Stayed 2 extra days because of elevated liver lipids. For patients covered by health insurance, out-of-pocket costs typically consist of a specialist copay, possibly a hospital copay of $100 or more, and coinsurance of 10% to 50% for the procedure, which could reach the yearly out-of-pocket maximum. Typically, the cost of gallbladder stone surgery in Kolkata might range from INR 55,000 to INR 1,50,000. Speechless. Thank you for letting me share this info with you. My wife had gallbladder surgery a month ago. Patients with symptomatic gallstones are advised to have their gallbladder together with the gallstones removed. 1 other location in the UK for Mr Andrew Jenkinson FRCS - Harley Street Show clinics, 2 other locations in the UK for Vale Healthcare - The Vale Hospital and Clinic Show clinics. Pruning trees before the storm season can help ensure dead branches won't imperil your home. When discovered, sheets and gown were changed but I was not cleaned. After removing gallbladder, digestion takes place normally but bile wont be stored along the way in gallbladder. Mr Bruno Sgromo is the Lead Consultant Bariatric Surgeon for the Oxford Bariatric Service & Consultant Upper Gastrointestinal Surgeon for the Department of Upper Gastrointestinal Surgery at the Churchill Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom. I am not going to include it for now). Dr. DeLine @ Porter in Denver, CO was a life saver, literally. Over $61,000 for the hospital surgical charges alone. Am just sitting here in shock at the amount of $79,731.82 on the paper in front of me. This can be done as outpatient surgery, although some people do stay overnight in the hospital for monitoring. Your gallbladder is an important part of your overall digestive system. On average, the basic cost of gallstone surgery ranges from Rs. All treatments first class. ER doc $1400 offering 20% , haven't gotten surgeon, Anesthesia or any others yet . Copyright 2023 | WordPress Theme by MH Themes, Do Not Let Gall Bladder Surgery Cost Stop You, gallbladder surgery it is mostly because of the pain, gallbladder is an important part of your overall digestive, Fruitful Remedies: The Best Fruits for Fighting Fatty Liver, If you are notified by your doctor that you need to have a. Old Dog Needs $6,000 Surgery. Copyright © Surgery Surgeon 2017. Using this method, surgeons remove the gallbladder through a series of small incisions in the abdomen. It took them about 5 days to finally get me the surgery I needed to get done. My wife said that there is another bill of $2000 floating around but I cant find it. This program is in Bakersfield, CA. Gallstone Clinic is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com. It involves a much larger, and more involved, surgery. In general, laparoscopic gallbladder removal is less costly than open surgery. The gallbladder is one of the less popular organs of the body that sometimes, issues and symptoms it causes can sometimes be related to other parts of the body until they are detected or ruled out as otherwise. Opted for elective gallbladder removal after gallbladder attacks in NY. Our writers are experienced journalists who adhere to our strict, Gallbladder surgery typically is covered by health insurance. From outside Ireland: +353 1 240 8787. 45,000 to Rs. Went to the ER for severe pain under right rib. We were able to call up six hospitals across the United States and was able to receive an "estimate" over the phone. I didnt have medical insurance and I went through Cirugia Sin Fronteras wich means Surgery without borders in english. This does not include any of the doctor fees, and any costs accrued in the event of a lengthy hospital stay. $225,000 Settlement: A woman needed to have her gallbladder removed in a laparoscopic surgery. Said if it gets worse to head to ER. All right reserved. I now owe almost a full years salary to this place?!? When discovered, sheets and gown were changed but I was not cleaned. Dr Maleckas has performed over 6,000 bariatric surgeries, is a pioneer of laparoscopic surgery in Eastern Europe, and is one of the most experienced surgeons in the region. If this is no longer working, then these particles will cause other pain and problems in the digestive tract. It is located behind your liver and delivers a chemical called bile which aids in the digestion of food. However, the final cost varies based on a wide variety of factors. When the surgeon decides to go ahead with the gallbladder surgery it is mostly because of the pain that the patient is in. After most of the gallbladder operations people may leave home after three days. Surgery to remove the gallbladder is usually recommended if your symptoms are more severe. We are registered with the Financial Conduct Authority as a credit broker. It took them about 5 days to finally get me the surgery I needed to