Facet joint arthritis treatment in 34 Neurosurgery and Orthopedic surgery clinics in Americas

Really good service for a tourist in need of a quick prescription. I was seen within 15 mins and got the medication I needed. Doctor spoke English which was helpful

They will not accept you if you don't have private insurance. They only accept payment from the insurance company, no credit or cash. If you are traveling here, go to a public hospital. The lady working there was extremely rude to me and was not willing to help me at all when I asked her where I can go to get medical help. I asked her for a hospital name and she essentially told me to F off. Luckily, I contacted a Spanish school for Spanish lessons and asked them where I can go. They gave me the name of a public hospital, and I was able to get my wound treated.

Malardo

In the offices of Patio Olmos, they scheduled me to be attended to by the guard and they NEVER called, at reception they informed me that the doctor who was going to attend to me LEFT!!! HE NEVER CALLED ME!!! A TOTAL LACK OF RESPECT. They take care of me at the guard and they don't have items to clean a wound!!!! Terrible attention!!! Physiological solution and gauze...they have nothing.

Came here as an international student. Best and most thorough care I have ever received for an acute condition that I regularly get admitted for. Nurses are very friendly. Clean facility. If i get sick in Córdoba again I'll go here!

I would strongly advice foreign tourists against this hospital. I made an appointment with a gastroenterologist and was immediately contacted by the International Patient Service. They're supposed to make your life easier but are actually an excuse to overcharge you without ever helping when needed. I've ended up paying over 500 USD to see a doctor and get some exams done, probably double of what I'd pay in Germany. They're very blunt about it and wrote to me they apply different tarifs to foreigners. We've all got a travel insurance, and I'm totally ok with a bit of a mark-up, but here I feel like a cow that's being milked to the very last drop.

Have been passed around from test to test for 3 months trying to get clearance for surgery without any treatment for my condition. Seems like all they want to do is test and not treat problems. Impossible to contact doctors offices by phone. Ordered tests without telling me. Asked for referral to hand surgeon and they sent me to shoulder specialist. Asked for referral to ear doctor and they sent me to throat doctor. Did multiple tests on heart and all good but they are ordering more tests. Think they are more interested in generating revenue than healthcare

My first bad experience, I have been admitted here several times and my stay had always been good, until today that I already have 6 days admitted with my son here we had a double room where the first nights I was touched by very decent and respectful people, the last two nights I have been touched by a couple with their son who leave the light on until late at night, they spend the day in phone calls and with a very inadequate tone of voice, the husband stays to sleep and has an awful snoring because those that are very difficult For me and my baby to have rest time! I talked to the manager who didn't do anything, I don't talk to people or take the delicacy to even see if she could move us to another room I don't care if it was with another person maybe they weren't as indecent as these which the sick people have told her that please if they can keep their composure and they don't even change! The truth is that I would have liked to have another person to help me and be more condescending with the situation, because I have seen empty rooms since last night even double, but according to the person I spoke they were not available! I'm still here and I can't take a break! As a hospital you need to put some rules like do not let man stay at least in double bedrooms, do not permit loudly noise in the room and for the residents on the rooms to keep respect to others and peaceful space appropriate for recovering!

My sister had surgery at Columbia Presbyterian Hospital. Her surgeon called me at 11:14 to report that she was out of surgery, and that the recovery room staff would be in touch when we could see her. I did not hear from the recovery room, so I called them. The desk clerk rudely told me that the nurse would call. It is now 2:50 - almost 4 hours since my sister left the OR, and I still have not heard a thing from the recovery room nurse. It is inexcusable to treat family members in this way. In addition - they have a one way texting app for communicating with family members - useless, apparently, because they don't use it. I understand nurses can be extremely busy, but it only takes seconds to communicate to worried, waiting loved ones.

BEWARE: Don’t send your family here and if Dr.Simon of Lakeview is the doctor get another doctor. Keep my brother on restraint and lots of medication and keep him in ICU My brother was sent here without our consent on 10/16/2023, plus we had informed admissions there and Lakeview case manager that he was not to come there by any means necessary weeks before the 16th. My brother was sent Monday and family had no idea & died that Tuesday morning about 6am.No one has reached out to the family to explain what happened and why he was sent there. What Rea happened at Pam Rehab ? I have been calling Scott with Pam , want call back . Also been calling Gretchen with Lakeview No answer and will not return calls. We just want to know what happened. Answers , but look like a cover up is happening here.

