Hospital Ruber Internacional is a JCI-accredited private hospital in Madrid, Spain. Ranked among Spain's top 6 hospitals by Forbes. Specializes in neurosurgery, orthopedics, and cardiology.
Hospital Ruber Internacional is a JCI-accredited private hospital in Madrid, Spain. Ranked among Spain's top 6 hospitals by Forbes. Specializes in neurosurgery, orthopedics, and cardiology.
This procedure removes skin cancer, ensuring complete disease control and improved recovery.
"},"361":{"operation":{"name":"Topical therapy of melanoma","alias":"topical-therapy-of-melanoma","use_for_listing":true},"country_price":{"US":{"amount":4500,"max_amount":9000,"currency":"USD","clinic_count":0,"price_kind":"estimate","price_source":"parsed","scope":"country"},"TR":{"amount":1800,"max_amount":3400,"currency":"USD","clinic_count":0,"price_kind":"estimate","price_source":"parsed","scope":"country"},"TH":{"amount":1800,"max_amount":3200,"currency":"USD","clinic_count":0,"price_kind":"estimate","price_source":"parsed","scope":"country"},"AT":{"amount":1800,"max_amount":4800,"currency":"USD","clinic_count":0,"price_kind":"estimate","price_source":"parsed","scope":"country"},"ES":{"amount":5000,"max_amount":8500,"currency":"USD","clinic_count":1,"price_kind":"from_range","price_source":"tariff","scope":"country"}},"available_clinics":{"US":false,"TR":false,"TH":false,"AT":false,"ES":true},"description":"This therapy applies medicine directly onto skin cancer to halt its growth and spread, offering lesser side effects.
"},"363":{"operation":{"name":"Mohs microsurgery","alias":"mohs-surgery","use_for_listing":true},"country_price":{"US":{"amount":1800,"max_amount":4500,"currency":"USD","clinic_count":0,"price_kind":"estimate","price_source":"parsed","scope":"country"},"TR":{"amount":6500,"max_amount":0,"currency":"USD","clinic_count":1,"price_kind":"from","price_source":"tariff","scope":"country"},"TH":{"amount":1900,"max_amount":2600,"currency":"USD","clinic_count":0,"price_kind":"estimate","price_source":"parsed","scope":"country"},"AT":{"amount":1500,"max_amount":3500,"currency":"USD","clinic_count":0,"price_kind":"estimate","price_source":"parsed","scope":"country"},"ES":{"amount":7200,"max_amount":10500,"currency":"USD","clinic_count":1,"price_kind":"from_range","price_source":"tariff","scope":"country"}},"available_clinics":{"US":false,"TR":true,"TH":false,"AT":false,"ES":true},"description":"This therapy removes skin cancer layer by layer, checking each for cancer cells, ensuring minimal tissue loss.
"},"364":{"operation":{"name":"Wide excision of melanoma","alias":"wide-excision-of-melanoma","use_for_listing":true},"country_price":{"US":{"amount":6500,"max_amount":12500,"currency":"USD","clinic_count":0,"price_kind":"estimate","price_source":"parsed","scope":"country"},"TR":{"amount":6300,"max_amount":0,"currency":"USD","clinic_count":1,"price_kind":"from","price_source":"tariff","scope":"country"},"TH":{"amount":2800,"max_amount":4200,"currency":"USD","clinic_count":0,"price_kind":"estimate","price_source":"parsed","scope":"country"},"AT":{"amount":2600,"max_amount":4300,"currency":"USD","clinic_count":0,"price_kind":"estimate","price_source":"parsed","scope":"country"},"ES":{"amount":5000,"max_amount":10000,"currency":"USD","clinic_count":1,"price_kind":"from_range","price_source":"tariff","scope":"country"}},"available_clinics":{"US":false,"TR":true,"TH":false,"AT":false,"ES":true},"description":"This treatment involves surgically removing skin cancer, specifically ensuring a clean, cancer-free margin around it.