get done. The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis, or treatment. This does not apply to patients who are uninsuredwithout insurance, you shoulder the full cost of your medical procedure. Usually, the cost of gallbladder removal surgery is 50,000 INR to 1,00,000 INR. Sohow much does gallbladder surgery costand what are the factors you need to consider in choosing the right healthcare provider? We provide consultations in London (at the moment only online due to COVID-19) and the surgeries are performed in the clinic which is situated in Kaunas, Lithuania. I got my gallbladder surgery a month ago. Copyright 2023 Digestive Surgery at the Mater, Clinical Fellow in Peritoneal Surgery (HIPEC) at The Mater Hospital. Nearly everyone who has gallbladder removal surgery will have to pay some of the cost out-of-pocket. I wonder if I can get a bail out from my Uncle Sam that I served him so faithfully in the past. In some cases, an X-ray called a cholangiogram will be done to look for blockage or gallstones in the bile duct. When the gallbladder is not working properly or is blocked by a gallstone in the bile duct, it is no longer helping the body process food. They discounted $ 13,561.02. When I researched how much would have cost the surgery that figures given was between $6000-17000. Gallbladder removal surgery is considered to be a safe procedure, but, like any type of surgery, there's a risk of complications. Open Cholecystectomy is a more traditional procedure where a relatively large incision is made in the area where the gallbladder resides. Of course, you can function without a gallbladder. Our long term goal is to provide advocacy for transparent informed consent for heath consumers seeking treatment of gallstones. Said if it gets worse to head to ER. Also, WebMD offers a decision-making tool[. A healthier diet of fewer fats and cholesterol will help your body be able to function without it. I was told it was Diverticulitis and sent home in pain. The average cost of gallbladder removal surgery in the United States is $15,250, though prices can range from $6,250 to $18,750. Pensacola, FL 32502. Our goal is to have satisfied and happy medical tourists. Spread the cost. By analyzing, research and taking help of the experts you will be able to get the best gallbladder Surgery in Ireland. Having a gall bladder removal surgery, then, should not be done without some major consideration. 0. And also said I'm am very young (nearly 26) for gallstones, surgery isn't necessary right now, let's try losing weight and improving overall health first and review you again in 6 months. The amount of 44,910 doesnt include anesthesia or surgical center costs. What local providers can provide this service at a reasonable rate? When the pain gets severe enough you will need to seek out medical treatment. We have semi-private insurance coverage but because of high demand, was placed in 4 patient room. Weve partnered with top surgeons around the country to offer all-inclusive discounted pricing ranging from $4,700 to $5,700. The laparoscope is put into the patients body through a tiny cut made just below the navel. We believe in treating every patient as an individual, ensuring the very best tailored treatment plan. For example, Washington Hospital Healthcare System[, A gastroenterologist typically will diagnose gallbladder problems and recommend surgery. I dont have insurance so I have all the costs up front. All our surgeons are members of BAAPS / BAPRAS and are all on the GMC Register. Another important benefit of the laparoscopic gallbladder surgery is minimal post-operative pain. A laparoscopic cholecystectomy is done in one or two hours. Generally, there are three factors that cause healthcare costs to vary: The cost of surgery for gallstones will vary greatly between inpatient and outpatient facilities. As with other types of medical procedures, Laparoscopic Cholecystectomy price can also be affected by a lot of factors, including: The conventional type of gallbladder removal which is the opentype can still be performed but are becoming less and less of an option since it is more invasive because of the large incision, has longer healing time, and has more possible complications. Most of the patients have doubt about the normal functioning after removal of gallbladder. The main function of the gall bladder is to collect and concentrate a digestive agent, called the bile, which is produced by the liver. Find out more about diet after gallbladder surgery. My son refers to it as criminal activity. Before discounts it was over $98K. If you want to find out how you are covered, discuss the pre-authorisation process, or talk to us about self-funding gastric sleeve or gastric bypass prices, please call the consultant rooms directly, or our Freephone Enquiry Line 1800 60 10 60, Monday to