“ We Don’t Amputate!” Peripheral Vascular Intervention treatment, Save diabetic infected legs from amputation.

1% diabetic patients will face amputation, and 30 to 50 percent of amputees may have the other leg amputated within 3 to 5 years. Since the establishment of Peripheral Vascular Center in 2012, peripheral arterial vascular interventional technology has been used in this hospital to help diabetic patients with severe obstruction, limb ischemia and foot ulcers. To date more than 1,700 have been performed for 924 patients with peripheral arterial occlusion to keep 1,210 feet from amputation, achieving the limb salvage rate of 93%, the success rate of 96% with followed long-term treatment and tracking. The Center has published dozens of international SCI papers. In 2012, it was awarded the “Lifetime Health Promotion Award” by the Ministry of Health and won the SNQ National Quality Mark in 2015.

Children’s post void residual urine and bladder void volume standard New World Standard

Children’s lower urinary tract dysfunciton (bladder and urethra dysfunction) often cause bed-wetting, urine incontinence, overactive bladder, dysuria, bladder outlet obstruction, urinary tract infection, vesicoureteral reflux and hydronephrosis. Our urology department investigated more than a thousand children’s bladder function and established children’s normal reference value of post void residual urine, and the reference value was adoped by International Children’s Continence Society (ICCS) as a new world standard in 2014. Peak uroflowmetry nomogram, the Tzu Chi Nomogram, is a valuable parameter in defining lower urinary dysfunciton.

Through understanding of lower urinary tract function in children, we teach proper voiding posture, adequate liquid intake, early toilet training, and etc to treat baby urine tract infection/ vesicoureteral reflux. The results show a reduction of 95% surgery for vesicoureteral reflux with 9% recurrence rate of infection, which is much better than the world wide 30% recurrence rate. In 2014 and 2015 our team was awarded National SNQ Quality Mark.

Organ transplantation

Our teams have excellent experiences in transplantation of heart, liver and kidney (including living donor), cornea and bone marrow. In the heart transplantation, the hospital developed a “Skirt-type apical catheter implantation technique”. This techniqie allows the tube to be attached firmly with no serious complications and infection, thus prolonging patient’s waiting period from 30 days to 191 days, whereby the transplantation can be completed smoothly. In addition to extending the patient’s waiting time for the heart, it also enhances the quality of life. The hospital used ventricular assist device for 12 heart transplants, 7 patients stayed in regular ward while waiting for the heart and rehabilitation.

Corneal transplantation has advanced from full thickness corneal replacement to only transplanting the diseased layers, thereby significantly improving graft survival and visual outcome. Corneal scars in the more superficial or anterior layers of the cornea can be replaced by anterior lamellar keratoplasty ( deep anterior lamellar keratoplasty, DALK). The posterior layer of the cornea with insufficient endothelial cells can be replaced by endothelial transplantations (descemet’s membrane automated keratoplasty, DSAEK).

Artificial ascites combined with high frequency cauterization for liver cancer.

Artificial ascites combined with high frequency ablation can effectively treat the liver cancer which is difficult or increasingly risky to ablate. Artificial ascites also serves as a protection which separated tumor and adjacent organs, reduce the risk of thermal injury to adjacent organs. At the same time, through the water medium the ultrasound displays tumor location more clearly such as tumor in dome area and guides the probe into the tumor. This technique is useful for patients of liver tumors less than 5 cm and 3 tumors or less. The wound is very small and the rate of complication was less than 1%. Patient can move around 4 hours after treatment and may be discharged from hospital after 3 days observation.

Pulmonary recovery exercise

Patients with chronic obstructive pulmonary disease often breathe heavily after a simple body movement, seriously affecting the quality of daily life. Based on the integrated exercise cardiopulmonary function test, the team of thoracic medicine in the hospital tailor made exercise prescription for the patient. According to the individual cardiopulmonary capacity and physical fitness, experts will arrange suitable exercise plan to allow the chronic obstructive patients to move around without breathe heavily, a substantial improvement of patient’s life quality.

Joint clinic for children ‘s growth and development

To improve the growth of school children and to correct the parents’ myth regarding children’s growth. The hospital established a joint clinic for children’s growth and development in 2014. It is the first hospital to iincorporate pediatric endocrinology, traditional Chinese medicine and dietitian clinics at the same time, in the same clinic area. For children having growth and development issues with various reasons, we tailor make the most needed growth and development advice and treatment.

Knee Health Promotion Center

The Knee Health Promotion Center was established in 2014. Through detailed physical examination and image supports, each patient is carefully evaluated on the severity of knee condition. Then the most appropriate treatment is given according to different stages of osteoarthritis. Other than providing the updated information on the pathomechanism of osteoarthritis and methods of maintaining healthy knee joints, our team also offers respective physical therapy and training education for every single patient.

