Best Neurosurgeons In Thailand

[benjammin]

I have a brain tumor and it needs to be removed. I'm facing the difficult decision whether to do it here in Thailand where it would be much more affordable, or returning to the United States where the quality of care MIGHT be higher.

This decision is complicated by the fact that I need to have the surgery done while AWAKE. Yes, I will be conscious for part of the surgery so that the neurosurgeon can map my brain. This will allow him to remove as much of the tumor as possible without inflicting any brain damage.

Not only will the neurosurgeon need to be highly skilled for the surgery, but the entire team will have to be top notch. The anesthesiologist will be very important as will the neuropathologist(person looking through the microscope to diagnose the grade of cancer) and the neuroncologist(brain cancer doctor).

Money is of course important, but to me, quality of care is of GREATER importance. My question is: if someone was cutting open your skull to slice out a tumor while you were awake, would you feel more comfortable having the operation here in Thailand, or in the United States?

I've spoken with some docs here who seem incompetent and one who seemed quite good. Does anyone know anything about the quality of NEUROSURGERY here in Thailand? Is it comparable to the care in western countries? I understand that many of the doctors here were trained in the west, but I'm looking at OVERALL care from the entire team.

Thanks for any input.

[BEENTHEREDONETHAT]

From what I have experienced and observed at Bumrungrad Hospital, it would be my choice for most anything I can think of. However I don't have any knowledge about neurosurgeons. I might add that has nothing to do with the cost, the efficiency and care there puts most other hospitals to shame.

Should add I haven't been in a US hospital in over 25 years. Australian hospitals don't even come close to the care you get in LOS.

Hope everything turns out well for you whatever choice you make.

[owen01]

For what it's worth - last year my Mother-in-Law had NeuroSurgery in the Paolo Memorial Hospital - and as I understand it - the surgeon was Swedish. The operation was fully covered by her private insurance but as I recall the bill for the operation and aftercare - including physical therapy - was around 1million baht

She recovered 100% (more's the pity )

Might be worth investigating

Best of luck

Owen

[Old Man River]

Benjamin, you ask where we are most comfortable having this type of surgery, Thailand or the US. For me, it would also be Thailand. I woudn't know which hospital to go to in the US, but I also would chose Bamrungrad Hospital. The Neurosurgeon I know the best is Dr. Roekchai and if I needed the surgery you mention, I would trust him to tell me what I should do. He might tell me to go to a certain hospital in the US, or he might tell me a different surgeon other than himself, or he might say he could do it. What he told me is what I would do.

[geordie]

I had a brain operation done in Sakon Nakhon, i had a massive brain hemorage. The Neurosurgeon had just qualified. I spent 3 weeks in hospital 2 of them in a private room. 1st week on a life support system and in a coma. I never had insurance, the total cost was 84.000 baht. This was done in a government hospital.

I went back to the UK and made an appointment to see a Bupa specialist. He said that the surgeon had done a fantastic job, he did everything that Buba would have done. He also said that the surgeon would probably have studied in the UK.

I recovered 100%, so i would say yes have the operation done in Thailand.

[KayT]

I have a brain tumor and it needs to be removed. I'm facing the difficult decision whether to do it here in Thailand where it would be much more affordable, or returning to the United States where the quality of care MIGHT be higher.

This decision is complicated by the fact that I need to have the surgery done while AWAKE. Yes, I will be conscious for part of the surgery so that the neurosurgeon can map my brain. This will allow him to remove as much of the tumor as possible without inflicting any brain damage.

Not only will the neurosurgeon need to be highly skilled for the surgery, but the entire team will have to be top notch. The anesthesiologist will be very important as will the neuropathologist(person looking through the microscope to diagnose the grade of cancer) and the neuroncologist(brain cancer doctor).

Money is of course important, but to me, quality of care is of GREATER importance. My question is: if someone was cutting open your skull to slice out a tumor while you were awake, would you feel more comfortable having the operation here in Thailand, or in the United States?

I've spoken with some docs here who seem incompetent and one who seemed quite good. Does anyone know anything about the quality of NEUROSURGERY here in Thailand? Is it comparable to the care in western countries? I understand that many of the doctors here were trained in the west, but I'm looking at OVERALL care from the entire team.