Friday, 9am - 6pm. I wonder if I can get a bail out from my Uncle Sam that I served him so faithfully in the past. . Went to the ER for severe pain under right rib. She wasnt even admitted! You can also ask if there is a generic version of the same medicine, which can help lower the cost. We have semi-private insurance coverage but because of high demand, was placed in 4 patient room. A total of $58,111.02 (-13,561.02. The hospital did CT Scan, X-Ray, Ultrasound, Blood Work. No complications, no diet, no restrictions, etc And wait it is not over yet. Withlaparoscopic cholecystectomy, the patient can return to work quickly, he experiences lesser post operative pain, has a shorter hospital stay, and a swifter recovery. The hospital forms part of the Aspen Healthcare Group that runs high quality hospitals and healthcare centres in England and Scotland. However, this is the same as any necessary surgery. of the providers who will treat you are in-network for your insurance. 55,000 approximately. Related articles:Anesthesia,Health Insurance, Your email address will not be published. In such cases, patients can opt to go in for laparoscopic gallbladder repair surgery in countries like Mexico, India and Costa Rica. The incision is usually approximately six inches in length and is made below the ribs, on the right side of the body. Let us tackle each as we go along in this article. and a $52.00 blanket. These days, it's more likely that your doctor will choose laparoscopic surgery. Laparoscopic Method. This means a lengthy hospital stay and a much longer recovery time. Insured patients have historically paid less than uninsured patients for gallbladder removal, especially when they stay in-network. Request the price Below average Above average According to 21 clinics presented in the ranking Read more Explore 21 Verified Resection of gallbladder Clinics in Turkey Check that all providers are in-network. I rather pay a couple of hundred dollar bills than thousands.I am still waiting on my appointment with the surgeon which can take up to 6 months >:@. A laparoscopic gallbladder surgery entails only an overnight stay at the hospital. It was an ER visit in the morning with surgery that afternoon, no complications and I believe I was discharged the next day. Many patients go home from the hospital on the day of surgery, but some require a short stay, usually one day. Nationwide Gallbladder Removal Cost Averages - Gallbladder Surgery Without Insurance Watch on Possible complications include: wound infection; bile leaking into the tummy; damage to one of the openings (ducts) carrying . It usually takes around two weeks to perform normal activities. What options are available if I dont have healthcare insurance? This skilled and experienced gastrointestinal and bariatric surgeon consults from three clinics in London. Based on our data, the target fair price for gallbladder removal surgery is $5,750, whether you have health insurance or not. Gall Bladder Surgery Cost Package: 4,500 to 6,000 U.S. (850) 898-1410 The first day I got there, they took me in quickly because the abdominal pain I had was serious. With Health Insurance: Copay + 10%-50% Coinsurance, Without Health Insurance: $10,000-$20,000, CostHelper is based in Silicon Valley and provides consumers with unbiased price information about thousands of goods and services. The amount of each of these costs depends on your health plan. You can find all the latest health matters news and exciting discount vouchers. You'll have gallbladder surgery under general anaesthesia. Your surgeon will free up the gallbladder duct and artery. patients.dartmouth-hitchcock.org/billing_questions/out_of_pocket_estimator_dhmc.ht www.healthcarebluebook.com/page_Results.aspx?id=75&dataset=MD, www.nlm.nih.gov/medlineplus/ency/article/002930.htm, www.nlm.nih.gov/medlineplus/ency/article/007371.htm, www.mayoclinic.com/health/gallbladder-removal/AN00067, www.whhs.com/about/washington-hospital-discount-policy-for-uninsured/, patients.gi.org/find-a-gastroenterologist/, www.webmd.com/digestive-disorders/should-i-have-surgery-to-treat-gallstone-attacks, Check Out All Costs for Health & Personal Care. My piggy Biscuit (male, 3 years) has been diagnosed with bladder stone after an ultrasound and he needs surgery. Gallbladder Stone Surgery Cost Lowest Cost (approx) Rs. Dr. Vashistha is a renowned senior Bariatric and advanced Laparoscopic surgeon in India with over 20 years. Advanced Laproscopic/ Robotic/ Bariatric/General Surgeon
