Grandmed" Hospital, which entered the Mongolian health sector in 2009 to provide the best, quality and safe medical diagnosis and treatment to every citizen, is now a third-level central hospital operating in the field of spinal microsurgery and surgery nationwide. The hospital's achievements, success, and hard work have been recognized not only in Mongolia, but also internationally repeatedly receiving awards from prestigious conferences and festivals held in countries such as Switzerland and the United States. Recently, the spine surgeons of "Grandmed" Hospital introduced neck laparoscopic surgery to our country making our country the second country in the world to perform this type of surgery. In this regard, I spoke with B. Nurbek, head of the Department of Spine and Spine Surgery at "Grandmed" Hospital, senior surgeon and master of medicine.

• It is good news that our country became the second country in the world to perform laparoscopic neck surgery in our country by the doctors of the spine and spinal surgery department of "Grandmed" hospital. Has this type of surgery been done before?

Our country has become the second country to perform laparoscopic neck surgery. Previously, South Korea was the only country in the world to perform this type of surgery. Now our country has become the second country to do so. In the 1970s and 1980s, the first methods of neck surgery were developed. However, the operation was performed in an open manner. For an open procedure, an incision is made behind the neck. But recently, scientists have determined that neck muscles play a very important role. Open surgery has many disadvantages, such as frequent headaches and neck pain after surgery, as it damages the muscles. But in 2016, there was a new method that can be performed endoscopically. The main purpose of laparoscopic surgery is the same as that of the 1970s and 1980s, but it can be said to be significant in that it is done without damaging the muscles of the head and neck. In general, this type of surgery is very difficult because the nerves behind the spinal cord are freed by neck surgery. Therefore, it was not done in other countries except South Korea.

• It must have been a hard and complex surgery that the operation was performed only in South Korea while the world's health sector is developing rapidly.

The neck itself has very small bones making Laparoscopic surgery on it very risky. That is why this operation is not performed in many countries. For us, it means that we were able to localize this surgery due to operating on many people. This makes it the second country to perform this type of surgery. Laparoscopic neck surgery is performed in South Korea. But not common. There are very few doctors who specialize in this type of surgery.

• In what cases is this operation performed?

What we call Osteochondrosis, or calcification of the neck, it occurs when the bones grow, causing neck pain, headaches, and even more severe symptoms that extend to the shoulders. In this case, one nerve, two nerves, or three nerves are often compressed. At such times, the surgery is performed to free the nerve. Currently, in the case of such circumstances, open surgery is performed from the front of the neck to replace the disc. Due to the incision being made from the front of the neck to replace the disc , there is a high risk of damaging the esophagus, larynx, and carotid artery. Secondly, replacing one disc in the neck affects the other disc, and after a certain period of time, there is a risk that the other disc will deteriorate. It means that other disks take the load of one. The laparoscopic surgery stated above is performed behind the neck to release the nerve. It does not affect the other discs like front neck surgery. 

• Could you tell our readers more about the importance and results of laparoscopic surgery rather than cervical disc replacement?
  
  

Many people have had their neck disc replaced. After a while it affects the other disks. Osteochondrosis does not press only one nerve. Three or four nerves are pressed at the same time. So there is no concept of changing three or four disks at the same time. Three or four nerves can be freed simultaneously with laparoscopic surgery. Second, it is less painful because it does not damage the muscles. Third, there is a lot of calcification and bone growth in the neck, but there is usually only one nerve that causes the main pain in the neck. Because it is not easy to find the exact nerve without affecting the spinal cord. Fourth is usually old people are affected by this condition. Those people usually have osteoporosis. In that sense, there is a risk of the disc being pushed back and breaking. But endoscopic surgery can be done even if you have osteoporosis. Our main advantage is that we use the narrowest diameter (7 mm) scope, perform the surgery with a small incision furthermore the patient leaves the hospital after one day.

• How many people are diagnosed with calcification of the neck and pain felt in the shoulders and scapula in Mongolia

There are many people diagnosed with osteochondrosis who suffer from headaches, arm stiffness, and neck pain. Often people over 50 years of age suffer from this type of pain and spend sleepless nights. They say that their neck and head aches. There are also cases of chest pain. When a test is done through the heart there is no diagnosis. It is usually due to the neck.

• What are the risks of delaying neck surgery when necessary?

As we know the muscles of the hands of old people are sunken with dimples. When the nerves are compressed for a long time the muscles become stiff. However, only five percent of people diagnosed with neck osteochondrosis suffer from the severe form above. The remaining 95 percent provide rapid treatment results.

• People say that their neck and head feel very stiff. Is this another symptom of this condition?

Yes it is. People who suffer from neck and head pain usually link it with increased and decreased blood pressure. The constant pain of the neck and head is always related to the neck.

• How many operations of this type have currently been operated?
  
  

In total, we have performed more than 2,000 laparoscopic surgeries. After long-term research and endoscopic surgery on more than 1,500 people, we have the right to say that we have been able to localize endoscopic neck surgery. It means that we are moving to the next level because we have prepared ourselves very well.

• As for the composition of the surgical team?

There are currently three doctors working in our team. All are qualified laparoscopic surgeons. We perform 400-500 laparoscopic surgeries a year. It took a lot of support to localize the operation above. A lot of support is needed from investments, hospital management and team. For us today, all those conditions are well met.

• I heard that many foreigners are treated in your hospital
  
  

We have operated on citizens of many foreign countries such as Russia, China, USA, Germany, and they know our hospital well. In addition, many people who underwent the surgery was unsuccessful at Bumrengrand Hospital in Korea, Thailand, and other foreign hospitals, they have underwent repeated surgery at our hospital and recovered. In general, our people need to understand that not every foreign hospital and every doctor is good. Today, Grandmed Hospital performs all types of laparoscopic surgery for intervertebral disc herniation and neural compression at the international level, which is a great opportunity for our citizens to be treated in their own country and avoid further economic risks.

• We have been able to localize laparoscopic neck surgery. It must have took a lot of time and patience to localize this delicate surgery, could you tell us about your experience?

These technologies have been created through the hard work of our team for more than 10 years, and we are always grateful to the team of Jigur Grand Group for constantly helping us in this endeavor and providing us with all the conditions for our work. As a team, we are happy to localize this operation. As a result of researching, combining and comparing the new techniques of the world's most advanced countries like USA, Japan, and Korea, we have been able to create our own original technique among all of them, reaching world class levels. In return, foreign doctors and hospitals who taught us highly appreciate the renowned technique created by our doctors and learn from us. Once we had to always follow the development of the health sector, but today we have the ability to go along with it.