Thanks for any input.

Hi

after doing the rounds of many Drs and hospitals here in Bangkok to get a diagnosis for my own head problem I found Dr Ketchai at the BNH hospital in Silom.He was the only one who took the time to look at my films and my previous results from other places and to help me with treatment even though my medical picture is not textbook diagnosable.He is trained in the US and is part of a very very competant neurology team at the BNH hospital.Fees are reasonable and your insurance will help more than at Bumrumgrad.

As a result of the care and attention I have been able to maintain a very god level of brain health.

At no stage did he just want to just give me drugs and send me off and he has gone out of his way to care for me even when I had to go to another hospital when my insurance would no longer cover my costs.He set up appointments and assisted the new treating Drs as well.

BNH has a great lab and operating facilities and the level of care is second to none.

I hope this helps.

I wish you speedy healing and a long healthy future.

Light and Love to you

[tim armstrong]

From what I have experienced and observed at Bumrungrad Hospital, it would be my choice for most anything I can think of. However I don't have any knowledge about neurosurgeons. I might add that has nothing to do with the cost, the efficiency and care there puts most other hospitals to shame.

Should add I haven't been in a US hospital in over 25 years. Australian hospitals don't even come close to the care you get in LOS.

Hope everything turns out well for you whatever choice you make.

I'm inclined to agree with Been There. Sorry to hear about your predicament. Maybe useful to break down exactly what you mean by quality of care. At the level of International hospitals, the overall quality of care is generally very high around the world because they need successful outcomes to attract customers. The cost of treatment is not usually the first consideration. For sure the US is acknowledged as having a very high level of medical expertise, but so are several other western countries, depending on what area we are talking about. Neurosurgery is a small and highly specialised field, so the pool of expert surgeons is smaller aroundthe world. If your surgeon in Thailand has trained at a well known western hospital, AND has operated recently on other patients with a similar condition, he/she would be my choice, if you have made Thailand your home.

Provided the quality of nursing care, aftercare around infection control and follow up is OK and well regarded, I would focus more on finding the right surgeon, rather than the right country or hospital. I have had good hospital experiences in the UK, Australia, and Thailand, because of very skilled Drs, despite all the criticisms of the health systems in each of those countries. I wissh you the best of luck, this must be a difficult time. Regards.

[benjammin]

Thanks everyone for the input. I am aware that there is some very good quality health care here in Thailand and have had good experiences myself, while hearing about very mixed results from friends here.

I guess that my case is quite specific. The need for an AWAKE craniotomy is making me feel like I need a surgeon/team experienced in doing this type of surgery on a regular basis. I don't want a doctor making his second or third try on me. I really would like a surgeon who does these on a regular/semi regular basis.

I spoke with one surgeon who has some experience with these but he made it sound like he did many awake brain surgeries in the past, but in recent years, "not so many." This made me a little nervous. He also claimed that there weren't many other surgeons in Thailand who could do these. A surgeon I spoke with at Bumrungrad said that they are quite routine(although that doctor told me several things that I knew were not true).

I'm thinking that maybe the surgeons in the U.S. might be more experienced in doing these.

[Sheryl]

The level of skill in neuriosurgery in Thailand is extremely good. In fact, courtesy of the country's suicidal motorcyclists, it is something of a Thai specialty. Was even more so back before the helmet laws. That said, of course individual surgeons vary greatly and should be chosen wioth care.

Awake craniotomies have been done in Thailand since 2000 and were first perfromed at Siriraj, a major government hospital. The surgeon who first introduced the technique here (and thus presumably has the most experience with it) is Dr. Sarun Nunta-aree, who trained in Japan. . Although based at Siriraj where he is on the faculty, he has private practice a few hours a week at Bangkok Hospital, Samitivej Srinakarin Hospital and Thonburi Hospital. Suggest you consult with him at whichever of these is most convenient.