All treatments first class. Thank you for letting me share this info with you. Hope this helps. It will be $6700 if it takes 2 hours, if less time then the anesthesia portion will go down. Total cost for laparoscopy gallbladder removal: $4,000. Went to local clinic with protracted flulike symptoms, then to closest emergency room where diagnosed iflamed gall bladder. Usually, the process does not require more than a day of hospitalisation, and normal activity can be resumed after 4-5 days. But sometimes it can take up to two to three hours. Your email address will not be published. There are a few things you can do to help speed up your recovery time. Occasionally, various complications arise from the gall bladder. The cost of gallbladder removal surgery can vary between insurance providers. It usually takes around two weeks to perform normal activities. Medical Tourism Corporation is an international medical travel company based in the US. Most patients who undergo this gall bladder surgery laparoscopically have a much shorter hospital stay. Open surgery takes one or two hours. The function of gallbladder is to store biles which are produced by liver and it is a substance responsible for breaking down fats. He specialises in laparoscopic gastric band insertion, endoscopic gastric balloon insertion, laparoscopic roux-en-Y gastric by-pass, laparoscopic sleeve gastrectomy and revisional bariatric surgery. Gallstones are first observed through X-ray or ultrasound. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); How Much Does a Torn Meniscus Surgery Cost. She went into the ER at 23:00 on Sunday, had surgery at 16:00 hours on Monday, and discharged at 14:00 Tuesday. However, there are instances where it is the required type to remove a patients gallbladder due to some factors like if previous surgery in the area has already been performed, the patient has a bleeding problem, or for some reason the surgeon is having problem seeing the patients gallbladder clearly like in the case of obesity. To date, Mr Sgromo has performed over 500 key hole surgical procedures for weight loss. In very rare cases, a physician may find tissues that must be tested in a lab. The cost was $4,400.00 plus airfare $500.00 for me and $500.00 for my daughter. Sent it to collection company in less than 75 days in spite of two payments being paid. This includes the doctors charge for the procedure as well as post-operative care after the removal of the gallbladder. With this type of surgery, the surgeon will cut three small incisions into the abdomen and use a small video camera to aid in the removal of the gallbladder. Even with insurance it still cost me over $3000. Ask what the typical cost is if the surgeon finds other areas that need to be repaired during your procedure. 45,000 to Rs. A physician may prescribe painkillers or antibiotics post-procedure. To get free no obligation Quote For Gallstone Surgery in India: click here Phone Numbers Reach Us-India & International : +91-9860755000 / +91-9371136499 Email : contact@indianhealthguru.com So, diet changes have to be made reducing overall fat intake. Surgery took 1 hour on healthy 34 year old. Of course, these numbers may go further up if there is onset of complications. One week of acetaminophen-hydrocodone, amoxicillin-clavulanate. Learn more about Patient Assists Gallbladder Surgery Programtoday! Ask your surgeon how long it will take to do your operation. However, todays methods for performing gallbladder surgery are much different. However, the smaller incisions made during laparoscopic gallbladder surgery heal up very nicely. HSE Instagram. Gallbladder surgery can be expensive, but you may be able to save thousands by scheduling your procedure with our Patient Assist Gallbladder Surgery Program. Talk about highway robbery! Excellent credit, always paid bills and now I dont know what will happen. Gallstones Clinic Urologist,M.D., Urologist Category: Urology Satisfied Customers:4,106 Experience: Board Certified in Urology, Fellowship trained Verified Gallbladder surgery Ireland is safe and sound and is performed when it is absolute medical necessity. Stayed 2 extra days because of elevated liver lipids. These include epileptic seizures and spinal conditions such as disc prolapse. The laparoscopic gallbladder removal surgery takes about 1 to 2 hours. All our surgeons are members of BAAPS / BAPRAS and are all on the GMC Register. Since inpatient facilities tend to cost more to run, patients end up paying more for care. Some people are able to go home the day of the surgery. But when I opened the mail and saw the total I thought I was going to have a cardiac arrest. Paid $6,850 with insurance meetingp my max out-of-pocket. Spent 2 days at local hospital ( charged 19957.26 there) Then transferred to Cleveland for surgery. One week of acetaminophen-hydrocodone, amoxicillin-clavulanate. This doesnt include the $349 I have already paid the primary visit, ultrasound and specialist consult. Why not follow, like or link in with us on social media? Many patients go home from the hospital on the day of surgery, but some require a short stay, usually one day. I had insurance last year the premiums were over $300 