"}}},"operationIndicators":{"details":{"anesthesia":"general","days_in_clinic":2,"days_in_country":7,"rehabilitation_days":14,"satisfied_percent":78,"treatment_duration_hours":3},"illness_kind_details":{"requests_processed":46119}},"responsibleDoctor":{"id":290,"alias":"yesim-yildirim","name":"Yesim Yildirim","photo":"doctor/699da18e34fa6","advisory_text":"20 years of experience\nMedical oncologist, ESMO certified","linkedin":"","specialities":[{"id":"onc.001","name":"Clinical oncologist","illness_kind_id":10}]},"direction":{"id":10,"name":"Oncology","alias":"oncology"},"illness_kind":{"id":10,"name":{"en":"Oncology"}},"parsed_details":{"procedure_type":"surgery","fields":{"anesthesia":["local"],"back_to_work_days":{"min":1,"max":7,"unit":"days","qualifier":"Simple-closure excision, desk work. Longer for manual work, reconstruction, or leg, foot, joint sites; nodal surgery excluded."},"complication_rate_pct":{"min":5,"max":15,"unit":"percent","qualifier":"Wound complications (infection, hematoma, dehiscence, delayed healing) after excision alone; higher on lower limb; serious ones rare."},"contraindications":["Unmanaged bleeding disorder or anticoagulation (relative)","Active infection at surgical site (usually deferred)","Severe comorbidity or frailty making surgery unsafe (relative)","Life expectancy too limited to benefit from excision"],"days_in_clinic":{"min":0,"max":0,"unit":"nights","qualifier":"Outpatient under local anesthesia. Extensive reconstruction or sentinel node biopsy may need a day-case or overnight stay; not included."},"diagnostic_duration_minutes":null,"diagnostic_preparation":null,"diagnostic_referral_needed":null,"diagnostic_result_time_hours":null,"exercise_resume_weeks":{"min":2,"max":4,"unit":"weeks","qualifier":"Simple closure; avoid wound-stretching strenuous activity until healing confirmed. Longer on trunk, back, joints, or after reconstruction."},"final_result_months":{"min":6,"max":12,"unit":"months","qualifier":"Time for scar maturation after wide local excision; oncologic outcome is determined by pathology and surveillance, not by this timeframe."},"fly_home_after_days":{"min":7,"max":14,"unit":"days","qualifier":"After simple closure once suture removal and wound check are done; later after graft or flap."},"follow_up_visits":[{"purpose":"suture_removal","requirement":"routine","after":{"min":7,"max":14,"unit":"days","qualifier":"Typically 7-14 days; longer over joints or on the lower limb."}},{"purpose":"result_review","requirement":"routine","after":{"min":7,"max":21,"unit":"days","qualifier":"Review of excision margin pathology and discussion of staging and further management."}},{"purpose":"assessment","requirement":"routine","after":{"min":90,"max":180,"unit":"days","qualifier":"First surveillance skin and lymph node examination; subsequent schedule depends on stage."}}],"indications":["Biopsy-proven primary melanoma needing wide excision with Breslow-based margins","Re-excision after diagnostic excisional biopsy with positive or inadequate margins"],"main_risks":["Bleeding or hematoma","Wound infection","Wound dehiscence or delayed healing, especially on the lower limb","Visible, widened or hypertrophic scar","Numbness or sensory nerve injury","Incomplete excision requiring re-excision"],"pain":"Local anesthetic injection causes brief stinging; afterwards mild to moderate soreness for a few days, usually managed with simple analgesics.","preparation":["Review of biopsy pathology and clinical staging as indicated","Marking of the biopsy scar and planned excision margins","Medical history review including bleeding tendency and allergies","Perioperative medication instructions given by the surgical team","Arrange wound care; companion if walking or driving affected"],"recovery_timeline":[{"phase":"Day 0-3","description":"Dressing in place; mild pain and swelling. Rest and elevate the area if on a limb.","restrictions":["Keep dressing dry","Avoid strenuous activity and stretching the wound"]},{"phase":"Days 7-14","description":"Suture removal or wound check; pathology review of margins.","restrictions":["Avoid heavy lifting or strain on the wound until cleared"]},{"phase":"Weeks 2-4","description":"Wound healing; gradual return to normal activity and exercise.","restrictions":["Avoid vigorous activity involving the area until healed"]},{"phase":"Months 3-12","description":"Scar maturation with sun protection and ongoing skin surveillance.","restrictions":["Protect scar from sun exposure"]}],"rehabilitation_days":{"min":7,"max":14,"unit":"days","qualifier":"Functional recovery after simple-closure excision; longer after graft, flap or lower-limb surgery. Nodal surgery excluded."},"result_longevity":"The excision scar is permanent once matured. Cure depends on tumor stage, not time; lifelong skin surveillance is advised because of recurrence and new melanoma risk.","revision_rate_pct":{"min":2,"max":8,"unit":"percent","qualifier":"Re-excision for positive margins or later scar revision, or return to theatre for wound complications."},"scars":"Linear scar from elliptical excision, about three times as long as wide; size depends on tumor thickness and margin. Grafts or flaps leave larger scars. Scars mature over 6-12 months.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single excision visit; follow-up not counted. Sentinel node biopsy is additional, outside base scope."},"stages":[{"code":"wide_local_excision","label":"Wide local excision of the primary melanoma site with closure","after":{"min":14,"max":56,"unit":"days","qualifier":"Usually 2-8 weeks after diagnostic biopsy."}}],"qualifier":"Excision-only base protocol; reconstruction and nodal surgery are not included."},"success":{"metric":"Local recurrence-free after wide local excision","value":97,"unit":"percent","horizon":"5 years","population":"Adults with primary localized cutaneous melanoma (in situ or thin to intermediate thickness)","evidence_status":"limited"},"techniques":[{"name":"Wide local excision with primary closure","suits_whom":"Most primary melanomas, with margins set by Breslow thickness (generally 0.5-2 cm).","recovery":"Sutures removed in about 1-2 weeks; return to light activity in days."