Pam was indeed a life saving facility for my husband. After suffering a severe stroke leaving him paralyzed on one side PAM took him into their Ltac unit where with their professional, knowledgeable and caring team got him to the point that he was moved to the rehab unit. There the team worked daily to get him started back on the road to an independent life. All the team from the front desk, front office, maintenance personnel, especially the nurses, therapist, aides and PA Lisa made us feel like family. We are forever grateful for our time there.

I started there in February of 2023 with my first surgery and had a wound vac, I was so scared , but I met Ashley, Amber , Amanda, Natalie , Kim and Chris and I knew I was going to be well taken care of and all my fears went away. They are all amazing then and now I’m back with second surgery . I was asked if I wanted home health nurse and i said”NO”that I wanted to go back to wound care. They are amazing I would highly recommend to anyone to go there. From the receptionist, the staff and everyone there , all are friendly and professional.

While I appreciated the procedure being done my beef is this places billing department only affords you 6 months to pay your balance. So even tho I have insurance through my place of employment and reached my déductible prior to surgery, and even though I have been making payments monthly for the remaining 20% ... if my balance isn't paid in full within 6 months their "policy" is to send it to collections. Now I was offered 'financial assistance' IF I submit two or three years of taxes, plus several paycheck stucs. (So basically all of my personal information) which is not only time consuming but also invasive. I'm just a single gal trying to make ends meet. I needed the surgery to prevent further complications down the road so I elected to have it done. Perhaps I missed information prior to getting the surgery? But I NEVER thought that even though I am paying monthly a fair amount towards the remaining balance that I would STILL be threatened with having it go to collections. And just for that reason I would NEVER recommend this place to anyone. Period

The Nurses, CNAs, PTs, & Staff were all AMAZING!!! My mom had knee surgery a week ago and our experience there was great!! Everyone was kind and helpful from admission to post op. I can’t remember everyone’s names but I did take some down! We loved how kind and helpful her nurse Kaylani was!!! The most important part to us was having a Spanish speaking nurse on staff. My mom only speaks Spanish and it was so comforting to us knowing at night she was left with someone she could understand and communicate with! Thank you to Josephina and Nasthja for taking such good care of my mom! The physical therapist, Ruth is incredible!!! My mom adored her and made us feel confident about taking her home!! Special thank you to KASS, CNA!!!! She provides excellent patient care. Spine and Joint hospital provided quality care!

Arizona Spine and Joint Hospital gave me outstanding service and care during my stay. I would also like to thank Dr. T, his wife Kate, and Dr. Kralik for their great skills and knowledge. I'm so thankful my wife and I found these skilled surgeons. I'd also like to thank the nurses and staff who took care of me while there: Debbie, Cathy, Karen, Deanna, Becky, Dickson, Katherine and Veronica! Thanks again. My drive from Lake Havasu was well worth it!

Couldn't visit my grandpa in the emergency room. I drove an hour to get here and then they tell me there is a 2 visitor limit. There is little to no reception in the building so I couldn't even get in contact with who was in there. I called into the room and when I asked about someone leaving she pretended I didn't even talk to her and went mhm mhm and hung up. I love hospitals that won't let a grandson see his grandfather in the ER

I am deeply thankful for the exceptional care and attention I received during my recent visit to the emergency department at Brigham and Women's Hospital. The doctors and nurses demonstrated genuine concern and provided excellent care for my difficulty swallowing, gastric issues, and rapid weight loss. Their professionalism and compassion made a significant difference during a challenging time. I want to express my sincere gratitude to the entire medical team for their dedication and outstanding support. Thank you for helping me through this health concern with such skill and kindness.

During my dad's ICU stay at Brigham and Women's Hospital, the nurses provided outstanding care. They kept us informed and made us feel safe throughout a traumatic time for our family. The level of expertise, compassion, and seamless coordination between day and night shifts was remarkable. My family and I will be forever grateful for Nurse Bryan, Katie, Kayla, and Lauren from Unit 3B.

