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The terms ‘general surgery’ and ‘abdominal surgery’ intercross but the general surgery has a wider sphere, including skin and soft tissues treatment not only in intestinal area. Abdominal surgery normally is open surgery done through the abdominal wall. It includes operations on inner organs and bowels, and some other issues as inguinal hernia. Its first and easiest representative is appendectomy, and, presently, it is difficult to imagine that some time ago appendicitis could be a mortal disease. Despite of development of minimally invasive methods, there are still many conditions which are treated with open surgery only.
In 2019, more than one in three hospital patients in Germany underwent surgery - a total of a good 7.1 million people. This is shown by a current evaluation by the Federal Statistical Office. The proportion of inpatient interventions has not changed compared to the previous year.
More than half of the surgeons treated in 2019 were 60 years and older. Most of them had surgery on the intestine followed by surgery on the bile. In addition to age, the operations that were performed also depended heavily on gender.
The three most common surgeries for women 2019:
The three most common operations for men in 2019:
The three most common operations for children in 2019:
Acute condition sometimes of uncertain origin;
Exploratory laporotomy is normally undertaken to examine inner situation in case of penetrating trauma or other reasons causing the internal bleeding. The middle incision is made and all the possible sources of bleeding or suppurations are found and examined. The associated surgery may be applied when needed, as liver resection or colon treatment. The purpose of the procedure is to find a lesion of possible infections and peritonitis and eliminated them immediately or postponed. If further invasion is required the incision could be temporary stitched or closed till the prolongation of the treatment.
Inguinal Hernia is a disorder in which a part of inner abdominal content, such as a bowel, protrudes through the thinned abdominal wall. It is not always dangerous but quite annoying. When it is not treated it could lead to sudden life-threatening condition.
The symptoms of inguinal hernia are:
The hernia has becoming dangerous when it is incarcerated. It causes many growing symptoms including fever, nausea, vomiting, and sudden pain. In this stage, it is necessary to contact a doctor as soon as possible.
Hernia could be treated with open surgery or laparoscopy with local anesthesia. A surgeon make an incision, pushes the bulge inside and stitch.
Some patients experience chronic inflammatory disease which is not cured with medication. In those cases the surgery could be advised. During the procedure, the surgeon examines the intestine and cures the revealed problems. Sometimes that could be ulcerative colitis or blockages in the intestine. Crohn’s disease which is a combinatory disease of complex genesis also could be treated during the surgery.
The relive after abdominal operation always takes longer, than after many others type of surgery. As it often involves the bowel, the patients experience difficulties with eating and feel weakness. One of the possible postoperative conditions is ileus, preventing the patients from taking a food. It is important part of postoperative recovery is to restore the normal digestion.
Another reason is a pain. The irritated inner organs cause significant pain, especially, if treatment was in colorectal area. The patients are prescribed the pain killers and mild sedative medicine. For more effective reliving the pain, 0-10 scale of pain indication is used, where “0” is “no pain” and “10” is “worst pain I ever had”. For sure, cooperation of the patients is needed.
At present, to avoid above complications minimally invasive techniques are used in all the cases, when possible. They are not applicable in every case, for example, laparoscopy is not very good at emergency and when excessive internal bleeding, also it is not used for big lesions, but in many cases it is effective alternative to the open surgery, which allows to reduce the risk of infections and inflammations.
Laparoscopy is also a good diagnostic method, helping to find hidden cysts and other neoplasm. In one procedure, it is possible to reveal the problem, to perform surgery and to take the material for biopsy. Today, this technique is widely used in every clinic in Germany and to find your surgeon you need only to make a call. It is your right to choose from the best.
02.05.2019
A second "DaVinci Xi" has recently been made available to the Surgical University Hospital Heidelberg. The robot is the latest generation in its class and is now being used to support minimally invasive procedures.
"The focus is on surgery on the large and small intestine and the pancreas. A large part of the open surgical procedures can thus be carried out in future with robot support. In addition, the 'Xi' is also used in stomach and esophageal surgery as well as in liver surgery", explains Professor Markus W. Büchler, Medical Director of the Department of General, Visceral and Transplantation Surgery. "With the new system, the number of robot-assisted surgeries in the abdominal surgery area will increase from around 20 to planned 200 surgeries a year", adds Professor Thilo Hackert, Senior Physician and Head of the Department of Pancreatic Surgery at the clinic.
Especially in complex operations, the robot offers the highest precision and a three-dimensional function of the instruments that enable wrist-like movements during preparation and reconstruction. Professor Thilo Hackert: "Precise movements are possible in the smallest space in the body, so that the finest organ structures are protected and even seams can be created with the utmost precision during reconstruction. The Xi robot is clearly superior in terms of vision and degrees of freedom in the operation movements and also allows highly complex interventions in which minimally invasive surgery otherwise reaches its limits."
The large incision with which the surgeon must open the abdominal wall or thorax during an open operation is eliminated in robotic surgery. Instead, five to six small cuts are sufficient, through which the instruments are brought into the body via sleeves (so-called trocars). When this is done, the "DaVinci" takes over the movement of the instruments. The surgeon sits on a console and controls the robotic arms from there.
With these, the tissue can be taken and cut, in addition, the instruments can be changed and used. Over a three-dimensional high-resolution camera image, the surgeon sees the operating area enlarged ten times, in addition, there is a digital zoom.
02.05.2019
Professor Matthias Kemen, Chief Physician of the Clinics for General and Visceral Surgery at the Protestant Hospital Herne, has been named the top abdominal surgeon in Germany by "Focus Gesundheit".
His treatment successes in the areas stomach, intestine, pancreas and liver were evaluated. Important for the evaluation were, among other things, recommendations from patients and medical colleagues.
A total of 300 inpatient and 300 outpatient procedures.
In the spring, the magazine had already named Kemen as one of Germany's leading obesity surgeons. In the same issue, he was also listed as a top nutritionist.
The current issue is about visceral surgery, ie abdominal surgery. A total of 3,000 inpatient and 300 outpatient procedures are performed annually in Herne. The stomach surgery beats with more than 150 interventions annually.
"I'm glad that in the area of the stomach obviously our many innovative treatment methods were important," says Kemen.
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