Wooridul's technique recognized internationally :Posted by Korea Times

When stepping inside the front door of Wooridul Spine Hospital in Cheongdam-dong in southern Seoul, many can't help but be surprised by the number of foreign patients walking around in the building. 
Since it was established in its first location in Busan in 1982, the hospital has been solely focusing on spinal treatment. Since 2006, more than 16,000 foreign patients from 130 countries including China, Japan, the United States and Russia have visited the hospital for spinal surgery. 
Right before the interview with The Korea Times, Lee Sang-ho, a spinal orthopedic surgeon and chairman of Wooridul Hospital, asked Brazilian orthopedist Breno Frota to meet and consult with a patient from that country with Lee. Frota has been participating in a fellowship course at the hospital.

 

The Brazilian doctor also participated in Wooridul's minimally invasive spinal surgery (MISS) course in 2017. The MISS program is a training session on minimally invasive spinal therapy techniques, which provides lectures, observation of operations, and supervised hands-on workshops to practice the surgical technique.
Since the hospital started the course in 2004, 403 specialists from 41 countries have participated, with the 100th session being held in May.
"Despite unimaginable pain in their back or legs, many patients with herniated discs are afraid of having surgery because they are scared that such a large and long procedure will produce side effects affecting their daily lives, such as walking problems," Lee said. 
"But with the MISS technique, patients don't have to worry excessively about side effects such as backaches and difficulty in mobility. Patients can sometimes even walk home on the day of the surgery," he added.
Based on a "small is better, less is better" philosophy, the hospital's signature MISS technique, researched and developed by the chairman in 1992, preserves as much of the regular disc tissue as possible, leaving a minimal scar and helping patients recover quickly with dramatically reduced complications. 
Unlike conventional open spine surgery, surgeons don't have to use a large incision over the operating site to allow them to see and access the spine. 
The minimally invasive treatment is an endoscopic spine procedure, which is a way to operate on the intervertebral disc without a big incision. Under local anesthesia, an endoscope is inserted through the skin and a high frequency laser is used for the procedure. Using the high-frequency laser combined with the endoscope, surgeons can remove herniated disc tissue safely even on elderly patients with hypertension or diabetes. 
"The key to this procedure is to treat only the disc segment bulging out of annulus fiber, while preserving normal tissue." Lee said.
Lee came up with the idea of using an endoscope right after he established the hospital in Busan in 1982, when his mother was diagnosed with a herniated disc. 
"I wanted her to have surgery promptly without receiving a blood transfusion. But at the same time, I didn't want her to go through the side effects of spinal surgery."
Lee said he decided to go to France where he could learn the best microsurgery at that time. Lee was able to conduct clinical trials with donated corpses there, but later he flew to Uppsala University in Sweden which had the technology to freeze bodies immediately after death, so he could try operations on a body similar to that of a living human.
His new technique had a great ripple effect in Korea at that time. Patients were flooding into his hospital to get the procedure, but Lee said he soon faced strong resistance from other doctors as open surgery was the common operation method.
"The medical field puts the most value on verification and demonstration when it comes to a new surgery technique. I couldn't blame other doctors for condemning the new method as some kind of magic or fraud, because this MISS technique was radical and innovative. Besides, patients could return to their normal lives just a few days after the procedure," Lee said.
"So I decided to share this technique with my colleagues so that many patients could receive the benefits of this procedure," Lee said.
It is his belief that there cannot and should not be patent rights for medical techniques.
"I thought if I treat around 5,000 patients in my life here, I would be able to treat another 5,000 if I teach another doctor. This is how the MISS course was started," Lee said.
The hospital's international course also provides a fellowship program, with two to three foreign surgeons taking intensive training in the MISS technique for one year. Since 2004, 396 people from 46 countries have attended the fellowship program.
Lee has been dedicating himself to making the MISS technique mainstream in academia for almost 30 years, with 346 papers written by Lee or other Wooridul Hospital surgeons registered on the Science Citation Index (SCI) or the Science Citation Index Expanded (SCIE). 
His dedication has been recognized. He received the Paviz Kambin Award, an award given to the world's most prestigious spinal endoscopy experts, twice ― the Blue Award in 2017 and Gold Award this year. 
Lee now plans to set up a hospital in the United States, but the biggest hurdle is having a license to practice in the country. Wooridul already has 10 hospitals in Korea, as well as one in Abu Dhabi and another in Dubai.
In 2014, the Ministry of Health and Welfare and the Health Authority Abu Dhabi (HAAD) agreed to allow Korean doctors with three years of clinical experience in Korea to work as physicians there, a drastic cut from the previous eight years. But such an improvement in the medical sector is not making much progress between Korea and other countries, Lee said. 
"We once had a hospital in Jakarta in Indonesia in 2010, but had no choice but to close it mainly due to license issues," Lee said.
"I strongly believe doctors should find patients instead of waiting for them. I hope the government will help us find a breakthrough in the license matter," Lee said.