Following conservative treatment, different surgical methods may be considered according to the specific condition of each patient. In the early stages of osteoarthritis, arthroscopic cartilage regeneration facilitating procedure (ACRFP) may be performed through minimally invasive method, aiming to recuperate from the symptoms and ameliorate the degenerative process. However, if the patient is assessed to have advanced stage of osteoarthritis, our team is able to provide high standard unicondylar arthroplasty (UKA) or total knee arthroplasty (TKA), which solve the chronic painful problem caused by osteoarthritis of knee joints.

LigaSure Hemorrhoidectomy

Traditionally, the surgery for treating acute incarcerated hemorrhoids cannot be done until the swelling subsides so as to prevent blood loss during surgery and possible complications after surgery. In Tzu Chi Hospital, an instrument LigaSure has been applied for the treatment. For LigaSure Hemorrhoidectomy, there’s no need to wait for the subsidence of the swelling; besides, it reduces both postoperative pain and has lower blood loss during surgery.

A mean pain score of 8.3 before surgery is dropped to 3.2 after surgery. Besides, there’s low recurrence rate. Through a long-term follow-up, the satisfaction rate for the operation is 92.1% and there are no wound infections. In the hospital, the number of treatment cases has been increased to reach 5000—the most patients in Taiwan.

The paper about the outcomes of the surgical treatment was published on Surgery and Surgery Today (June 2014; Vol 44). Besides, Reviewer reviewed “The Best Treatment Method for Grade III and IV Hemorrhoids” published by Taipei Tzu Chi General Hospital.

Doctors from Taichung General Hospital, Changhua Christian Hospital, Tungs’ Taichung MetroHarbor Hospital and China Medical University Hospital came to learn LigaSure Hemorrhoidectomy. In 2015, three doctors also came from Olaya Medical Center to learn the surgical technique.

In 2015, the hospital was awarded the Symbol of National Quality (SNQ) by Bio-Development Foundation.

Through the improvement of the administration process, the policy of “Same Day Surgery” came into force. 99.7 percent of patients with hemorrhoids chose LigaSure Hemorrhoidectomy. 97 percent of patients had the “Same Day Surgery” to reduce hospital-stay and costs.

The Surgical Technique for Complex Scoliosis with the Big Cobb Angle

The team of orthopaedics applied the “Staged Posterior Correction” surgical technique to treat Complex Scoliosis with the big Cobb Angle of more than 100 degrees. The two-stage posterior-only approach not only improves the scoliosis but also is safer.

With no drawbacks of the traditional approach which requires opening chest and halo traction, the “Staged Posterior Correction” applying gradual correction has less impact on spinal nerves, improves the effects of correction and is safer during surgery.

The orthopaedics of Taipei Tzu Chi Hospital has treated more than 100 scoliosis cases since 2005, including different types of scoliosis. There are 30 cases of complex scoliosis. The mean correction rate is about 70%.

Thoracoscopic Nuss Procedure for Treating Pectus Excavatum

Applying Nuss procedure, two 2-3 cm incisions are made in the side of the chest. The minimally invasive procedure results in lower blood loss and avoids osteotomy. Patients stay in the hospital for only 5 to 7 days. Most importantly, it can significantly improve the cardiopulmonary function and the caved-in appearance of the anterior chest.

9 papers about the related experience in the procedure have been published since 2008 (8 papers published on Science).

Cancer Treatment

The Cancer Center of Tzu Chi Hospital has been set up for people’s health. The services offered consist of the prevention of cancer, cancer screening, treatment and care, cancer researches and the quality evaluation of the researches, educational training and clinical evaluation. In addition to the 11 treatment groups for head and neck cancers, breast cancer, lung cancer, liver cancer, gynecologic oncology, colorectal cancer, central neurocytoma, urinary tract cancer, esophagus cancer, gastric cancer and blood cancers, there’s the palliative care group. The Center integrates resources from all departments, offers integrated treatment with high techs like Rapid Arc, sets up the outpatient center and cancer resource center; it offers good quality of services from cancer prevention, diagnosis, treatment to palliative care.

Preventive Medical Center

Health Check-up Taipei Tzu Chi General Hospital set up a Preventive Medical Center, offering a comprehensive health checkup of high quality. It is well equipped with exclusive medical instruments, complete with a team of various professional physicians of family medicine, anesthesiology, gastroenterology, ophthalmology, obstetrics/gynecology, dentistry, ENT etc. It provides our guests the best diagnosis, checkup, and anesthesia. The hospital was awarded the quality certificate of health check-up program on October 12, 2012.

Full Arch Reconstruction Dental Implant The hospital set up its department of dentistry in July 2005. It is equipped with modern instruments, friendly environment and a team of vaious professional dentists. It offers patients the best care of oral hygiene. With continual research and teaching in the field, the dentists gain the latest knowledge and upgrade their skills day by day, to assure the most moderate oral services to all patients.

Peripheral Vascular Therapy The peripheral vascular center was established in the hospital on June 20 2012. It integrates the physicians of Cardiology, Cardiovascular Surgery, Plastic Surgery, Hyperbaric Oxygen, Infection, Nephrology, Metabolism and Endocrinology, Rehabilitation Medicine,forming a complete medical team. It give patients an integrated medical care.