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01244 660 954www.melydmedical.com

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March 2013 Issue No. 270 ISSN 1747-728XThe Leading Independent Journal For ALL Operating Theatre Staff

2 THE OPERATING THEATRE JOURNAL www.otjonline.com

Find out more 02921 680068 • e-mail admin@lawrand.com Issue 270 March 2013 3

The Next issue copy deadline, Monday 25th March 2013All enquiries: To the editorial team, The OTJ Lawrand Ltd, PO Box 51, Pontyclun, CF72 9YY Tel: 02921 680068 Email: admin@lawrand.com Website: www.lawrand.comThe Operating Theatre Journal is published twelve times per year. Available in electronic format from the website, www.otjonline.comand in hard copy to hospitals throughout the United Kingdom. Personal copies are available by nominal subscription.

Neither the Editor or Directors of Lawrand Ltd are in any way responsible for the statements made or views expressed by the contributors. All communications in respect of advertising quotations, obtaining a rate card and supplying all editorial communications and pictures to the Editor at the PO Box address. No part of this journal may be reproduced without prior permission from Lawrand Ltd. © 2013The Operating Theatre Journal is printed on FSC approved papers using biodegradable ink. Any waste from the production of the magazine is recycled.

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Father Dies From Result of Target Driven Surgery in Lincoln HospitalAfter Mr Law died from medical complications due to negligent hospital staff, the former hospital chief executive speaks out against the high pressure targets issued out by senior NHS staff says Asons Solicitors

In the wake of the death of Mr Ray Law, 60, senior NHS doctors are now questioning the ever growing pressure placed upon surgeons to meet unrealistic targets set by NHS of cials leading to clinical negligence.(1)

Mr Law died of medical complications after having prostate surgery at Lincoln County Hospital in February of 2010.(1) Since then, its former chief executive, Mr Gary Walker, has spoken out against his reported £500,000 con dentiality agreement in revealing how patient care has become compromised under “dangerous” pressure from higher of cials in order to ensure targets are reached to the detriment of patient safety and care, especially in emergency surgery.(1)

It is alleged that they are expected to perform an impracticable number of procedures, compromising the safety of the patients.

With ever growing resentment towards the NHS, with a string of failures coming to light in recent months, such as the Mid Staffordshire inquiry; more formal investigations are thought to be put into place to shed light on the failings of patient care.

In February 2013, Mr Law’s widow Kathleen, spoke to The Daily Telegraph to express her distress and concerns over the matter. She spoke of her ‘anger’ about not being noti ed of the truth behind her husband’s circumstances sooner. According to The Daily Telegraph Mr Law’s daughter, Nikki, who will be looking for surgery compensation said: “It’s absolutely despicable. I have no trust in the NHS whatsoever. We’ll de nitely take legal action” (1)

According to The Telegraph report the spokesman for United Lincolnshire Hospitals NHS Trust said: “We are sorry to hear about the concerns of the family of Charles Raymond Law. We offer our sincere condolences for their loss and would invite them to come and talk to us.” (1)

Mr. Walker also claimed that Dame Barbara Hakin, while head of East Midlands Strategic Health Authority, had put pressure on him to take the hospital off “red alert”; a status telling medical staff when the hospital is at capacity, preventing people from being admitted to the hospital where they would then continue to receive unsatisfactory service.

The article continues to allege that he told the Today programme: “I said the hospital is not safe to come off red alert because it’s full. And the response was, ‘We have a capital budget that we are going to approve today, and if you are still on red alert it’s going to be dif cult for me to support your case to the board.”

He added: “These sorts of threats are made to you, in order for you to keep trying to deliver targets.” (2)

Unfortunately for many, decisions such as these are what leads to patients being neglected, and in the case of Mr. Law, death, because the hospital allegedly failed to admit him to a high dependency ward.(1)

(1) ‘Father died after surgery driven by regime of targets’ The Telegraph, 14th Feb 2013 http://www.telegraph.co.uk/health/healthnews/9871844/Father-died-after-

surgery-driven-by-regime-of-targets.html

(2) ‘Patient died after surgeon was ‘forced to carry out three operations in a day’ at under- re hospital’

The Telegraph, Feb 14th 2013 http://www.telegraph.co.uk/health/healthnews/9869579/NHS-whistleblower-

faces-ruin-after-speaking-out-about-patient-safety.html

Source: www.asons.co.uk

J&J discloses government probes of hips, surgical mesh (U.S.)

* Federal prosecutors review marketing of a recalled product.

Federal prosecutors are investigating Johnson & Johnson’s practices in marketing a line of hip replacements recalled in 2010 because many had to be replaced within a few years — part of a string of more than 30 product recalls by the health care giant in the last 3 1/2 years.

The U.S. Attorney’s Of ce in Massachusetts and the Civil Division of the U.S. Justice Department in August sent New Brunswick-based Johnson & Johnson an “informal request” for information about its ASR XL hip replacements, J&J reported in a regulatory ling Friday.

The company’s annual report to the Securities and Exchange Commission states that the government has asked for additional documents from DePuy Synthes and two related subsidiaries. It has turned over the documents and are cooperating fully with investigators, the ling states.

DePuy Synthes is one of the world’s biggest makers of joint replacements, surgical trauma equipment and other orthopaedic surgery products.

The ling didn’t specify what the government is looking for, but J&J has had legal problems before over its arti cial joints. Just days before the ASR systems were recalled, the Food and Drug Administration told DePuy to stop marketing its Corail Hip System for two unapproved uses.

Kickback settlement

And in 2007, J&J agreed to pay $84.7 million in nes as part of a settlement of a sweeping investigation by the Justice Department into alleged kickbacks. J&J and the four other top U.S. makers of replacement hips and knees were alleged to have paid surgeons to get them to use their products exclusively, from at least 2002 through 2006.

DePuy recalled two arti cial joint systems — the ASR Hip Resurfacing System and the ASR XL Acetabular System — in August 2010 because of unexpectedly high rates of failure. That means they caused pain and dif culty walking because they no longer t perfectly, or that tiny pieces of metal had aked off inside the patient’s body, allegedly causing immune system problems in some people. More than 90,000 of systems were recalled in the U.S. and other countries.

That was part of an embarrassing spate of J&J recalls of arti cial joints, contact lenses, prescription drugs and over-the-counter medicines that began in September 2009. Reasons range from contamination with bacteria and incorrect levels of a drug’s active ingredient to a nauseating smell on containers and liquid medicines that may contain tiny metal shavings.

Lost product sales and expensive, ongoing factory upgrades have cost the company well over $1 billion.

