Endoscopic Procedures (Gastroscopy, Colonoscopy)
Endoscopy, which lexically means looking inside, has an important place in the diagnosis of digestive system diseases and is the gold standard in the diagnosis of many diseases. Gastroscopy, that is, looking at the stomach, provides information about the esophagus, stomach and duodenum. Inflammatory, physical and cancerous diseases of these organs are diagnosed and a biopsy can be taken at the same time.
Similarly, colon and rectum, that is, large intestine cancers, which we see frequently today, can be diagnosed with colonoscopy, that is, the large intestine, and the diagnosis can be made by taking a biopsy. Both procedures can be performed by taking into account the comfort of the patient with the application of light anesthesia, which we call sedation. It is recommended that everyone in the population over the age of 50 should have a colonoscopy. In this way, the polyps that constitute the initial stage of colon cancer can be seen and generally cleaned in the same session. In this way, lesions that may cause cancer in the future can be cleaned from the intestine.
All Biopsy Procedures
Biopsy, which is applied especially for the definitive diagnosis of cancer, is the pathological examination of a tissue piece taken from different parts of the body such as breast and thyroid to reach a definitive result. The structure of the tissue is examined, and if there is a tumor, its type can be determined. The results obtained from the biopsy are also useful in the part of the treatment to be applied to the tissue and its surroundings. Biopsy does not cause the disease to spread or worsen.
While open surgery was used to take a piece of tissue in the past, today, thanks to advanced technologies, tissue removal, namely, biopsy, has started to be performed using different needles. During the biopsy, it is determined by which method the suspicious mass in the relevant organ can be seen most appropriately. Thus, the location of the suspicious mass is determined clearly. The biopsy, which is applied with local anesthesia, enters the targeted lesion with a needle and takes small pieces. The pieces taken are examined in the pathology laboratory. There are no cuts and stitches in the biopsy process, which takes about 15-20 minutes.
Outpatient Surgery (Day Surgery)
In recent years, in parallel with the developments in patient monitoring and the advances in anesthesia and surgical technique, there has been a shift in health services from surgical procedures that require high cost long-term hospital care to surgical procedures where patients can be sent home on the same day after surgery.
Same-day surgery is a surgical procedure in which patients are sent home the same day after the surgery is performed.
Laparoscopic (Minimally Invasive) Surgery
Minimally invasive surgery is performed with cameras and hand tools inserted through 0.5-1 cm incisions in the anterior abdominal wall. It is a method used in many areas from hernia to heart surgery and is performed with the basic principles of open surgery. The most important difference between the two techniques is that the minimally invasive procedure is performed by means of a camera and hand tools inserted through small holes.
The most frequently performed minimally invasive surgical intervention today is the removal of the gallbladder with the help of laparoscopy, also called "laparoscopic cholecystectomy". However, many general surgery operations, especially inguinal hernia, appendicitis, reflux and gastric hernia operations, are performed laparoscopically. In addition, in cases where the spleen or adrenal gland needs to be removed, laparoscopic surgery is also used in colon cancers. • Trauma and Emergency Surgery
Trauma and Emergency Surgery, we provide services for trauma patients with an experienced general surgery, orthopedics and neurosurgery team.
Surgical Diseases of the Endocrine System
It is the system that transmits information from one part of the body to another part through chemical signals called “hormones” in the bloodstream. It helps to maintain and maintain balance by providing control and coordination with all other systems of the body. Too little or too much hormone in the blood, or the body's unresponsiveness to the hormones secreted, indicates the presence of a problem related to the endocrine system. Diseases of the endocrine system organs may be caused by tumors (malignant/benign) or by various reasons that impair organ functioning. Endocrinologists and general surgeons should work together in the treatment of these diseases.
Although there are many endocrine system organs in our body, the organs treated with surgery within the scope of general surgery are Thyroid and Parathyroid glands, Adrenal (Adrenal) glands and pancreas.
Breast Diseases Diagnosis and Cancer Treatment
What are the symptoms of breast cancer?
- Palpable mass (stiffness, swelling) in the breast or armpit
- Nipple discharge,
- Inward retraction, collapse or deformity of the nipple,
- Wound or redness of the breast skin,
- Edema, swelling and inward retraction of the breast skin (orange peel appearance),
- Breast enlargement or asymmetry,
- Muscle pain,
- In some patients, cancer can be detected on mammography without any of these symptoms.
What are the risk factors for breast cancer?