and NOTHING paid before the $10,000 deductible. He earned his MD in Italy in 1998 and completed his general and laparoscopic surgery training in Italy and the Netherlands. Surgery takes about an hour and a half. No criminal record. How Much Does A Gall Bladder Surgery Cost? This surgery, called a cholecystectomy, was done by the surgeon making a large incision in your abdomen in order to take out the gall bladder. The surgeon will use a laser to create a longer incision and remove the gallbladder with conventional instruments. All content, including text, graphics, images, and information, contained on or available through this website is for general information purposes only. Why chose to have gallbladder removal surgery abroad. It is just that its function as a regulator will be missing. There are many different considerations to be taken into account when thinking about the gall bladder surgery cost. Resident - Medical officer in Holy family hospital, Bandra, Mumbai. Now recuperating with no known complications. Had to go to Costa Rica in 2008 for laparoscopic gallbladder surgery. This doesnt include the $349 I have already paid the primary visit, ultrasound and specialist consult. Many things can affect the cost of healthcare, regardless of which type of procedure youre getting. Morale go to your doctor NOW if you have symptoms. All of our consultation appointments, surgery, and after care appointments take place on-site at either the Vale Hospital or Cardiff Bay Clinic. Infection in the wound is uncommon following laparoscopic cholecystectomy. When a person suffers a gallbladder attack they will experience a lot of pain in the area of the right side of the chest. They were amazed he was alive due to the infection in his blood from the gall stones blocking the duct. typical x ray and blood work. They gave me some strong pain medication that did the job three hours later. Learn more about, Patient Assists Gallbladder Surgery Program, Outpatient centers are just as safe as hospitals, Los Angeles, CA Cholecystectomy (Gallbladder Removal) Cost Average, Atlanta, GA Cholecystectomy (Gallbladder Removal) Cost Average, Chicago, IL Cholecystectomy (Gallbladder Removal) Cost Average, Dallas, TX Cholecystectomy (Gallbladder Removal) Cost Average, Houston, TX Cholecystectomy (Gallbladder Removal) Cost Average, Miami, FL Cholecystectomy (Gallbladder Removal) Cost Average, New York, NY Cholecystectomy (Gallbladder Removal) Cost Average, Philadelphia, PA Cholecystectomy (Gallbladder Removal) Cost Average, Phoenix, AZ Cholecystectomy (Gallbladder Removal) Cost Average, Washington, DC Cholecystectomy (Gallbladder Removal) Cost Average, Cholecystectomy (Gallbladder Gallstone Removal Surgery) Cost Average. The gallbladder is then taken out through one of the incisions. Risks of gallbladder removal surgery. It cost me only 3,470.00 us dls. However, it may vary depending on the type of hospital, the availability of the skilled surgeon, type of surgical procedure, and length of hospital stay. The average cost of gallbladder surgery for a dog is $3500. ER doc $1400 offering 20% , havent gotten surgeon, Anesthesia or any others yet . The price of gallstone surgery in the Philippines can range from Php 12,000 to Php 150,000 or more especially in private hospitals. At times this pain can be debilitating. This pain is caused by small gallstones that are blocking the bile duct. This package includes hospital stay, laboratory tests, anesthesia, operation theater fees, the doctors fees, ride to and from the hospital, ride to and from the recovery center, and medications. Our bariatric surgeon, professor Almantas Maleckas is very well known in Europe. As an Amazon Associate, we earn from qualifying purchases. Your surgeon will make several small incisions (cuts) in your abdomen (stomach). Whereas, an open gallbladder removal surgery, requires the patient to stay at the hospital for about 5 days. OMG. Dallas, TX 75219, USA. The Vale Hospital: Our hospital is located in 3.4 acres of rural parkland, adjacent to Hensol Lake (in the Vale of Glamorgan, just 15 minutes outside of Cardiff City Centre), and has 25 private rooms with en-suite, and two major operating theatres with state of the art laminar flow technology. The cost of gallbladder removal surgery in Hyderabad is not much. The patients may complain of tiredness for up to four weeks following the procedure. After most of the gallbladder operations people may leave home after three days. 45,000 Average Cost (approx) Rs 95,000 Highest Cost (approx) Rs. We will be pleased to discuss finance plans with you if you wish. Notify me of follow-up comments by email. Injury to other abdominal organs during the procedure occurs in less than 1%. In some cases, you may be charged a separate fee for an initial consultation with the surgeon before the surgery. I now owe