},{"name":"Wide local excision with skin graft or local flap reconstruction","suits_whom":"Larger defects or sites (face, acral, lower limb) where direct closure is not feasible.","recovery":"Longer healing and activity restriction; may require a longer stay."}],"treatment_conditions":["outpatient"],"treatment_duration_hours":{"min":0.5,"max":1.5,"unit":"hours","qualifier":"Primary closure under local anesthesia. Sentinel biopsy, reconstruction and nodal surgery excluded and take longer."},"initial_assessment_documents":["Biopsy histopathology report with Breslow thickness","Dermoscopy or clinical photos of the lesion site","Pathology slides or digital slide scan (if available)","Ultrasound or CT reports (if available)","Previous skin cancer or melanoma treatment records"],"travel_trips":{"min":1,"max":2,"one_trip_possible":true,"qualifier":"Single excision; stay 10-14 days covers suture removal and margin pathology review. Second trip only for surveillance or further staging."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check that the surgeon has experience treating melanoma","scope":"procedure","source":{"url":"https://www.aad.org/public/diseases/skin-cancer/types/common/melanoma/after-diagnosed","host":"aad.org","quote":"The surgeon who performs this surgery is usually a surgical oncologist who has experience treating melanoma.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Check that the clinic provides pathology examination of removed tissue","scope":"procedure","source":{"url":"https://www.aad.org/public/diseases/skin-cancer/types/common/melanoma/diagnose-treat","host":"aad.org","quote":"The tissue that your dermatologist removes will be sent to a lab, where a doctor, such as a dermatopathologist, will examine it under a high-powered microscope.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C3","text":"Check that sentinel lymph nodes can be tested when indicated to determine whether cancer has spread nearby","scope":"procedure","source":{"url":"https://www.aad.org/public/diseases/skin-cancer/types/common/melanoma/node-biopsy","host":"aad.org","quote":"Having a sentinel lymph node biopsy (SLNB) can tell whether cancer cells have spread to a nearby lymph node.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C4","text":"Check that the clinic can assess surgical margins for remaining cancer cells","scope":"procedure","source":{"url":"https://www.aad.org/public/diseases/skin-cancer/types/common/melanoma/after-diagnosed","host":"aad.org","quote":"The removed tissue will be checked to make sure that there are no remaining melanoma cells along the edges.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C5","text":"Ask for certification information and the name of the body that certified the surgical setting","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Ask for certification information and the name of the certifying body when assessing a surgical setting.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F2","text":"Forceful persuasion or cheap, time-limited offers pushing you into a quick decision","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Don’t be pressured into quick decisions either through forceful persuasion or cheap, time limited offers.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"A price that sounds too good to be true probably is","scope":"treatment_abroad","source":{"url":"https://www.plasticsurgery.org/news/articles/will-economic-uncertainty-drive-more-patients-overseas-for-plastic-surgery-what-to-consider-and-how-to-stretch-your-dollar-back-home","host":"plasticsurgery.org","quote":"If the price sounds too good to be true, it probably is.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Incision site opens up","urgency":"contact_clinic","general":false,"source":{"url":"https://melanomasurgery.ucsf.edu/sites/default/files/2023-09/ucsf-melanoma-and-skin-cancer-surgery-handout.pdf","host":"melanomasurgery.ucsf.edu","quote":"Your incision site opens up","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"W2","text":"Excessive drainage from the incision","urgency":"contact_clinic","general":false,"source":{"url":"https://melanomasurgery.ucsf.edu/sites/default/files/2023-09/ucsf-melanoma-and-skin-cancer-surgery-handout.pdf","host":"melanomasurgery.ucsf.edu","quote":"There is excessive drainage from the incision.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},{"id":"W3","text":"Pain medication does not control pain","urgency":"contact_clinic","general":false,"source":{"url":"https://melanomasurgery.ucsf.edu/sites/default/files/2023-09/ucsf-melanoma-and-skin-cancer-surgery-handout.pdf","host":"melanomasurgery.ucsf.edu","quote":"The pain medication does not control your pain","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Home doctor needs the clinic's follow-up recommendations in a written discharge summary","document":"discharge summary","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"When you have treatment abroad, you must ask the treatment provider for their follow-up recommendations documented within a written discharge summary in English.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T2","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T4","text":"Home doctor needs the dates for required blood tests and follow-up appointments","document":"written aftercare plan","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"This should include any medication and doses, as well as any dates that blood tests and follow-up appointments must be carried out.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"Surgery is impractical or contraindicated for melanoma in situ","name":"Radiation therapy","source":{"url":"https://www.aad.org/member/clinical-quality/guidelines/melanoma","host":"aad.org","quote":"Nonsurgical approaches (imiquimod and traditional forms of radiation therapy) should only be considered if surgery is impractical or contraindicated, and only for melanoma in situ, lentigo maligna type, as the cure rates associated with these treatments are lower.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200},"operation_id":null}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"technique_details":{"status":"ok","items":[{"id":"wide-local-excision-with-primary-closure","name":"Wide local excision with primary 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