Arti cial joint systems, made of high-tech metals, plastics or ceramics, replace deteriorated joints causing severe pain and limiting mobility, usually in older folks with advanced arthritis. Hip replacement parts include the top of the thigh bone, the ball atop that and a plate lining the hip socket.

They’re generally expected to last at least 10 to 20 years. In the case of the recalled DePuy ASR hip systems, one in eight patients needed theirs replaced within ve years.

Attorneys representing patients needing replacements have alleged Johnson & Johnson knew about the problems with the DePuy hip systems back in 2008, but didn’t stop selling them until 2009 and didn’t recall the remaining products until 2010. The company has denied that and said it acted properly. It has set aside about $1 billion to cover costs of the recall and lawsuits.

Source: NorthJersey.com LINDA A. JOHNSON

4 THE OPERATING THEATRE JOURNAL www.otjonline.com

Xograph and Canon celebrate 15 year partnershipThe Year of 2013 sees Xograph Healthcare celebrating 15 years of partnership with Canon inc. Canon have established themselves as the DR innovator and world leader in imaging DR technologies with over 19,000 systems installed worldwide.

In 1998 Xograph installed the rst Canon Direct Digital Radiography (DR) detector, the CXDI-11, a 43x43cm detector mounted on an upright stand predominantly used for Chest imaging. Today, and over 100,000 images later, this very same detector is still in clinical use, as are the majority of the early adopter Canon DR detectors.

Nine generations of Canon at panel DR technology have been introduced over the 15 years with the largest range of DR detector models available, including the rst portable DR detector – the CXDI-31, DR detectors for use in upright stands, universal stands and imaging tables, as well as portable DR detectors for use with, and sharing between, both static and mobile applications.

The 2013 generation of Canon detectors include the cassette-sized CXDI-70C Wireless, and its smaller sibling, the 27x35cm CXDI-80C Wireless, both have an enhanced resolution of 125 microns ( m) and an increased level of sensitivity to deliver higher image quality with signi cantly lower patient dose. The wireless Canon detectors have been designed to deliver on the promises of improved portability and ease of use for the bene t of users, as well as convenience and improved imaging capabilities that directly bene t the patient.

Building on the outstanding image quality and speed of the CXDI series for radiography, in 2010 Canon developed a portable DR detector capable of acquiring and displaying uoroscopic images as well as static radiographic images – the CXDI-50RF.

The Canon CXDI DR detector range now numbers an unparalleled 13 models to suit every requirement.

The Canon design philosophy has always remained constant however: to maintain an unrivalled level of detector reliability, by way of uncompromised product quality, whilst introducing continuous innovations to the range. A three year manufacturer’s warranty is included with each detector.

For those situations where wireless transmission is not the preferred option, Canon also include a number of portable detectors with detachable cables including the Canon CXDI-501C. This ultra light 35x43cm portable detector is the same thickness as a conventional X-ray cassette, can t into existing bucky trays and weighs just 3.1kg. For added convenience the cable can be detached and reconnected without having to restart the DR control system. Where a xed detector is required, the super-high resolution CXDI-401C 43x42cm detector can be installed in a Table, Wall Stand or Universal Stand and delivers maximum image quality with outstanding dose ef ciency in digital X-ray rooms; a compact version is also available that can slide into an

existing bucky tray to provide a very fast and cost-

effective DR upgrade.

Each Canon DR system is provided with a modality workstation equipped with Canon’s dedicated CXDI-NE acquisition, image processing, image display and management software. Unique image processing options from Canon’s renowned digital imaging software division provide image presentation settings to suit every preference and application. RIS/PACS connectivity is included as standard and a large touchscreen user-interface allows direct user interaction without the need for a mouse or similar pointing device.

An on-screen preview image is available in just 3 seconds after exposure and if another exposure is required, the detector will be ready in seconds thanks to its rapid refresh cycle. With only a single calibration required annually, living with the Canon DR system is simple and work ow remains unhindered by periodic calibration demands.

Canon is continually improving the performance of its DR systems while also enhancing the company’s overall DR system line-up.

For more information contact: Xograph Healthcare on:Tel: +44(0) 8449 800 800 or view more online at: www.xograph.com.

Canon Detectors available from Xograph

Celebration of 15 years logo

When responding to articles please quote ‘OTJ’

Obesity related hospital admissions increase in England, new report shows Female admissions almost triple the number of male admissions *Regional data is available at PCT level

Hospitals in England reported 11,740 inpatient admissions with a primary diagnosis of obesity in 2011/12, new analysis from the Health and Social Care Information Centre (HSCIC) showed recently.This is one per cent more than in 2010/11 (11,570) and triple the number recorded ve years earlier (3,860 in 2006/07).Female admissions were almost three times the number of male admissions (8,740 compared to 2,990); continuing the recent pattern of female admissions being substantially higher than male admissions.Regionally, North East Strategic Health Authority (SHA) had the highest admission rate at 56 per 100,000 of the population; while East of England SHA had the lowest rate (12 per 100,000). Todays report: Statistics on Obesity, Physical Activity and Diet, England 2013; brings together several sources of recently published information to provide a comprehensive picture of obesity related issues in England.It also includes information about hospital inpatient admissions with a primary diagnosis of obesity and a procedure of bariatric surgery (procedures performed to help weight loss; including stomach stapling and gastric bypass), which shows that in 2011/12:• Hospitals recorded 8,790 inpatient procedures; nine per cent more than in

2010/11 (8,090) and over four times more than in 2006/07 (1,950). • Females continue to account for the majority of such procedures; with 6,710

procedures for females and 2,080 procedures for males.

• East Midlands SHA had the highest procedure rate at 36 per 100,000 of the population (1,620 in total); while North West SHA had the lowest rate (six per 100,000, or 460).

The report also shows that fewer than two in ve adults (37 per cent) in England are classed as a normal weight according to Body Mass Index (BMI), although this proportion has remained between 36 per and 38 per cent since 2001.Half of women (50 per cent) aged 16 and over were a normal weight in 1993, but this proportion had fallen to 39 per cent by 2011. For men of the same age, the proportion dropped from 41 to 31 per cent over the same period. Just over a quarter of women (26 per cent), and just under a quarter of men (24 per cent) were classed as obese in 2011, while 58 per cent of women and 65 per cent of men were classed as either overweight or obese.HSCIC Chief Executive Tim Straughan said: It wont have escaped the majority of people that obesity is a high pro le issue in this country. This annual report is important in bringing clarity to how this actually affects people, patients and the NHS, from the weighing scales to the operating theatre.Based on the Body Mass Index measurement, the proportion of adults estimated to be of a normal weight has dropped substantially since this reports time series began in 1993. This data, along with the breadth of other obesity related information in this report, will be of interest to the public as well as health professionals and policy makers.The full report can be viewed at: www.ic.nhs.uk/pubs/opad13

Find out more 02921 680068 • e-mail admin@lawrand.com Issue 270 March 2013 5

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State of the art training centre for surgeons launched in

GlasgowA state of the art centre that will provide hands-on surgical skills training will be launched in Glasgow on Monday 4 March.

