Visceral Surgery

Visceral surgery deals with diseases affecting organs of the digestive system, the peritoneum and other organs in the abdomen such as the spleen, extending to encompass the endocrine glands (such as the thyroid). Our surgeons use both conventional surgical methods (laparotomy) and ultramodern minimally invasive methods such as laparoscopy (inserting specialised surgical instruments through keyhole incisions and controlling them using a camera which shows the affected organs in real time). Visceral surgery also includes endocrinological procedures, interventions involving the mammary gland, surgical oncology and proctology (conditions affecting the anus or rectum).

Many abdominal conditions and symptoms require surgical treatment. These operations can usually be carried out via small incisions, but sometimes larger incisions are required. Often, they involve the partial or complete removal of organs (such as the gall bladder, tumours or inflamed areas) or organ repair (for example in the case of an inguinal hernia or bowel prolapse). 

We offer the following for the conditions listed:

Colorectal surgery (colon)

• Tumours (malignant and benign)
• Diverticular disease (acute inflammation)
• Chronic inflammatory disease (ulcerative colitis, Crohn’s disease)
• Rectal prolapse
• Appendicitis (acute inflammation of the appendix) or other diseases affecting the appendix

Hepato-biliary surgery (liver, biliary ducts, gall bladder)

• Gallstones in gall bladder
• Gallstones in biliary ducts
• Liver tumours (benign, malignant, metastases)
• Alveolar hydatid disease

Pancreatic tumours

• Tumours

Stomach

• Reflux disease

Small intestine

• Adhesions (adhesions of scars or within the abdomen following inflammation or surgery)
• Tumours

Highly specialised rectal surgery

• Specialised functional and reconstructive proctology (sphincter reconstruction)
• Pacemaker fitting for the sphincter
• Defecation disorders

Hernias

• Inguinal hernias
• Abdominal hernias
• Incisional hernias

Miscellaneous

• Bariatric surgery (weight-loss surgery)
• Spleen removal
• Biopsy (tissue sample, including from difficult-to-reach sites)

Visceral surgery includes the surgical treatment of internal organs, i.e. the gastrointestinal tract from the oesophagus to the anus, the liver, gall bladder, pancreas, spleen and retroperitoneal area. Treating abdominal diseases also falls within the remit of visceral surgery; this primarily entails treating hernias of all types.

Abdomen

Hernias:a hernia is a weakness or tear when an organ protrudes through a muscle wall. More specifically, it is the stretching and then rupture of an existing (typically on the inguinal canal) or recent (typically an incisional hernia) weakness in the abdomen. Inguinal hernias are usually found:
– Above the inguinal ligament
– Below the inguinal ligament

Incisional hernias:
Weaknesses in the abdominal wall following surgery.
Other:
– Rare hernias, e.g. Spigelian hernias
– Pelvic floor hernias
– Lumbar hernias

Gastrointestinal tract

Stomach:
– Reflux disease
– Diaphragmatic (hiatal) hernia
– Tumours (benign, malignant)

Small intestine:
– Tumours (malignant, benign)
– Adhesions (scars caused by surgery or inflammation)
– Inflammatory diseases (Crohn’s disease)
– Rare conditions (Meckel’s diverticulum, rare tumours)

Colon:
– Diverticular disease
– Colon tumours
– Other inflammation

Rectum:
– Rectal tumours
– Partial or complete rectal prolapse

Surgical techniques and technology

Surgeons choose between two methods for abdominal surgery:

open and laparoscopic.

Open

The abdomen is opened using one relatively large incision (in certain cases this will run from the breastbone to the pubic bone). Pros: significantly more tactile option for the surgeon, makes it easier to carry out complex interventions involving several organs and several stitches. Cons: postoperative pain, high risk of incisional hernia (up to 20%), increased risk of abdominal adhesions and associated problems (up to 30%).

Laparoscopic (keyhole, minimally invasive)

The abdomen is filled with carbon dioxide gas via a small incision. A trocar (access tube) is then used to gain visuals in the abdomen via a state-of-the-art video camera feed to a screen.

Pros:         

• Significantly reduced pain
• Significantly quicker recovery
• Significantly lower risk of postoperative incisional hernia
• Significantly lower risk of postoperative abdominal adhesions
• Less blood loss

Cons:       

• Requires expensive technology: 3-chip HD camera, HD screen, state-of-the-art CO₂ insufflation unit, cold-light source, specialist instruments
• Restricted tactile perception
• 2D image
• Restrictive for complex interventions