You will roll the dice with anesthesiologists at this facility. I was "assigned" Dr. Traylor. A freakishly large, imposing and intimidating man with zero resemblance of care or compassion. I'm sure he chose this field because no one would EVER seek his services. His patients haven't a choice. He suggested a female doctor. Best suggestion he's ever made. In walks Dr. Sarah Cocoma complete with a raging eye infection. This woman SNUCK behind my bed, DISTRACTED me and FORCEFULLY shot VERSED in my IV. It burns given gently. To render me unconscious, without asking, warning or care. Filthy conditions in every area including the elevators. Stay away from the trauma this place leaves behind. You've been dutifully warned.

The worst communication. Terrible gaslighting. The INEXCUSABLE FILTH in this facility. It was everywhere. The waiting room, the bathrooms, the hall was littered with garbage type red biohazard bags. Even INSIDE my Operating Room...garbage on the floor. When I objected to what I was seeing, they promptly canceled my surgery. I couldn't get out of that place fast enough...but not before one last gross show of filth, the floor of the elevator was littered with 2x2 gauze pads...soaked in something orange. I quickly pointed it out to my husband so he can see for himself what I was trying to describe. He quickly understood as an employee's foot was standing over some ofthem. My biggest fears were handled BEAUTIFULLY by this pre-surg staff, they are willing, if able, to accommodate women patients with women doctors/ residents...they allow small gestures of modesty and that is commendable. And just so you know...all those personal questions they ask you? And all the personal questions you ask them? EVERYONE CAN HEAR YOU...as there only curtains for privacy. HIPAA laws must be out back on a smoke break with the 3 janitors this place employs. 2 thumbs down and shame on you.

Had a good experience. Brought my father in law into Rush to be evaluated from stroke he had 3 weeks ago. They had him in a bed in less than 30 min. He was admitted and put into their stroke rehab program in less than a week.

Dealt with this hospital for several years. No matter what day or what doctor I've always been left with the same experience; cocky doctors playing God with the absolute worst bedside manner. Never again.

My husband was a heart transplant patient here. One time they failed to give an accurate report for him to adjust his warfarin accordingly. Subsequently he suffered a stroke and had to have intracerebral hemorrhage surgery. My husband overlooked a lot of things and this hospital had the nerve to kick him off the transplant list. They called an old number and then said that since they couldn't get in touch with him he was non-complaint. I gathered so much proof to show that they were the ones who made an error. I got all the phone records and proof that we updated his information but it was evident that they just wanted to get rid of him. I wanted to sue so bad but I left them all to God. You should have been in that break up meeting. By the grace of God he got his transplant at an excellent hospital in CA.

Lynn at the gift shop was extremely helpful and made ordering flowers a seamless process. She was so kind and patient too. Thank you Lynn!

I want to give them a 5 star because as soon as my son was checked by the emergency, nurses and doctors came and admitted him into CCU. They saved my son! Now I know where my donations can go. We can't thank doctors and nurses and all the volunteers and staff enough. Beside their professional knowledge and equipment, everyone wats to make sure parents and siblings are well taken care of. However, the emergency is as busy and not very favorable a unit as all other ones in Canada. At 2:00 am, there was only one nurse doing the reception job and checking patients. She could attend to our son sooner but she was busy with the reception.

I appreciate the hospital's efforts in managing a high volume of patients, and I understand the initial wait time for a bed. However, after securing a bed, there was an additional four-hour wait to see the doctor. While I recognize the challenges, it was disheartening to wait for a medical consultation only to be informed that we were cleared to go home after the doctor's brief checkup. In order to enhance the overall patient experience, I would like to suggest that the hospital consider increasing the number of doctors available, and if possible, encourage doctors to start their checkups a bit earlier. This adjustment could potentially help free up beds more promptly for patients in need of urgent care.

One of the Best Hospital in the world, best patient care, The doctors are very friendly , professional and using advanced methos to detect the problems, I visit this hospital frequently with my nephew for his sickness. The hospital is very clean and well maintained. Parking is available in underground $20.

We unfortunately had a five night stay at the NICU over the Thanksgiving holiday. The staff provided excellent care to our kid and were extremely compassionate to us as parents. We were grateful for the private sleep rooms and shower, and they even had a free Thanksgiving dinner for everyone. The parent / family lounges have places to grab coffee and store food, and everything is very clean and organized. The doctors and nurses were very communicative and kept us in the loop the entire time.