The Clinical Anatomy Skills Centre (CASC) has been purpose built with high tech surgical instruments that will be used to train surgeons and other health professionals in techniques such as traditional open surgery and laparoscopic (key hole) surgery.

The Centre will use bodies (cadavers) bequeathed to the University of Glasgow’s body donation programme. The University’s Laboratory of Human Anatomy is internationally renowned for its leadership in the care and preparation of cadaveric donors and is recognised as offering the best in cadaveric simulation.

The Centre, which is a joint initiative between two of the UK’s leading medical training institutes - the University of Glasgow and the Royal College of Physicians and Surgeons of Glasgow - will also be used for teaching anatomy and supporting the development of medical devices, such as heart valves and prosthetics. Research and development at the Centre will help to provide valuable insight into major diseases, such as dementia and cancer.

The Centre is one of only a handful in the UK that offers surgeons the chance to train with cadaveric material. Most surgical training is done using computer and video simulation or animal tissue. Cadaveric material offers a signi cant advantage for training - the real anatomy and tissue delity and individual differences in each human body make for more realistic training. It also allows surgeons to practice new techniques and re ne their skills in a safe environment before performing them live.

The Royal College of Physicians and Surgeons of Glasgow is a leading international organisation in the provision of ongoing career support, training and examination for the medical, surgical, dental, travel medicine and podiatric medicine professions.

It is involved in setting the standards of care and ensuring the best levels of training are available to doctors and surgeons with the ultimate bene t to patients. The College will use the Clinical Anatomy Skills Centre to train the next generation of high-skilled surgeon and facilitate the advancement of medical science to enhance the treatment and care of patients.

The Centre is equipped with high tech audio-visual equipment for live broadcasting and distance learning, ensuring that the highest quality of training can be delivered both locally and internationally.

Dr Frank Dunn, President of the Royal College of Physicians and Surgeons of Glasgow, said “I am delighted to see this facility of excellence come to fruition and for the Royal College to partner with the University of Glasgow in such a venture. This will, I believe, be the foundation for a number of additional educational projects with the University.”

Mr John McGregor, Vice-President (Surgical) of the Royal College of Physicians and Surgeons of Glasgow said, “The Clinical Anatomy Skills Centre will offer the most sophisticated clinical and anatomical skills training in the UK. Professionals across the medical spectrum from junior doctors to experienced consultants will bene t from the Centre. We are delighted to be a part of this landmark partnership with the University of Glasgow.”

Professor Anna Dominiczak, Head of the College of Medical, Veterinary and Life Sciences at the University of Glasgow, said: “The new Centre will provide unrivalled facilities and realism for surgical training, anatomy teaching and medical device development. Together with the Royal College of Physicians and Surgeons of Glasgow we will provide a world-leading centre of excellence for surgical skills training.”

The Centre is a lasting tribute to William and Elizabeth Davies who are benefactors of the Royal College of Physicians and Surgeons of Glasgow, and whose charitable foundation has made a generous contribution to providing the Centre with state of the art equipment.

www.facebook.com/TheOTJ

6 THE OPERATING THEATRE JOURNAL www.otjonline.com

Antimicrobial Copper Lights Shine at Arab Health

The world’s rst antimicrobial copper surgical lights, aimed at reducing the spread of infection in operating theatres, were debuted by ALVO Medical at Arab Health 2013, the largest healthcare exhibition and medical congress in the Middle East. Attendees were dazzled by their elegant design, teamed with the broad-spectrum antimicrobial ef cacy of copper.

Magdalena Galezewska, Commercial Director of ALVO Medical, says of the event: ‘The audience was wowed by these new lights. Nothing like this has been on the market before, and with infection control at the forefront of modern healthcare, it’s important to consider how a product can better protect patient health. These offer an additional line of defence against infection, which could be critical to patient outcomes.’

ALVO Medical’s surgical lights

Explaining ALVO Medical’s decision to offer antimicrobial copper products, Magdalena notes: ‘Copper is inherently antimicrobial - with no special treatments or surface coatings, it will rapidly kill a huge range bacteria and viruses that threaten human health. ALVO Medical is committed to providing cutting-edge products that offer the nest functionality and aesthetics, which is why we now offer a range of antimicrobial copper touch surfaces. All of these products will continuously reduce surface contamination, in-between regular cleans, reducing the risk of infections being passed around. They’re better for patients, better for healthcare workers and better for everyone passing through the hospital environment.’

Other antimicrobial copper products offered by ALVO Medical include anaesthesia carts, endoscopy carts and instrument tables. All of these bear the Cu+ mark, used by leading manufacturers of hospital equipment, furniture and ttings to indicate that their products are made from antimicrobial copper (meaning pure copper, or a copper alloy proven to bene t from its antimicrobial properties).

For more antimicrobial copper products on offer from companies around the world, visit the Online Product Directory:http://antimicrobialcopper.com/uk/ nd-products-and-partners.aspx

When responding to articles please quote ‘OTJ’

NHS Blood and Transplant pilot scheme comes to Royal Liverpool

and Broadgreen HospitalsA pilot scheme aimed at changing the way blood stocks are maintained and delivered in hospitals has been launched at Royal Liverpool and Broadgreen University Hospitals Trust .

They are one of four hospital trusts in the country to be involved in the pilot being trialled by NHS Blood and Transplant (NHSBT).

The pilot will see IT systems working across 3 hospital sites – Royal Liverpool, Broadgreen and The Liverpool Women’s Hospital.

Using IT systems already in place at the hospitals, the pilot will allow NHS Blood and Transplant to test a new way of working which will:

• Enable NHSBT to monitor hospital stock levels on a ‘live’ basis and provide automatic optimum top up deliveries of blood and blood components

• Enable NHSBT to send an automatic delivery note with all details of the blood stocks being supplied to the Royal Liverpool and Broadgreen University Hospitals Trust, reducing potential transcription errors and allowing more information on every donation to be passed to the hospital

• Lower hospital costs associated with unnecessary deliveries or out dating of blood and blood components, by improving stock control

The new automated stock replenishment system uses IT software to send a message containing current stock levels from the hospitals’ blood bank to NHSBT.

Blood is then restocked based on how much has been used and how much is needed to replace it.