almost a full year's salary to this place?!? Laparoscopy "is a 'Band-Aid' surgery, and the recovery is much . This surgery involves four small incisions, 1-2cm in diameter in the upper abdomen. The above costs for Gall Bladder surgery reflect the following Clinical/MBS Codes 30443, 30445. New Choice Health, Inc. One factor that can greatly affect the cost of gallbladder removal surgery is whether you have the procedure performed in an inpatient facility, like a hospital, or an outpatient surgery center. A cataract operation is likely to cost between 2,000 and 2,500. Good thing I didnt or it would have probably cost me at least $250,000.02. That ($65,272.58) was the total amount billed after discounts. In some cases, an open surgery is needed if the gallbladder is too big or there is too much scar tissue to safely do the procedure laparoscopically. 3824 Cedar Springs Rd, #801-4762, Even with insurance it still cost me over $3000. While some patients with gallstones may remain symptom free the majority eventually develop symptoms, notably pain due to a stone blocking the outflow from the gallbladder, fever due to infection of the gallbladder or bile duct and jaundice or pancreatitis due to a stone passing out of the gallbladder into the bile duct. It is suggested to go for thorough check to doctor and help oneself. She sued for medical malpractice. Just that 3,470 dls. * Our fixed-price packages include the cost of your surgery and all appropriate aftercare appointments. Your surgeon will make several small cuts on your abdomen. For example, a Breast Augmentation surgery which costs between $7,500-$8,500 in the US costs only between $3,000-$3,500 in the Philippines which would be a saving of about 58% to 60%. The more complicated it is, the more costly it is. May 17, 2021 Outpatient centers are just as safe as hospitals but could save you thousands on your medical bill. While there is still an incision made, they are very small; only about 1/2 in size. The average female gallbladder surgery recovery time is between one and two weeks. 3 W Garden St. STE 206 Open Cholecystectomy. Despite working on a very high risk patient group, he has achieved a 0% mortality rate and anastomotic leak rate well below the national average. No criminal record. Many people suffer from regular stomach or abdomen aches. The late August sun can leave a mark. The gallbladder is instrumental in helping to break down cholesterol, fatty foods, and toxins left over from digestion. including everythin, surgeon, assistant, anesthesia, pathology and hospital of course. Mostly, they fail to understand the underlying cause of stomach ache until it becomes severe. Bile released from the gallbladder, after eating, aids digestion. Several small incisions are used, rather than one large one. The Cobham Clinic is the private patient unit of the Luton & Dunstable Hospital NHS Foundation Trust. The cost will range from $15,000 - $ 18,000. It cost me only 3,470.00 us dls. Spent one night. What's the most expensive vet bill? For more information about North West Independent Hospital in Limavady please. Vale Healthcareoffers rapid access services for a wide range of specialities including Plastic (and Cosmetic) Surgery, Orthopaedics, Spinal Surgery, Weight Loss Surgery, Rheumatology, Dermatology, Pain Management, Urology, Gynaecology, Neurology, ENT, Cardiology and Sports Medicine. From causes to treatment, find in-depth information to help cope with various digestive disorders. 1 lakh to remove. The cost of gallbladder stone surgery in India is relatively low compared to the rest of the world. It is important to make sure the surgeon is board-certified by the American Board of Surgery, Of course, it is crucial to consult with a doctor about the decision to have surgery. One thing you will need to think about is what your diet will be like afterward. To avoid high prescription prices, make sure the prescriptions you receive are covered by your insurance policy. Gallstones are small hard masses consisting, primarily of cholesterol and bile salts, and are formed in the gallbladder or in the bile duct. When you are having severe pain in your abdomen and it is diagnosed as a gallbladder attack, surgery is the only option for lessening the pain. . I have absolutely no idea how well be able to pay it off. Significant haemorrhage occurs in less than 1% of patients. Read more about how MDsave works. This type of surgery is very safe and necessary for the sufferer to find relief. A family doctor can provide a referral, or The American College of Gastroenterology offers a physician locator, For surgery, the gastroenterologist typically will refer the patient to a general surgeon. Here's another one: How can a person with good insurance wind up paying $6,104.64 for gall bladder surgery?
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