Absolute terrible service , my child who has a seizure disorder and potential c- diff was made to wait in the ER for 3 and half hours plus without even being properly triaged . She didn’t receive a wrist band , at any point & we can run the cameras back , no one was alerted to her allergies , there was no band received for that as it typically is .. and she begin to have diarrhea thru the long wait due to the virus she’s had the past week and in turn she begin to get worked up and her fever returned . I asked how much longer the wait would be abd for an approximate timeline .. as I’ve observed plenty of patents come in after one in which I knew personally with less servere circumstances… literally come and go and my child was still suffering in the ER … the Nurse on duty was unaccomidating and almost seemingly unwilling to engage .. as I waited for some kind of answer on when my severely sick child would be seen . I asked if it would be more then another 30 mins and he said he couldn’t promise but shouldn’t be . Well it was . After 45 mins of them calling more then 3 patients who arrived after us .. I reluctantly decided it best to take my fevering , baby who now was covered in feces home.. as she was in her 3rd bowel movement and we had difficulty changing her in the nasty public restroom . I ultimately watched them call two more patients who had come after us exhibiting no signs of eminite health scares then I ordered our ride so I could take my child home to change her and give her medicine to help reduce fever and prevent seizure . I am pissed and very upset that my child and I spent. 3 plus hours we can’t get back in the ER after already being across the street at the Berger building for 3 hours prior this was wayy less then pleasant This is the second poor experience in this particular Emergency Dept but this is the first time it was so horribly handled that I had to leave with not only an even sicker baby then I arrived with . She still now will have to go to another ER to be seen .. because she did infact have a seizure once we got home from her fever that arose& I informed them but that did nothing to medicate the situation or get her seen. Now my kid is home fevering still sick potentially has c-diff and I am skeptical to return her to this terrible hospital because they haven’t even returned my call. I called to speak with charge nurse after filing formal complaint and was told by Jennifer in WR I could not speak to any charge nurse and then she took my information and said a nurse on duty would call back and it’s been an hour with out a returned call. This is negligence and unprofessionalism tht promoted us to leave in the first place and CHOP is looking at a pretty decent lawsuit if we do go to another practice and something is severely wrong with my child with so much documented instances of me trying to get her helper seen and have a team leader consult about next steps. This place wasted my time , cash as it’s costed money I didn’t have to travel to and from and I felt like the poor treatment was racially motivated , as as kid who came in after us was pulled to the back cuz her mother told them she was seizing but I was looking at the child. Who literally just had woke out her sleep. This place is incompetent , and of all the amazing experiences we’ve had here . Today ultimately casted a shadow on them all and I will be contacting the PA board of insurance aswell to file a formal complaint because they need to do better on managing and transparency in the ER wait times. We got there at 12:15 and didn’t receive a text saying my child’s room was ready until 4:15 pm that’s 4 freaking hours for a child who had 2 seizures in past week, has a virus, and cold and caught fever while there … when she has a history of febrile seizures … 0/10 would not recommend. Shame on u all

Very friendly staff and amazing doctors. The information desk is very helpful. The front lobby is well designed and honestly fun to be in due to it's design: there is a meandering ramp that goes up several stories with interesting interactive stops on the way. The lobbies on each floor are also all well laid out: they have great views outside and inside were designed with children and comfort in mind. The plaza out front and the cafeteria/Cafe are both relaxing places to recharge.

I found some english speaking doctors here and they have an international office to help you translate if you dont speak spanish. Thank you very much Carolina 🙏

Horrible! Dont go to this clinic. The most unfriendly employees I have experienced in this Hospital. Yes I do speak spanish but once I didnt understand smth the lady just ignored me! Errors start already in front of the Clinic. Apparently they don't know the difference between a Swiss flag and a medical (red!!!) cross. So my question: is this a Swiss Clinic??? Of course not...

My mom got a well planned surgery in this Clinic. Excellent outstanding service what a relief. Fast service, very diligent and well trained all staff. Great place to get well and get some recovery. If you get sick go there you will be fine quickly. Do not visit Los Nogales clinic or La Colina. Marly is the best! Thank you all for your service! Mom is doing great. The doctor was very profesional!

Super-delayed patient care, I don't want to imagine where a calamity happens and more than 30 people arrive, they will die here, I have a pain in my stomach since 4 in the morning, diarrhea, vomiting, fever and chills, I arrived at 3:00 pm and it's 6:00 pm and they don't attend to me, I have to writhe in pain to be attended to.