Lynda Hamlyn, Chief Executive at NHS Blood and Transplant, says: “We are delighted to be working in partnership with the Royal Liverpool and Broadgreen University Hospitals Trust. This pilot is intended to demonstrate how two very different NHS organisations, both with the same determination to provide the very best patient care, can work together to improve quality and treatment, whilst still reducing costs to the NHS.”

The pilot is the rst step of a key part of NHS Blood and Transplant’s ve-year strategy to further improve and modernise the blood service by providing an even better service for donors, patients and the NHS.

Aidan Kehoe, Chief Executive at Royal Liverpool and Broadgreen University Hospitals says; “The principle behind this is similar to a hotel mini-bar where products used are registered on a central computer system, so they can be replenished ef ciently. This project is a great example of how sometimes the simplest ideas can make the greatest innovations. It is one of the ways in which we are using technology and innovation to make cost savings that we can reinvest into direct patient care and we are proud to be pioneering this project.”

Since 2009, NHS Blood and Transplant has made major reductions in its costs - saving the NHS £34m a year - money that can instead be spent on care and treatment for patients.

Stem Cells Cultured on Biomedical Plastic Could Lead to New Therapies

for Bone RepairResearchers at the University of Southampton, in collaboration with the University of Glasgow, have developed a new method to generate bone cells. The researchers cultured human embryonic stem cells on the surface of plastic materials, which included polycarbonate plastic, a method cheaper and easier than traditional ways of culturing embryonic stem cells, according to a press release from the university. They used nanotopographical patterns on the materials to manipulate the stem cells towards bone cells.

The technique can be used to aid tissue engineering, potentially leading to new methods for bone repair. It could eventually result in new medical device designs and cell culture designs, according to a press release from University of Southampton.

Stem cells are dif cult to grow in suf cient numbers as the process of stem cell differentiation prevents the cells from maintaining their original stem cell characteristics. The recent research builds on previous research from the University of Southampton and the University of Glasgow where the research team used plastic with nanopatterns to grow and spread adult stem cells, while maintaining their stem cell characteristics. The new study demonstrates that human embryonic stem cells respond in a similar manner.

Source: medtechinsider

Touch SurgeryWe are four surgeons who share a passion for teaching and education. Our vision is to provide high tech, high quality and highly accessible learning.

We feel that surgical trainees are not being given the best education that can be provided using modern technology.

Having talked to many of our colleagues, we found that we were not alone in feeling this way.

So we decided to do something about it.

Building upon a key technology conceived by our CTO Ad, we set out to change the way that surgical education is delivered.

Touch Surgery provides Cognitive Task Simulation (CTS) - teaching key operative decision making in a way that has been never done before. This allows you to learn, practice and rehearse a surgical procedure wherever you are, and whenever you need to. We hope this will improve your training experience, and allow you to be better prepared when the time for action comes.

We hope you enjoy using Touch Surgery. We would greatly appreciate any feedback.

http://www.touch-surgery.com/

Find out more 02921 680068 • e-mail admin@lawrand.com Issue 270 March 2013 7

01943 878647 sales@aneticaid.comQueensway, Guiseley, West Yorkshire, LS20 9JE UK.

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See the latest range of products from Fukuda Denshi at the 33rd ISICEM in Brussels

Fukuda Denshi is a leading supplier of advanced patient monitoring and user-con gurable clinical information management systems, as well as cardiac monitoring and imaging technology. The company will be attending the 33rd International Symposium on Intensive Care and Emergency Medicine, being held from 19th to 23rd March in Brussels.

The four day symposium aims to provide participants with an up to date review of the most recent, clinically relevant, developments in research, therapy, and management of the critically ill. It’s open to all physicians, nurses and other health professionals with an interest in critical care or emergency medicine.

Fukuda Denshi will be attending the event with their DS-8500 high end anaesthesia/critical care monitor incorporating Fukuda Denshi’s most intelligent user interface. It allows users to tailor the monitor to meet their speci c requirements by offering a full suite of modules as well as a full 5 agent gas bench.

The DS-8500 is highly versatile and can be mounted as a standalone system or alternatively attached to any anaesthesia machine. In addition, all patient data can be collected and viewed at the bedside or central station with its seamless patient record transfer from monitor to monitor via an HS 8000 super module.

Also on show will be Fukuda Denshi’s MetaVision Clinical Information System, the MVICU, which is speci cally designed for critical care use.

Visitors will receive a warm welcome from the Fukuda Denshi team, who will be on hand to demonstrate their state-of-the-art products as well as provide full product information and answer any questions.

Fukuda Denshi: Healthcare bound by technology.For more information visit www.fukuda.co.uk. When responding please quote ‘OTJ’

Are Surgical Robots Worth It?The FDA looks into the safety of the da Vinci system in light of increased adverse incidents.

Surgical robots allow surgeons to perform a variety of less invasive operations because their miniaturized instruments can work through small incisions in the body and are more dexterous than traditional laparoscopic tools (see “The Slow Rise of the Robot Surgeon – Link below”).

The result is that patients leave the operating room with a smaller surgical wound with the promise of faster recovery and less scarring.

In 2000, Intuitive Surgical’s da Vinci system became the rst FDA-approved commercially available robotic surgical platform and has since been used on hundreds of thousands of patients. According to a report on Bloomberg’s news site, the FDA is now taking another look at the system in response to an increase in reports of adverse incidents. As reported by Bloomberg:

What the agency is trying to determine is whether a rise seen in incident reports sent to the agency are “a true re ection of problems” with the robots, or the result of other issues, said Synim Rivers, an [FDA] spokeswoman, in an e-mail. “It is dif cult to know why the reports have increased,” she said.

The increase in incidents could be due to the growing number of surgeries performed by the robotic systems, which are not automated but instead driven by a surgeon in a seated at a console. Still, the rise in reports has tripped the wires of the FDA’s Adverse Event Reporting System, so the agency is surveying surgeons on complications they’ve seen and their training, according to Bloomberg.

The systems are quite costly (around $2.5 million) and recent studies suggest they may not provide the improved patient safety that they promise. Researchers reported in the Journal of the American Medical Association last week that robotic-assisted hysterectomies had similar rates of complications to laparoscopic surgeries (which also involves small incisions).