- Although age breast cancer can occur at any age, its incidence increases after the age of 40-50. Breast cancer develops in one out of every 8 women over the age of 85,
- Known history of breast cancer. Having previously treated cancer in the same or other breast of the patient increases the risk of developing cancer again,
- Family history of breast cancer. Detection of breast cancer in the family members of the patient poses a risk for breast cancer. Detection of breast cancer in the mother and sisters means 2-3 times increased risk for the patient. The risk is higher if breast cancer occurs at premenopausal age and in both breasts,
- Genetic predisposition. Genetic factors play a role in 5-10% of breast cancers. This rate is higher especially in breast cancers that occur at an early age. Defects in the BRCA1 and BRCA2 genes are the most important cause of genetic breast cancer,
- Prolonged exposure to estrogen and estrogen therapy. Women who are exposed to estrogen for a long time have an increased risk of breast cancer. This may be due to the use of estrogen for any reason, or it may be in the form of early puberty or late menopause. The risk is also increased in women who do not bear children or become mothers at a late age
- Having received radiation therapy,
- Obesity,
- Smoking,
- Hormone therapy. Breast cancer is more common in women receiving hormone therapy after menopause
- Precancerous lesions. Detection of atypical ductal hyperplasia or carcinoma in situ in breast biopsies performed previously for any reason increases the risk of cancer.
What are the methods used in the diagnosis and screening of breast cancer?
Mammography
Mammography is a very valuable method in the diagnosis and mass screening of breast cancer. Especially after the age of 50, diagnostic reliability is higher. A mammogram is recommended for every woman after the age of 40.
Ultrasonography
It is useful in distinguishing whether the mass is filled with fluid (cystic mass), especially in patients with a palpable mass in the breast.
Magnetic Resonance (MR)
Although the price of MRI in the breast is expensive, it can be preferred due to its high level of diagnostic reliability. It can be used to investigate whether there is another hidden tumor in patients who are planned for breast protective surgery.
Genetic tests
After establishing a relationship between the mutation of the BRCA1 and BRCA2 genes and genetic breast cancer, mutations in these genes can be detected in high-risk patients with a blood test.
Oncological Surgery
Surgery is the removal of cancerous tissue from the body. It is a method of surgical treatment in many cancers and surgical treatment is provided in some cancers. Surgery is also a treatment method used for biopsy, staging, side effects and reduction of pain. Side effects of surgical treatment depend on the type of surgery and the patient's general health before treatment. The most common side effect is pain, which is easily treatable in most patients.
The most distinctive difference of cancer surgery from other surgeries is that the tumor tissue is completely removed together with the lymph nodes and all the associated organs, without touching the tumor as much as possible, without drilling, and especially in therapeutic cancer surgeries, by always recovering healthy tissue around it.
Chemotherapy Port
Chemotherapy applied in Oncology can cause damage to the veins of the hand and arm. There may even be difficulties in administering medication. In order to prevent it and not to disrupt chemotherapy, the ports can be applied under local anesthesia in a same-day procedure. We advance the tip of the catheter up to the heart. With the help of the scope, we check whether the catheter is in place. We place the reservoir of the port under the skin. It does not prevent the patient from entering the MRI. Depending on the patient's condition, it can remain in the body for 1-3 years without causing any harm. All kinds of chemotherapy medications, medications that need to be administered through other veins, and blood and blood products can be administered easily from the port. It can be easily removed with the information and advice of your doctor when the patient no longer needs it.
Laparoscopic Rectum and Colon Surgery
Laparoscopic Rectum and Colon Surgery
Laparoscopy is a surgical procedure which helps diagnosis and treatment, done by opening holes to enter in the navel and abdomen of the patients, the image is projected onto the optical device, carbon dioxide gas is given to better visualize the organs in the abdomen. In rectal and colon surgery, it can be applied in selected early-stage cancer cases, albeit less frequently than open surgery. The operated organ is taken out of the abdomen through an incision similar to the cesarean section.
Stomach Cancer Surgery
In patients with stomach cancer, the disease progresses insidiously, where the patients have hunger pangs and indigestion, coupled with bitter and sour water coming to their mouths, but they never consult a doctor. When there is unexplained weight loss and loss of appetite, then they visit doctor, but the disease will have already progressed. Sometimes they have weakness, slowly bleeding cancer causes blood loss in the patient. Their skin may be off-white. Sometimes the cancer progresses to a level that they cannot eat or drink water. The important thing is to detect stomach cancer on time, namely, at an early stage while the complaints are still minor. The best diagnosis is early diagnosis and urgent endoscopy. During endoscopy, cancer is diagnosed and biopsies are taken.
