Technicians role in HT procedures

[chris39]

There have been some notable threads recently in regards to the use of technicians involvement in the HT surgery as a whole.

So to exactly what extent should technicians be involved in the overall procedure ?

Basically , the HT surgery comprises 3 principal segments :

1) Graft extraction

2) Donor area incisions

3) Graft placement

 

Graft preparation is an also an important part of the process , but it's generally accepted that technician's will perform this part of the procedure anyway .

 

So , what parts of the surgery is it imperative that the surgeon performs these parts of the surgery ? In my opinion at least , graft extraction and donor incisions should be undertaken by the surgeon based on my research to date . Others may disagree and have valid reasons as to why his may be so . Presently , how many surgeons are solely involved in processes 1 and 3 ?

Which begs the question as to what input the technicians should have in the overall procedure . Now , to get any overview as to what that may be , the overriding factors would be the knowledge , skill level and experience of the technicians involved . The unknown constant in this respect is that this is information that is not readily available . We may be told that the technician's have x years of experience in the procedure , but that doesn't really tell us very much .

This is likely a subject that will come to the fore in the next few years . At present , any surgeon undertaking the donor extractions and recipient incisions is only likely to be able to attend 1 or maybe 2 patients in a given day . Profitability and volume will likely dictate the technicians involvement in the overall procedure.

As the HT industry continues to improve and costs become more affordable , supply is likely to exceed demand . This is possibly most apparent in the Turkish market ( amongst others ) , where a proliferation of Technicians only clinics are apparent . There may be a surgeon(s) in overall supervision , but the hands on involvement is minimal .This is also the market which possibly gives greatest illustration of the blurring lines between surgeon and technicians involvement .

The more well known and established Turkish clinics are now being questioned on these very issues , as quality / success of HT procedures are starting to come into question . Some of these clinics are charging premium rates built off past results , but it seems that to accommodate additional capacity , surgeon involvement in the procedures are diminishing . Why pay a premium rate for the procedure when there's the chance that the result may be no better ( or even worse ) than the cheap , all for one sum technicians clinic ?

So , what's the answer ? I'm sure we'll find out a bit more in this regard in the coming years .

One thing that is not open to question is the importance of the technicians in the overall procedure . To my mind , some form of certification would go some way to establishing minimum standards across the industry . It may not happen , but just as we are advised to only consider certified surgeons , why should the same not apply to the technicians ? Stig alluded to something similar in a related thread .What training and qualifications do you need to be a technicians - none as far as I can see.

Interesting also , is the variance in opinions as to what the technicians should do and also as to what skill level they may have . One thing that I would disagree with is that surgeons are bound to be more adept / skilled , whatever you want to call it , than the technicians .This may be true in many instances , but it's certainly not a given . Some people just have a natural disposition to having a certain skill that no amount of training will ever exceed .

I don't expect many ( if any ) surgeons to respond to this thread , but if they do it would be appreciated.