The researchers did identify a major difference—the cost of the surgeries. The robotic surgeries cost on average $2,139 more than the laparoscopic procedures.

http://www.technologyreview.com/news/418141/the-slow-rise-of-the-robot-surgeon/page/2/

Source: MIT Technology Review

8 THE OPERATING THEATRE JOURNAL www.otjonline.com

STARKSTROM’S NEW S-LED EXAMINATION LIGHTS THE LATEST

ADDITION TO THE S-equiP SOLUTIONStarkstrom is proud to introduce the S-LED range of examination lights. The lights are the newest addition to the company’s market-leading, fully integrated, operating room and critical care area equipment solution, S-equiP. The S-LED, which is available in two models, was designed by Starkstrom in direct response to clients’ requirements for a more effective examination light, and uses advanced LED chip technology. It is very exible and can be tted to the patient bed in a critical care area, operating room, recovery area, or wherever required.

The S-LED examination light outperforms rivals in several areas:

• The uniform light spot allows even light distribution over the wound site, so the entire wound site is equally clearly lit

• It uses LED technology which has a very low heat release, so the light remains cool at all times, eliminating the risk of burns for anyone using it, and ensuring air over the wound site remains cool

• The light is supplied on exible pendants with a 360° rotatable head, and is very light and easy to move

• It is available in two light intensities – 6200Lux at 0.5m and 18000Lux at 0.5m, depending on where it is to be used

• Both models run on very low power of 7W and 25W respectively, so are economical to run and better for the environment

S-equiP provides all the equipment needed for the 21st century operating room or critical care area. In addition to the S-LED examination lights, it features clinical lighting; pendants; surgeons’

control panels; isolated power supplies (IPS); uninterruptible power supplies (UPS); PACS viewing stations; battery backup systems; operating tables; transfer trolleys; MRI, RF, CT and X-Ray shielding; UCV canopies; SCP clocks and a range of consumables. S-equiP also offers Starkstrom’s exciting new audio visual system, VisionOR, in partnership with Richard Wolf’s Core System, a multilevel audio visual communication platform that is bespoke, vendor neutral and future proof.

Products from the S-equiP solution can be purchased and installed separately, but it is Starkstrom’s ability to provide and t a comprehensive package of integrated operating room and critical care equipment, as well as offering the fullest post-installation service provision and warranty, which makes it stand out from the competition – by using S-equiP, operating rooms and critical care areas can be tted out to world class standards.

Further information: StarkstromTel: 0208 868 3732 www.starkstrom.com info@starkstrom.com

When responding please quote ‘OTJ’

Codeine is a Dangerous Drug to Manage Post-Operative

Pain for Children After Tonsillectomy (U.S.)

When you get your tonsils removed, of course, you’re going to want a bowl of ice cream and a prescription of opiates. However, thanks to the U.S. Food and Drug Administration, children who have just had their tonsils and/or adenoids yanked aren’t going to be able to indulge in the post-operative pain relief drug, codeine.

On the 20th February, the U.S. FDA released a formalized warning that a subset of children with breathing dif culties from swollen tonsils are highly sensitive to the effects of codeine.

Hence, FDA is adding a strong warning to the drug label of codeine-containing products about the risk of the drug for post-operative pain management in children following tonsillectomy and/or adenoidectomy.

In addition to relieving pain, opioid analgesics like codeine suppress the respiratory control center of the brain. Combined with the obstructive sleep apnea already occurring in these kids, some of them are more hypersensitive than most for breathing suppression.

The FDA recognized this problem by reviewing adverse event reports recorded between 1969 and 2012. Codeine use in this scenario was associated with the death of ten children and an overdoses in three

The reason for codeine’s negative effectiveness in some kids and not others seems to stem from how the drug works relative to others in its class.

Most of the painkilling effects of codeine are due to some of it being converted to the strong opioid analgesic, morphine. While our bodies - particularly an enzyme in our livers called CYP2D6 - makes codeine active by replacing a part of the molecule to turn it into morphine, we usually think of drug metabolism as breaking drugs down. But in this case, drug metabolism produces a drug that’s more active than the one taken.

Codeine is given at doses when this conversion is optimal for pain relief without adverse effects on breathing. However, a small percentage of people are born with a single-letter change in their DNA for this enzyme that causes the codeine-to-morphine reaction go faster. These people are called ultra-rapid metabolizers.

While having an ultra-rapid metabolizer may sound like a good thing, it unfortunately isn’t. Then, when you take codeine, you convert much more of it to morphine than in most people, and if you’re a kid with breathing problems from swollen tonsils and/or adenoids and are an ultra-rapid metabolizer, and are getting codeine for post-operative pain, the usual therapeutic dose is potentially lethal.

Source: Science World Report

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Hunt told to ditch NHS competition regulations as staff morale crumbles

Jeremy Hunt needs to do the right thing and ditch new NHS competition regulations before competitive markets let rip across the NHS and staff morale crumbles still further, warns Britains biggest union, Unite.

Pressure is mounting on the government to strike out the new s75 regulations after one of the leading cheerleaders of Lansleys reforms, Dr Michael Dixon, backed by 1,000 doctors, today warned against opening up the health service to more competition.

The warning comes in the wake of the publication of the annual NHS staff survey which reveals a massive 38 per cent of NHS staff reporting work-related stress as a result of bullying and threats of violence.

Unite fears that the governments shambolic shake up of the NHS is taking its toll on hard working staff. It is urging every MP to sign a rarely used special form of Early Day Motion (1104) tabled by Labour with the support of the Green party and a clutch of Lib Dems, calling for the secondary legislation to be struck out.

Rachael Maskell, Unite head of health, said: Hunt can no longer ignore the professionals.

Attempts to sneak these regulations through have failed. He must now heed the warning of 1,000 doctors and one of the leading architects of the NHS reforms and scrap the s75 regulations.

It is no coincidence that staff morale is crumbling the governments rush to privatise the NHS is tearing it apart before our very eyes and it is NHS staff and patients on the frontline, who are bearing the brunt of this destruction.

Lib Dem MPs now have a chance to stop the governments back door privatisation of the NHS, by adding their names to the growing list of members calling for the regulations to be struck out.

Unite is urging hundreds of thousands of union members to write to their MPs calling for them to sign Early Day Motion 1104, tabled by Labour with the support of the Green party and rebel Lib Dems.

The regulations, which were laid before parliament by the government last week (13 February) under section 75 of the Health & Social Care Act 2012 appear to dramatically extend competition and force compulsory competitive markets on the NHS.

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Trust Starkstrom for Operating Tables and AccessoriesStarkstrom is now able to provide and maintain a full range of operating tables and accessories, suitable for all disciplines, from its integrated array of operating room and critical care area equipment. Offered as part of S-equiP, Starkstrom’s fully integrated solutions package.