Bangkok Hosp and Samitivej are high standard facilities easily up to international standrad with respect to facilities and the surgical team (anesthesia, nursing etc). Thonburi is small and probably not the best place to actually perfrom such surgery but OK as a place to get consultation. Bangkok Hospital specializes in gamma knife neurosurgery, don't know if appropriate to your condition or not, and in general prides itself on being up to date in neuro-surg.

Siriraj itself is excellent in terms of surgical team and facilities but being a government hospital ,not so easy as a point of initial access. (Beaurocracy, language barriers, not always possible to chose your doctor). Whether Dr Sarun does awake craniotomies at BH or Samitivej, or prefers to do them all at Siriraj, I don't know but if he prefers to use Siriraj I'm sure he will tell you so and arrange for the admission.

Good luck.

[benjammin]

Wow, thank you very much Sheryl for such specific and helpful information. I have in fact met with Dr. Nunta-aree and he seemed excellent. I got a very good vibe from him and he was very knowledgeable and did an excellent job explaining the surgery to me.

He actually recommended doing the surgery at Siriraj or Thonburi. I was somewhat reluctant because Siriaj was quite different from hospitals I'm accustomed to from the States or such as Bumrungrad here. I'm concerned about lack of English and perhaps less comfort during my stay. Dr. Nunta-aree did say that he could preform the surgery at Sumitivej although he seemed reluctant.

I'm also planning on meeting with some doctors at Bangkok Hospital which I've heard is noted for neurology. Someone recommended Dr. Nuntasak.

Thank you again for the information and it does give me some comfort in the idea of doing the surgery here.

[sibeymai]

There are top shelf private hospitals (read that "expensive") and there are other lower rung private hospitals who are less expensive but have similarly capable doctors. You need to satisfy yourself with the capabilities and experience of the doctor. Not necessary to go to a top shelf hospital. Even a government hospital could be ok with the correct doctor.

You must already realise there are no guarantees but a top hospital does not guarantee you a top result. If a surgeon/doctor is not willing to be open with you about their experience and capabilities then steer clear. Go with who you trust and makes you feel comfortable with the risks.

Unless you are a medical professional yourself what other yardstick can you use ?

Edited August 9, 2009 by sibeymai

[Sheryl]

I have in fact met with Dr. Nunta-aree and he seemed excellent. I got a very good vibe from him and he was very knowledgeable and did an excellent job explaining the surgery to me.

He actually recommended doing the surgery at Siriraj or Thonburi. I was somewhat reluctant because Siriaj was quite different from hospitals I'm accustomed to from the States or such as Bumrungrad here. I'm concerned about lack of English and perhaps less comfort during my stay. Dr. Nunta-aree did say that he could preform the surgery at Sumitivej although he seemed reluctant.

I'm also planning on meeting with some doctors at Bangkok Hospital which I've heard is noted for neurology. Someone recommended Dr. Nuntasak.

Dr. Nuntasak is very well qualified but I don't know whether he has had experience with awake procedure.

Personally, if it were me, I would have it done by Dr. Nunta-aree for sure as I don't think anyone else in Thailand has as much experience in this procedure. And I would follow his recommendation re place of surgery; he knows best what his requirements are for doing this rocedure and where he is best supported.

Siiraj has private and semi-private rooms (extra cost, of course, but still less than the private hospitals. Need to request them.) so I would nto worry about comfort; in fact the royal family uses Siriraj. The private rooms are quite nice, even have sofa and kitchenette, set up so as to facilitate having firends or family stay with the patient.

The main inconveneince/dioscomfort of the place has to do with initial registration and getting to meet the specialist, a process you have already been able to circumvent and Dr. Nunta-aree may be able to facilitate the admissions process for you.

This does leave some language issues with the nursing staff. If you do not speak any Thai at all, see if you can arrange for a Thai speaker to be with you; the private rooms come with a bed for a relative/friend. Or, you can ask about hiring private duty nurses who speak English, I think this can be arranged through the hospital. Again, at extra charge, but still less than having this done at BH or Samitivej.

You may be interested in reading the following thread which recounts a foreigner's experience as an inpatient ar Siriraj:

http://www.thaivisa.com/forum/Experience-S...al-t284087.html