God bless every health worker in this hospital, those in surveillance, those in cleaning, those in the nutrition department, and especially the ophthalmological doctors, the retinologist, and resident doctors, and Yenny at the reception. And social work. Excellent service, in care and procedures, hospital, and control. Thank you very much for the great service you provided us on the two occasions we came. Thanks to the timely intervention they gave my mom, she is doing very well. We didn't do well in the children's cardio, nor in the clinic at the national university. They have a long way to go to know that the patient deserves respect and timely attention. THANK YOU HOSPITAL SAMARITANA, FOR YOUR EXCELLENT SERVICE. VERY GOOD ADMINISTRATION OF THE HOSPITAL, AND VERY GOOD CARE AND DIAGNOSIS BY THE SPECIALISTS. Since you are admitted for emergencies, the attention is very fast and timely. GOD CONTINUE BLESSING YOU 🙏.

Good hospital services

All staff member needs an urgent training to learn the meaning of empathy and serve to patients.

The best in town.

Omg I had to walk to the nurses station for everything from a blanket to medication. They have no tv in the rooms. They take for ever. You have to wait 6-8 hours to get something done. Just go to a regular clinic in Barranquilla they are not as nice but they get things done.

It is not possible to communicate to schedule an appointment. With so much advanced technology and they do not even have a telephone line available to contact them.

Terrible service, the worst place, bad attention..... The person in charge of making admission for the colonoscopies is rude, speaks reluctantly, does not respect the patients...... They schedule people on a schedule and I made them wait more than three hours.... The worst clinic I have ever known....

Hello, my lady was there for a few days, I chose to pay for a better service, so that she would be monitored all the time, for fear that something would happen to her at home, and she would not get to the hospital on time, and Lugo de I spent an entire night with pain and fever on November 19, on the 20th they told me that they couldn't do anything and that they suffered a demotion, the doctor failed and left them to die.

Great Service, Doctors are so respectful of patients times. Very clean hospital. Quite a different experience from other hospitals. Very pleased.

I went in with back pain. Got excellent care ,x-rays, diagnosis in less than 2 hrs.

This hospital is amazing! My husband had to attend and I was so impressed with the staff! As we do not speak Spanish, they were all very amazing and did their best to help us. They were kind, caring and detailed to ensure that we were well taken care of. Thank you so much for taking care of my husband! You are the best!

They should give users a racket to kill the mosquitoes inside 🤨

Of all the clinics and hospitals that I have visited inside and outside of Colombia, I dare to assure you that they have incredible human talent.

I am from out of country and my son fell off a chair and had a huge incision on his head. as soon as we got there they brought him in and attended to him. We were there for 10 hours for observation and had given amazing attention and care to my boy

Good attention

They take good care of patients, they are treated as they should be. The facilities are well maintained. The parking lot is ample.

Madhouse, worst service at ER

Good afternoon!! My name is Taynara, and I was admitted to the unit on 11/3/2023... with severe headaches and vomiting, and was soon sent for exams and measurements. I was immediately taken to the ICU, with full medical supervision from Dr Giuliano and his emergency team. On the 4th (Saturday), after more tests, a tumor was seen requiring surgery, which was carried out last Thursday, 11/24. The surgery was a success, the entire tumor was removed without any further complications. Today Monday, 11/27, I left the ICU and am recovering in the room. I would first like to thank God for the entire process, and for the Dona Helena team... from the nurses in the emergency, ICU and maternity ward. Thank you for all the love and care, to everyone I had the pleasure of meeting, they made this struggle easier, they all brought me a lot of confidence and serenity. Thanks mainly to Dr Giuliano, for all his professionalism and clarity. By ICU Techniques morning and afternoon (Karina, Karen, Carol, Larissa, Paula, Ângela, Anderson, Roberto) Amanda for all the braids in her hair before and even after cutting her hair for the surgery she took great care to wash , hydrate and make everything feel lighter after surgery. Night technicians and on-call technicians, physiotherapists Rose, Milena and Najara. The maternity nurses, technicians, kitchen maids and the entire team!! Thank you very much, and may God bless each one of you greatly!!!