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Transforming pleural services with SonoSite’s S-ICU™

Pleural services at the University Hospital Llandough (UHL), Cardiff, have been signi cantly improved by SonoSite’s SICU™ ultrasound system, according to Dr Helen Davies, Consultant Chest Physician at UHL. “UHL provides services to a population of just over 500,000 in Cardiff and the Vale of Glamorgan, as well as receiving referrals from the whole of South Wales for procedures such as endobronchial ultrasound. The S-ICU was purchased as part of an initiative to establish a more formal pleural service; having a dedicated clinic and ultrasound room helps us to treat patients in a more organised, timely manner, which makes a considerable difference. The system itself is straightforward to use and the image quality is good. It is very portable and can easily be transferred to different areas of the hospital, such as intensive care, if required, and images can also be stored for review, which is ideal for training purposes.”

Dr Davies added: “Previously, patients on the ward needing a pleural procedure would be referred to radiology for an ultrasound scan, and then be transferred back to the ward for treatment. Using the S-ICU, we can now perform an ultrasound scan and guided aspiration at the same time. This is safer for patients and streamlines the process, allowing us to increase the number of pleural procedures performed. It has changed what we do completely, helping to reduce the time from referral to procedure and giving new patients a far swifter diagnosis.”

For more information about SonoSite products, please contact: SonoSite UK, Alexander House, 40A Wilbury Way, Hitchin SG4 0AP T +44 (0)1462 444 800, F +44 (0)1462 444 801 ukresponse@sonosite.com www.sonosite.com When responding please quote ‘OTJ’

THE 2012 NHS STAFF SURVEY IN ENGLANDThe following statistics were released on the 28th February 2013 by the Department of Health: The 2012 NHS Staff Survey. Key points from the latest release include:

• Sixty-three percent of NHS staff said that if a friend or relative needed treatment they would be happy with the standard of care provided by their organisation. This gure is unchanged from that in the 2011 survey. In addition, 62% said that care of patients and service users is their organisations top priority.

• There continues to be an improvement in the proportion of staff receiving appraisals, up from 80% in the 2011 survey to 83% in 2012, however only 36% of staff said these appraisals were well structured.

• Only 40% of all staff were satis ed with the extent to which they felt that their trust values their work, this gure is lowest for ambulance staff (23%) and highest amongst social enterprise staff (47%). However, the proportion of staff who indicated that they would recommend their organisation as a place to work has increased for the rst time in three years (55% in 2012 compared to 51% in 2011, 53% in 2010 and 55% in 2009).

• Only 35% said that communication between senior managers and staff is effective, this gure is the lowest for ambulance staff (20%), and less than a third of all NHS staff (26%) reported that senior managers act on feedback from staff. Despite this 74% said that they are able to make suggestions on how they could improve the work of their team or department.

• Fifteen percent of NHS staff reported experiencing physical violence from patients, their relatives or other members of the public in the previous 12 months and thirty percent of all staff report that they experienced bullying, harassment and abuse from patients, their relatives or other members of the public in the previous 12 months. Just under two-thirds of incidents of physical violence and 44% of bullying, harassment and abuse cases were reported. The questions relating to such experiences were changed for the 2012 survey and so comparisons with earlier surveys are not appropriate.

More detailed commentary and analysis, and results for individual organisations, are published on the staff survey co-ordination centre website:

www.nhsstaffsurveys.com

10 THE OPERATING THEATRE JOURNAL www.otjonline.com

A wider range of exposure positions now available from Fuji lm’s FDR AcSelerate with new Cassette Tray Option

Public debate in European Parliament on future EU medical device legislation focused on the need for safety and timely accessEucomed, the European medical technology industry association, welcomes stakeholder calls at a public hearing of the European Parliaments Environment, Public Health and Food Safety (ENVI) Committee on 26 February, for much needed improvements to Europes regulatory system for medical devices. Physicians, patient groups and industry made clear their desire for a system that improves patient safety, protects patient access to life-saving medical technology and increases transparency and device traceability. Various stakeholder groups noted that a centralised authorisation system for high risk devices would not lead to the desired increase of safety and bring unnecessary delays in patient access of medical technologies. Research shows that a centralised system does not increase safety and patients subject to such a system wait on average at least three years longer for receiving life-saving medical devices compared to patients in Europe.

Medical device manufacturers agree with the views of doctors, patients and some Members of European Parliament expressed at a hearing on 26 February that the current system must be signi cantly improved to increase patient safety, maintain timely patient access to the latest life-saving technology and keep

medtech innovation in Europe. Panellists at the hearing proclaimed the need for greater transparency, traceability of devices and strict control of noti ed bodiesthe entities charged with reviewing new medical devices.

A large part of the debate focused on how to organise the approval process of high risk devices. Industry expressed its view to signi cantly strengthen the decentralised device-speci c approval system and not move towards a centralised pre-market authorisation system as seen in the US. Independent research concludes that patients subject to a centralised pre-market authorisation system, such as the US FDA system, wait 3 to 5 years longer for access to the latest life-saving medical devices. Research also clearly concludes that faster approvals in Europe do not compromise patient safety. Industry does support the idea that only a limited number of highly specialised Noti ed Bodies with proven clinical expertise should be eligible to approve Class III devices.

A concern was raised that European patients do not enjoy faster access than US counterparts because Europes national health systems are slow in reimbursing new technologies. While the approval of a medical device is for the whole of Europe, reimbursement

is organised differently via national health systems. Early patient access in most European countries is ensured through special payment mechanisms and / or leveraging available reimbursement for innovative medical technologies. The existing special payment mechanisms accelerate access and bridge the period between product approval and new speci c reimbursement for innovative technology. A recent study of the European Health Technology Institute (EHTI) conducted by the London School of Economics (LSE) reported that approximately 70% of countries surveyed use special payment mechanisms for innovative technologies and these are considered to be effective in integrating new technologies into the health system.

We welcome the growing awareness of the bene ts of the European device-speci c approval system. We have made it very clear on various occasions that we want to signi cantly improve this decentralised system to guarantee the highest safety and avoid unnecessary delays of lifesaving medical technologies reaching patients. The European Commissions proposal is a step in the right direction and we welcome many of the recommended measures. However, the proposed scrutiny mechanism is inappropriate because it does not contribute to patient

safety and is essentially a duplication of reviews. We have suggested replacing the scrutiny mechanism with a systematic control procedure. We were surprised to hear doubts about the fact that European patients have faster access to safe medical technologies. We acknowledge that national health systems reimburse devices in different ways and at different speeds, but there is simply no doubt that these life-saving devices are available to European patients sooner than anywhere in the world. The fact remains that a technology like renal denervation is already saving the lives of European hypertension patients whose condition cannot be treated solely by pharmaceuticals, while an estimated 7 million Americans with the condition are still waiting for this procedure to be approved. says Serge Bernasconi, Chief Executive Of cer of Eucomed.

