examinations.

In 2006, Hunter was awarded the Braakman Award for the top performance in the European Final Board Examination of Neurosurgery in Luxembourg and has passed three final regional and international examinations in neurosurgery.

He completed a complex spinal fellowship at the world renowned Walton Centre for Neurology and Neurosurgery, working with Crispin Wigfield, and immediately after, did post-fellowship work with Professor Steve Gill – both of whom helped to invent the artificial cervical disc (Prestige-Medtronic), which has been successfully introduced in Jamaica .

Hargreaves has advanced the development of its medical services, as well as its surgical offerings, while partnering with major medical technology advocates, both locally and internationally.

As a result, Medtronic (the world’s largest medical technology company, which supplied the SEXTANT) were in the island to support this historic case for Jamaica.

Also present were representatives of the Medical Technology Jamaica Company to witness and help with the SEXTANT kit, being used for the first time in the island, during Gordon’s procedure.

MANDEVILLE, Manchester:

Before Calvin and Sylvia Lyn took ownership of the Hargreaves Memorial Hospital, the establishment was in a debilitating state and many thought those who sought to invest in it would be making a big mistake.

But through their vision and passion for nation building, the Lyns have exceeded the expectations of many by restructuring the hospital into a modern-day health-care facility with services second to none.

At a function to commemorate the hospital’s 10th anniversary recently, the Mayor of Mandeville, Brenda Ramsay, hailed the management team for making great local health-care services possible.

“There is no doubt that because of their keen business acumen we are experiencing delivery of quality health care in keeping with the demands of the populace. There are many challenges, but you have demonstrated that we can receive good health care locally and it is not necessary to seek it either in Kingston or overseas,” she said

With more than 80 members of staff, 55 specialists, a new consultancy wing used by specialists in neurosurgery, cardiology, and rheumatology, a new wing (Vision of Hope), a two-storey medical complex with 18 suites, X-ray units, and the only facility in Jamaica with a 64-slice CT machine, among other services, Hargreaves Memorial is redefining how health services are being offered in Jamaica.

TREND WILL CONTINUE

As the new operating theatre for the hospital undergoes construction, Consultant Neurosurgeon Dr Roger Hunter is hoping that the trend of no deaths during a surgical procedure at the hospital will continue.

“We were able to do the first keyhole spinal fixation (surgery) in Jamaica right here at Hargreaves on a 94-year-old woman. We have done over 60 operations and partnerships. Through general surgery and neurosurgery, we have done nearly 150, and we have not had a single death or a single paralysed patient, and we are going to continue to build on these partnerships,” Hunter said.

In commending the entrepreneurial propensities of the Lyns, Member of Parliament for North East Manchester Audley Shaw noted the importance of the private sector in the development of a country.

“The truth is, to build a sustainable-health care system, it can’t be all about Government, and one of the things that characterises the health-care system in modern countries is that a big part of the health-care system is run by the public sector and run in an efficient way,” Shaw said.

Chairman of the Southern Regional Health Authority Wayne Chen, who deputised for Minister of Health

Dr Christopher Tufton as guest speaker, commended the Lyns but noted that the public sector had to improve on health care by better leveraging the current resources.

Three doctors and eight members of staff who served the facility for more than 30 years were awarded for their unwavering service.

On Friday March 15, 2019, the first pacemaker surgery at Hargreaves Memorial Hospital (2006) Ltd. was performed by Consultant Cardiothoracic Surgeon, Dr. Sunil Stephenson and his team along with equipment rental provided by METRAS Ltd.; in one of the hospitals State of the Art Operating Theatre.

Patient Grey was diagnosed with complete heart block, which according to the Boston Scientific Pacemaker Therapy is a condition in which the electric signals of your hearts natural pacemaker (SA node) are delayed or do not reach the ventricle.

The first pacemaker surgery was recorded in 1958 and to date pacemakers are present in millions of patients worldwide. A pacemaker is a small device that is used to keep your heart beating properly. This helps your body to get the blood and oxygen it needs.

Dr. Sunil Stephenson, explained that given Grey’s diagnosis, a dual chamber pacemaker was the most suitable. He explained that this device will look and see how the heart is beating and will provide small electrical impulses to the heart to stimulate it beating at the normal heart rate whenever the heart rate is slow.

Shortly before surgery Grey explained that he was feeling anxious and excited especially given that he was celebrating his birthday. The procedure lasted for approximately 2 hours and Grey was discharged the following day.

Grey will be assessed at six month intervals. During these visits, the device will be checked and the estimated battery life will be determined by a special programmer that is able to analyze the device. Any problems with the device or any abnormal heart rhythms can also be picked up at these visits. In time, the energy in the pacemaker battery will decrease to a point where the device will need to be replaced and the patient will need to undergo surgery again.

While no special medications are required, infections from pacemaker insertion is typically low. However, Grey was given antibiotics prior to starting the procedure. Dr. Stephenson explained that some medical procedures will require the pacemaker to be placed in a special programming mode to enhance safety. These are usually procedures where devices are used that can cause electromagnetic interference. Also the device will require special programming before Grey can undergo an MRI scan.

It is safe for patients to use regular household electrical appliances with their pacemaker and it is advised that cellular phones are held in the hand opposite the side where the pacemaker has been inserted. Additionally, there are no severe limitations after pacemaker insertion. The patient is only advised to limit raising the left arm above the head for the first few weeks.

Twenty four hours later, Grey stated that he was looking forward to recovering in the comfort of his home for the next two to three weeks. He expressed sincere gratitude to his friends, family and especially the Management and Staff of Hargreaves Memorial Hospital (2006) Ltd. who supported him throughout his time of need.