I've been with my grandmother at HDH twice in the last 30 days. The first time on October 21st in orthopedics, service provided by the doctor Barbara Miroski de Oliveira Pinto. The second appointment was today, a clinical appointment by doctor Murilo Melocra. In both appointments, the doctors were very clear, detailed and were excellent in their consultations. Even though consultations were carried out in the emergency room, the service was very complete and all possible information was provided. Service at reception and screening was also very good and courteous.

On Saturday, 02/08, my wife and I were admitted to the hospital through the emergency ward. We needed obstetric care. The reception was perfect. The nurses were amazing. The doctor who carried out the first assessment did well. But everything fell apart when they told us that there was NO doctor responsible for ultrasounds at the hospital, they were on alert. This specific doctor was supposed to be at the beach, as it took him over an hour to arrive. When he attended to my wife, he treated it as if it were nothing. A cretin. In a moment of total fragility. Irresponsibility on the part of the hospital for not having a team on duty (probably to save a few bucks) and the doctor is certainly from that new generation who only thinks about fundraising. Ultrasound care was vital for us, regardless of whether it changed the result or not. We just wanted an answer. The doctor (whose name I will refrain from mentioning here, but you will find out from the ombudsman) came in, gave the diagnosis and simply left. He left the rest to the other doctor who attended to us first (very well) and to the nurses. There's no point in having a hospital that prides itself on having whatever it is, with each professional identified by the color of their uniform and having emergency medical care that is rubbish. Ridiculous. Unfortunate for a hospital that was once a reference in the region. As for the doctor, I wish him no harm. I just want life to give him the same treatment he gives his patients. And I say this from the heart because there is time to change and be better.

I was in the emergency room on August 4, 2023 and I have never been so well attended. The entire nursing team is very dear, welcoming, providing humanized care. A million compliments to Dr. Thais, an excellent professional who comforted me throughout the service, did what she could and what she could not to welcome me. Thank you very much to all!

Excellent hospital, excellent facilities and top notch staff! Far superior to Rede D'or. If you have a serious medical case in your family, go there.

I had laser bladder stone removal surgery performed by Dr. Adrian Andres Jara Benitez at Hospital Pró-Cardiaco and I am extremely satisfied with my experience. From the beginning, I was impressed by Dr. Adrian's professionalism and empathy. He thoroughly explained the procedure and reassured me of any concerns I had. His clear and kind communication made me confident in his abilities as a surgeon. The Pró-Cardiaco Hospital also deserves praise. The medical and nursing staff were exceptionally attentive and helpful. The environment was clean, modern and welcoming, which contributed to my comfort and tranquility during my stay. During the surgery, Dr. Adrian demonstrated exemplary surgical skills. His dexterity and precision were remarkable, and I felt safe and confident in his skilled hands. Additionally, your attention and care before, during and after the procedure was greatly appreciated. The medical and nursing staff at Hospital Pró-Cardiaco continued to provide high-quality care throughout my recovery. They closely monitored my progress and responded promptly to all my needs. His dedication and professionalism were impressive and contributed to a smooth and peaceful recovery. I am immensely grateful to Dr. Adrian Andres Jara Benitez and the team at Hospital Pró-Cardiaco. They are true professionals who provide exceptional medical care with a humanized approach. I recommend Dr. Adrian and Hospital Pró-Cardiaco to everyone looking for quality medical treatment. I would like to express my sincere gratitude to Dr. Adrian Andres Jara Benitez and the team at Hospital Pró-Cardiaco. Your expertise and careful attention were critical to the success of my surgery and my recovery. SERGEY SERGIENKO

The structure of the building is good, but the service is lacking. In the office building there is no air conditioning and it is 35ºC hot. It is absurd that a private hospital environment does not have a decent structure to serve its clients!

I underwent a total thyroidectomy surgery on 08/17 and I was very well taken care of, from the time I arrived until I left (08/18). I would like to thank the entire team of Dr. Reginaldo Fujita, all the nurses and doctors in the recovery sector and all the nurses, physiotherapists and other employees in the hospitalization sector, for their love, care and patience. The structure of the hospital is wonderful (bedroom, operating room, recovery room)!!! My only complaint is about parking…..absurdly expensive. My mother paid 122.00 to stay 1 day with me!

I had septum surgery at this hospital and it went smoothly. Nurse Roberto took care of me with care. I stayed in room 509 where everything was organized and clean. Dr. Moacir's surgical team is very careful.