To clarify what is at stake with the current revision of the European medical device legislation, Eucomed has launched the campaign Dont lose the 3. The campaign showcases the advantage that Europeans currently enjoy and explains what changes need to be made to the current European system to make sure that Europeans continue to have timely access to safe, live-saving medical devices. www.eucomed.org

www.OOpera ngpera ngTTheatreheatreJJobs.comobs.comA one-stop resource for ALL your theatre related Career opportuni es

Fuji lm is a pioneer in diagnostic imaging and information systems for healthcare facilities, with a range of constantly evolving clinically proven products and technologies designed to assist medical professionals perform more ef ciently and effectively. The company have introduced a new Cassette Tray option for their FDR AcSelerate.

Fuji lm’s FDR AcSelerate is a streamlined solution that combines dynamic speed and sharp images for an X-ray room of the future, combining a new at panel detector, Csl scintillator, and Fuji lm’s proprietary “Irradiation Side Sampling” (ISS) technology. Now with the addition of a new Cassette Tray option, the FDR AcSelerate now also provides an even wider range of free exposure positions.

The Cassette Tray option is available for FDR AcSelerate’s table, and utilises Fuji lm’s FDR D-EVO plus C35i/s and D-EVO G35i/s cassettes with Csl scintillator, which capitalises on the high X-ray absorption characteristics of Csl and the ability of its needle crystals to deliver image sharpness.

FDR AcSelerate also incorporates (ISS) technology, which enhances image quality by reading the data from the surface of the detector, thus light is collected before the radiation can be attenuated and diffused within the detector. ISS signi cantly improves MTF and DQE compared to conventional methods.

A new datasheet is available from Fuji lm on the new Cassette Tray option for their FDR AcSelerate. For a copy telephone the company on 01234 326780.

Fuji lm – pioneers in diagnostic imaging and information systems.For further information, visit www.fujimed.co.uk...When responding to articles please quote ‘OTJ’

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Xograph win large contract for new Emergency Care Centre in Aberdeen, UKLeading independent medical equipment supplier Xograph Healthcare have won a contract to supply three new Xograph BuckyStar T2 Precision direct digital general radiography systems to the new build £115 million Emergency Care Centre at Aberdeen Royal In rmary, Aberdeen, UK.

This forms part of a larger contract which also includes the supply of two MobileDaRt Evolution direct digital mobile X-ray units, each equipped with a CXDI-70C Wireless at panel detector and the relocation and future digital upgrade of two legacy general radiographic systems into the new centre.

The new Emergency Care Centre at Aberdeen Royal In rmary will bring together the A&E, out-of-hours and acute assessment services together in one location.

Said to bene t around 70,000 patients a year, it is one of the largest of the new developments on the site and is essential for the future delivery and modernising of healthcare services.

The BuckyStar T2 Precision is a 5th generation fully motorised auto-positioning radiographic system designed for general and trauma radiographic applications and the fully motorised X-ray tube support also has the ability to be used in a manual mode if required. Simply selecting the required anatomical program on the touch-screen user interface sets up all exposure, positioning and collimator selections allowing the user to focus on their patient. The common user-interface on both the xed and mobile X-ray systems is an added bene t to users during training and this familiarity reduces stress and the likelihood of errors in service. The ability to share DR detectors across both the xed and mobile system platforms adds to the overall versatility and operability of the systems.

Blair Ashcroft, A&E Superintendent at Aberdeen Royal In rmary said: “This state-of-the-art system from Xograph will t nicely into our new Emergency Care Centre. We can’t wait to start using it and exploring the many bene ts the unit has to offer.”

Suzanne Nicholson, In-patient Superintendent at Aberdeen Royal In rmary agreed: “By bringing these rooms and mobile technology together it will give us many bene ts long into the future.”

Paul Andrews, Commercial Manager at Xograph Healthcare Ltd said:

Blair Ashcroft, A&E Superintendent at Aberdeen Royal In rmary, Charlie Doherty Country Manager at Xograph Healthcare, Maureen Tough, Outpatient Superintendent and Suzanne Nicholson, In-patient Superintendent at Aberdeen Royal In rmary with Alison Cottrell, Clinical Applications Manager at Xograph Healthcare.

“I am glad that Xograph Healthcare can be a part of this major development which will bene t so many patients. The BuckyStar T2 Precision is the ideal choice to reduce user manual handling and to increase speed and ef ciency. This unit ensures immediate and lasting bene ts.”

Radiometers Managed Service Contract helps to streamline services at Ipswich

Point-of-care services at Ipswich Hospital are reaping the bene ts of Radiometers Managed Service Contract (MSC) for its ABL800 series blood gas analysers, PICO arterial blood gas syringes and the RADIANCE POC Data Management System. The contract ensures that the hospital has high quality point-of-care testing with accredited operator training, ef cient stock control and effective nancial management. Point of Care Coordinator Alison Czarnota explained: We chose Radiometer blood gas analysers because of their proven reliability and quality of results. Staff nd the analysers easy to use, and results are ready in just a couple of minutes. Radiometers service engineers also offer a great service, and are always happy help, however minor the issue.

Roger Holloway, Purchasing Manager, added: The MSC is working very well, ensuring effective management of our point-of-care testing budget and reducing the risk of equipment ownership. The bene ts to the Trust are twofold; it offers tax bene ts in terms of VAT, and it saves staff time by having a single internal ordering process; ordering stock couldnt be easier and supplies arrive promptly. It is also comforting to know that Radiometer monitors all the equipment to ensure that it is working correctly, and that we will not run short of consumables. I can only say that Radiometer provides a rst class service.

To nd out more, please contact sales@radiometer.co.uk or visit http://www.radiometer.co.uk/

McIndoe Surgical Centre bucks breast surgery trend

THE McIndoe Surgical Centre says it is bucking a national trend of less women going under the knife to be given breast implants.

Figures revealed last week by the British Association of Aesthetic Plastic Surgeons show that while breast augmentation remained the nation’s most popular form of plastic surgery in 2012, 1.6 per cent fewer operations were performed nationwide than in 2011.

Cosmetic surgeon Asit Khandwala says there was no lack of business at McIndoe, in Holtye Road, East Grinstead, however.The consultant believes women are now looking to trustworthy practices after the 2011 PIP scandal.

Mr Khandwala said that an estimated 200 patients underwent breast augmentation at the centre in 2012, an increase compared to 2011.

“I have not seen a drop in the number, even though there has been nationally,” he said.