Surgery is the best method of treatment, if possible. It can be performed laparoscopically (closed) or open, depending on the type and location. If it cannot be done, chemotherapy can be applied. These treatment options are decided according to the stage of the disease.
Liver and Biliary Tract Cancer Surgery
Proper and necessary treatments are provided to the cancer patients who need to have the right and left lobes of the liver removed if necessary by open method in liver cancer, or patients who have been previously treated for a disease such as colon and large intestine cancer and have spread to the liver.
The only and first treatment for gallstones is surgery. The gold standard method is laparoscopic cholecystectomy. Laparoscopic treatment of gallstones and non-surgical endoscopic treatment of gallstones are done with successful results.
Esophagus Surgery
The esophagus is a tube structure consisting of two layers of muscle tissue that carries the food we eat from our mouth to our stomach. Today, more than 80% of esophageal surgery is performed with closed methods. Although other diseases other than reflux are not well known, the majority of people with swallowing difficulties are faced with a problem related to the esophagus. Esophageal Cancer, Diverticulum, Achalasia, and movement disorders are seen. •
Pancreatic Cancer Surgery
In the eyes of both physicians and patients, pancreatic surgery has a different place compared to other surgeries of general surgery for many different reasons. It is positioned differently due to the anatomical structure of the pancreas, its proximity to very different organs, its close relationship with very important vascular structures, the necessity of interventions related to these vessels during pancreatic surgery, the high incidence of problems related to some pancreatic surgeries after surgery, and the low frequency of pancreatic surgeries. Pancreas surgeries vary widely. Not all surgical procedures have same degree of difficulty, pancrease surgery is the most complex and challenging surgical intervention in general surger.
Reflux Disease Hiatus Hernia (Stomach Hernia)
Reflux occurs in many people after a meal, such as heartburn, indigestion and burning in the esophagus. This situation becomes more evident with the food acid coming up to the mouth. While some people experience this uncomfortable feeling temporarily, it is a frequently recurring situation in some people. A hiatus hernia is the leakage of part of the stomach into the chest cavity. Endoscopic diagnosis of reflux and hiatus hernia and their treatment with laparoscopic method in clinically appropriate patients are performed.
Treatment of Anorectal Diseases
Anorectal diseases
Diagnosis and high-technology treatment are provided for the anorectal diseases such as Hemorrhoids, Anal Fissure, Anal Fistula, Condyloma, which impair the comfort of the patient such as rectal bleeding, itching, pain, difficulty in defecation, and inability to sit.
Peritoneal Carcinomatosis (Tumours of the peritoneum and intra-abdominal warm chemotherapy (HIPEC))
The cancer of the membrane that surrounds the organs in our abdomen, which we call peritoneum, is called peritoneal carcinomatosis. It can be in the form of cancer in other organs, or it can be cancer of the membrane itself. The most commonly encountered is the spread of diseases of other organs to this membrane, accompanied by the formation of fluid in the abdomen, which is called ascites. This patient group, which is mostly characterized as advanced stage, is treated only in limited number of centers.
In this patient group, it will be decided if patient can receive surgery after evaluation upon information exchange among surgeon, oncologist, radiologist and gastroenterologist. In patients who will receive this surgery, this membrane should be removed together with the organs involved in the abdomen. After the diseased tissue in the abdomen is cleaned, the administration of heated chemotherapy into the abdomen, which we call HIPEK, can be applied in the same session, using a chemotherapy drug suitable for the predetermined disease.
Hernia Surgery
A hernia is the displacement of a tissue or organ to another place as a result of the rupture of the wall in between. It occurs in the groin and navel, as they are often the weakest points in the abdomen. In addition, a hernia may develop from the site of previous surgical wounds. Causes include lifting a heavy item, congenital tissue weakness, muscle diseases, chronic cough and constipation, obesity, and smoking.
If the hernia is not treated, it can lead to restlessness, pain, constipation and even decay of the organ depending on the trapped organ. Therefore, it should be treated without delay. In the treatment, first of all, the damaged part is repaired and if necessary, it is supported with a patch. These surgeries can be performed with the open technique as well as the closed method called as laparoscopy. Thanks to laparoscopic surgery, the patient can return to his daily life in a short time after staying in the hospital for one night.
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