Mayo Clinic of South Africa

The Mayo Day Clinic which is housed in Mayo No. 2, was the vision of its creator, Dr Wypke Wypkema. It opened in 1974 as part of the Mayo Clinic "one-stop medical and diagnostic centre" and began with one operating theatre and 20 beds.

It has since grown into a world class facility with two fully equipped operating theatres for general anaesthetic surgery, plus a minor theatre where local anaesthetic and conscious sedation procedures are carried out.

Although we are registered as a day clinic where a patient would be admitted and discharged on the same day, we do have the facilities for overnight stays for more complex surgery or in the event of complications. We are affiliated to the National Hospital Network and are contracted to most medical aids to charge negotiated rates for all our patients. Private patients are charged competitive rates with discounts offered for early settlement. Private patients are required to pay a nominal deposit on admission.

Our staff consists of eight theatre sisters, two ward sisters, five auxiliary staff and four admin staff members. Their professionalism and caring attitude has resulted in not only an increase in the number of patients visiting our theatres, but also more doctors and specialists using our facilities - even going so far as to transfer patients from other hospitals, performing a procedure and then transferring the patients back again!

Gastroscopy and colonoscopy procedures are performed to investigate the causes of digestive problems such as abdominal pain, constipation, suspected ulcers, heartburn, etc. The procedure in normally performed under deep sedation where the patient is given a 'sleeping drug'. A fibre optic tube is then inserted through the Sister Theresa calibrating the gastroscope.

Sister Theresa calibrating the gastroscope.

mouth into the stomach (gastroscopy) or through the rectum to the colon (colonoscopy) and the image is projected onto a video screen for the specialist to view and make an assessment of the problem. Polyps which may be causing an obstruction in the colon may be removed during the colonoscopy. An oesophageal dilatation may be performed during a gastroscopy where a balloon dilator gently widens a constricted oesophagus. The image viewed by the gastroenterologist is also printed out as a photograph for later reference. Further tests may be indicated and the gastroenterologist may recommend an oesophageal manometry investigation and pH study in our Gastro-Intestinal Unit.

ERCP (Endoscopic Retrograde Cholangiopancreatography) is an endoscopic procedure performed on the pancreatic and bile ducts. It may also include a sphincterotomy and a balloon dilatation of the ducts. Removal of stones from the bile duct is performed during an ERCP procedure.

	Excision or cautery of skin lesions such as moles, warts, lipomas and naevi under local or general anaesthetic.
	Skin graft procedure are performed on minor wounds
	Complete removal or wedge resection of ingrown toenails
	Excision of a lump in the breast
	Removal of swellings or in lymph glands
	Removal of foreign bodies
	Excision of basal cell carcinoma lesions
	Removal of ganglions. Those cysts involving the wrist usually require a general anesthetic. The ganglion is removed through an incision directly over the area of swelling. Care is taken to excise a small portion of the joint capsule or tendon sheath from which the ganglion has arisen.
	Removal of prosthetic plates and pins

Breast enlargement - Augmentation
This procedure enhances the size and shape of the breast using silicone implants. The procedure is done under general anaesthetic. The incision is made in the axilla (armpit) so that there are no visible scars on the breast. Generally a retropectoral pocket (behind the muscle) is used. This allows for a more naturally shaped breast and there is no communication with the breast tissue. The main advantages of this technique is that the breast can be examined for breast pathology and a mammogram can be performed without any obstruction of breast tissue.

Breast uplift - Breast Ptosis Correction.
The aim of this surgery is to tighten and shape sagging breasts by removing excess skin and repositioning the nipples. This is performed using a keyhole incision with the resultant scar around the areola extending to the inframammary fold and small scar in the fold.

Breast reduction.
The size of the breast is reduced and sagging breasts reshaped. A more extensive keyhole incision is used. An inferior pedical technique is often used because this method helps maintain the most sensation to the nipple.

Face lift - Rhytidectomy
The surgery redrapes facial skin, thereby improving sagging facial and neck skin and jowls. The superficial facial muscles are also tightened during the procedure. The incision starts in the temporal hairline, extends down in front of the ear in a natural crease and then behind the ear in the fold. The procedure is done under general anaesthesia or if a mini-facelift is performed, under local anaesthetic with sedation.

Correction of 'bat ears' - Otoplasty
Prominent ears can be corrected surgically. The most optimal time for surgery is when the patient is between the ages of 5-7 years, however adults will also benefit from this surgery. The proceudue can be done under local or general anaesthetic. The natural soft curve of the antihelical fold is created by a skin incision behind the ear and cutting of the cartilage, which is then reshaped and held in place with sutures.

Liposuction.
The procedure improves body shape by removing unwanted fat deposits that do not respond to dieting and exercise. Target areas include neck, upper arms, abdomen, hips, thighs, buttocks and knees. The surgery is done under general anaesthetic except for very small areas, which can be done under sedation.

Tummy tuck and abdominolipectomy
This procedure removes extra skin and fat and tightens the abdominal muscles. The scar extends from one hipbone to the other in the bikini line and around the umbilicus.


Before the procedure	Three months later

Laser treatment to the face to smooth wrinkles

Eye pouches - Blepharoplasty
This procedure is done for the upper, lower or both eyelids. Extra skin, muscle and fat are removed from upper eyelids with a fine scar which falls in the crease. For the lower eyelid an incision is made just below the eyelashes in a natural crease, or an incision is made inside the lower eyelid.

Minor nose surgery - Rhinoplasty

With the Mayo being a day clinic it is not necessary for you to bring sleepwear or toiletries, but you may like to bring a dressing gown. It is also better to leave your valuables at home for the day.

	Phone your medical aid to obtain pre-authorisation for the procedure. Have the following information ready when you call: Your membership number Name of the patient Date of admission Name of Hospital (Mayo Clinic) Hospital practice number (7700164) Name of attending doctor Doctor's practice number Procedure being performed (obtain the CPT code from your doctor if possible) Reason for having the procedure (obtain the ICD code from your doctor) Length of stay (one day)
	Check with your medical aid if your scheme rules require that you pay a co-payment on admission. If your co-payment is being paid out of your medical savings, please check that you have sufficient savings to cover these costs.
	Follow any preparation instructions given by your doctor.
	If you are having a general anaesthetic, make sure that you have nothing to eat or drink for at least 10 hours before your procedure. Ensure that you arrange for someone to take you home after the procedure as you will not be permitted to drive yourself.

Your doctor will have booked your appointment with the hospital and will tell you when to arrive. The time between arriving and going in to theatre will be taken up with filling in of admission forms, being allocated a bed, changing into theatre garb and being paid a visit by the anaesthetist who will check your anaesthetic history.

Please bring the following information with you for admission requirements:

	Medical aid membership card
	ID number of the main member of the medical aid, or of the guarantor for private admissions
	The pre-authorisation number supplied to you by your medical aid
	Any co-payment prescribed by your medical aid option
	If you are under 21 years of age, you will need an indemnity signed by your parent/guardian, authorising the procedure.
	Private patients are required to pay a deposit before admission

If you are having a general anaesthetic, make sure that you arrange for someone to drive you home.

After your procedure, the ward sister will offer you a cup of tea or coffee while you wait for the doctor to see you, or until your transport arrives.

A family member may collect your prescribed "to take out" medication from the Mayo Pharmacy while you sleep.

You will be discharged once the doctor is satisfied with your condition.