“I think that the reason for the overall decrease is to do with the PIP implant scandal. But, from my experience, this has also focused people’s minds on the surgery they are having.”

He continued: “I see the opposite ends of the spectrum as women come here for breast reduction as well,” he said.

“But whenever I have an appointment with a patient I am sure to warn them of the risks.

“Breast surgery affects your life, a very high percentage of patients choose to keep them for their whole life.

“So while breast operations are popular with people aged between 18 and 35, I want to make sure that it is not just what they want but what the possible risks are. Source:this is Sussex

The UK ODP Message GroupJoining is easy, just send an e-mail,stating your name, e-mail address,position and Hospital to:

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Find out more 02921 680068 • e-mail admin@lawrand.com Issue 270 March 2013 13

NELSON

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Are you a strong clinical nursing leader with superior

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BERKSHIRETHEATRE PRACTITIONERS - BAND 5

Our Client is a large NHS Foundation Trust who provides a full range of acute services to the surrounding population of approximately 450,000. They require forward thinking and dedicated individuals and RGN or ODP quali ed practitioners are invited to apply. It is

essential that you are exible and enthusiastic with current experience working in a UK Theatre department.

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with patient careand the operating theatre environment.

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Associate Business Unit DirectorAn exciting and rewarding opportunity within the Trust has emerged in the Theatres, Critical Care & Anaesthetics Business Unit.

Leading the provision of high quality, cost effective Theatre Services which meet all relevant quality and volume targets whilst delivering the clinical, governance, operational and financial requirements of the Trust, you will coordinate the development of a best in class service, driving change to achieve continual service improvements and cost effectiveness.

To succeed, you will need the ability to liaise effectively with customers of the service to ensure that the services provided are relevant to customer needs. You will act as the BUD’s deputy in leading the Business Unit and ensuring that the Business Unit delivers the clinical, governance, operational and financial requirements set upon it.

This role is part of the Trust’s Very Senior Managers pay arrangements.

As a place to live, work and enjoy life, Southend on Sea has a lot to offer. The border touches sea, city and countryside with some of England’s prettiest villages and liveliest towns. It is also just under an hour from London making it an ideal base to explore the capital city.

Southend University Hospital NHS Foundation Trust benefits from its close proximity to Southend Airport (1.5 miles). The Airport has two airlines running regular flights to Belfast and Waterford in under two hours.

For informal enquiries and further information on these posts, please contact: Kim Daley, Recruitment Manager to request an application pack, on: 01702 508013.

Applications will be required in the form of an emailed CV to: kim.daley@southend.nhs.uk with a covering letter detailing suitability for the post.

Closing date: 3rd April 2013.

The Trust operates a no smoking policy.

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New Chairman at Health Enterprise East

Dr Chris Winter has been appointed as the new Chairman of Health Enterprise East (HEE), taking over from Professor Alan Barrell who is now retiring from the post he has held since the organisation was established in 2004.

HEE is the NHS Innovation Hub for the Eastern Region, based at Papworth Hospital.

At the last Board meeting, Alan was presented with the gift of a watch and a framed collage of photographs from his years with HEE.

Dr Chris Winter brings extensive experience in creating value from innovative technologies and start-up companies to his new role. He is currently the Managing Partner for Brightstar Innovations Ltd, (having created BT’s Incubator Brightstar in 1999) and also Partner in New Venture Partners, as well as holding a number of advisory roles with start-up companies in the healthcare sector.

Commenting on his appointment, Dr Winter said: “I am delighted to be joining HEE as its new Chairman and look forward to working with the team at a time when innovation in the NHS has never been more important.

“The HEE team is extremely knowledgeable and since it was established has played a major role in championing the importance of innovation, as well as facilitating links between the NHS and medtech companies.

“I am also excited by the opportunity to build on the foundations put in place by Alan and help make the Innovation Hub into a major strategic force in the NHS.”

Outgoing Chairman Alan Barrell added: “Working for HEE has been one of the best and most ful lling jobs I have ever had and I have thoroughly enjoyed working with the HEE Team. I would like to offer my congratulations to Chris on his appointment and wish him every success in his new role”.

For further information please visit www.hee.org.uk.

Handing over the Chair at HEE: left new Chairman Dr Chris Winter with Professor Alan Barrell.

Managing PainDr Richard HalvorsenChronic pain affects more than 8 million people in the UK and is associated with a whole host of conditions. Increasingly, medical practitioners are looking to the ancient practice of acupuncture as a preferred method of treatment.

Dr. Richard Halvorsen was initially a sceptic, but after graduating from medical school took a part time course in acupuncture out of curiosity. Subsequently, for the last 25 years, he has included acupuncture in the course of his practice as a GP to relieve pain and to treat a number of conditions. Over 1 million people a year now receive acupuncture treatments in the UK.

In Managing Pain, Dr. Halvorsen sets out what he has learnt about the effectiveness of acupuncture over these 25 years. Combining his practice with the most up to date clinical research, he looks into effectiveness of acupuncture in treating conditions including: Chronic pain, nausea, migraines PMS, menopausal symptoms and many others.

He provides an unbiased account of the facts to help you decide whether acupuncture could be bene cial to you.

Dr. Richard Halvorsen is a practicing GP and author of The Truth About Vaccines.

Key Facts:

• Unbiased account of acupuncture based on author’s original observations

• Over 1 million people per year now receive acupuncture treatments in the UK

• Chronic pain affects over 8 million people in the UK• Acupuncture is now available on the NHS to treat lower back pain• Acupuncture is very safe, in a survey of 66,000 treatments no ‘serious’

side-effects were reported• Acupuncture is used as a treatment aid for addiction in 130 prisons in

the UK• Acupuncture studies have shown that:o 60% of patients with lower back pain saw an improvemento Acupuncture may help increase IVF success rates by 65%o Patients with osteo-arthritis in the knee saw a 40% decrease in pain and

a 40% increase in functiono 100% of the patients suffering from migraines reported fewer attacks

after treatmento 25% of patients scheduled for knee surgery cancelled after having

acupuncture treatmento 86% of patients with tennis elbow experienced a resolution in their

symptoms after acupunctureo The majority of patients with menstrual pains saw their pain decrease by

at least 33%o 59% of patients suffering from morning sickness stopped vomiting after 3

dayso An indicative study into Interstitial Cystitis found that 60% of patients

felt that acupuncture had brought them to a 75-100% recoveryo 84% of pregnant women with babies in breech position saw their babies

simultaneously turning after moxibustion (a form of acupuncture)

ISBN 978-1-908096-85-2 /Paperback Original/£9.99/ Gibson Square, Published 4 April 2013

what he has learnt about the

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