Surgery & Visceral Surgery

General surgery concentrates on the surgical treatment of diseases of the digestive tract including the oesophagus, stomach, small and large intestine, rectum, liver and pancreas. Furthermore, diseases of the abdominal wall (inguinal, umbilical and incisional hernia), the thyroid and parathyroid glands, the spleen, hand and vascular surgical diseases are treated by the general surgeon.

Due to the wide range of services that are covered, the prerequisites for optimal therapy are respectful conduct, competent counselling and the close cooperation with surgeons and specialists of other disciplines who specialise in specific areas.

 

Learn more about our range of surgical services ...

 

Services in our practice::

  • Initial consultation with specialist
  • Planning of the therapy with detailed explanation of the surgery
  • Discussion of the findings
  • Clinical examinations
  • Wound checks with removal of sutures or staples
  • Aftercare

 

Range of surgical services:

  • Operations for cholelithiasis / gallstone diseases
  • Minimally invasive intestinal surgery for inflammatory and malignant diseases
  • Hernia repair for inguinal hernia, umbilical hernia, incisional hernia, minimally invasive as well as open surgical technique e.g.: operation according to Lichtenstein, component separation for large and complex hernias, TAPP, IPOM, PUMP, EMILOS
  • Proctological operations – e.g.: anal fissure, anal fistula, anal abscess, phlebpthrombosis, haemorrhoid operations e.g.: HAL/RAR- Haemorrhoidal Artery Ligation and Recto Anal Repair
  • Pilonidal sinus – sacral dermoid
  • Treatment of varices (varicose veins and spider veins)
  • Colorectal tumour surgery – laparoscopic or open
  • Hand surgery: e.g.: carpal tunnel syndrome, ganglion, trigger finger
  • Colonoscopy – examination of the large bowel
  • Proctoscopy – examination of the rectum
  • Rectoscopy – examination of the rectum
  • Gastroscopy – examination of the upper part of gastrointestinal tract
  • Rubber band ligations
  • Removal of benign and malignant skin and subcutaneous lesions/alterations, e.g.: birthmark – nevus, staetoma – atheroma, benign fat tumour – lipoma; boil – abscess, furuncle, anal skin fold – marisca
  • Nail wedge excision – for ingrown toenails

If required, there is a close cooperation with plastic surgery.

 

Hernias / abdominal wall fractures

Hernias are all fractures in which the peritoneum bulges like a sack because of a gap or a defect in the abdominal wall. The most common abdominal wall fracture is the inguinal hernia (so-called hernia inguinalis) , which causes a protrusion above the inguinal ligament. In addition to occasional pain, especially during physical exertion, it can also lead to repeating painful incarcerations of the abdominal organs. As rare but serious complications, parts of the small or large intestine can get clamped and lead to intestinal obstruction.

Reflux Surgery
The backflow of stomach acids into the oesophagus (so-called reflux) can lead to complaints such as heartburn, sour taste in the mouth, foreign body sensation in the throat or irritable cough. Beyond that, the prolonged existence of reflux can also lead to changes in the oesophagus right up to cancer. The diagnosis is made after comprehensive medical clarification (gastroscopy, acidimetry in the oesophagus, functional swallowing X-ray).

More details about the treatment...

As part of the 24-hours impedance measurement, the acid load of the oesophagus is measured, recorded and evaluated. The measurement is performed on an outpatient basis; the measurement device can be taken home. Surgical treatment of a reflux disease is not always necessary and sensible. If, however, there is no improvement in the symptoms after a treatment with medication and a change in lifestyle, or if precursors of a malignant disease of the oesophagus develop, the diaphragmatic hernia (so-called hiatus hernia) which probably exists is repaired using the minimally invasive technique. Additionally, a cuff of the gastric fundus (fundoplication) is formed into a valve against the acid reflux.

Bowel Surgery

Malignant diseases of the colon rank among the most common types of cancer in Europe, along with breast, lung and prostate cancer. Changes in the colon are sometimes caused by inflammations which might make a surgical treatment necessary. One example is the diverticulum disease, in which small sack-like evaginations inside of the colon can cause repeating inflammations, abscesses, fistulae (e.g. into the urinary bladder) but can also lead to the development of narrowings (so-called stenoses) causing stool irregularities or pain. Inflammatory bowel diseasesdiseases (IBD) such as Chron’s disease or ulcerative colitis are treated primarily with medication. A surgical treatment becomes only necessary in case of complications such as stenoses or fistulae.

Read more about Bowel Surgery...

Surgery for diseases of the small intestine or the colon can be performed using open technique and minimally invasive technique. Less pain after the operation, faster mobilisation of patients, faster recovery and shorter stays in hospitals are among the proven benefits of minimally invasive bowel surgery, which is especially beneficial for older patients. In selected cases, the SILS-technique can also be offered for intestinal surgery.

Gall bladder and bile ducts

Recurring pain in the right upper part of the abdomen is often caused by stones in the gall bladder , which irritate the gall bladder wall and can cause a (painful) inflammation of the organ. Spasmodic pain (so-called colic) can occur when small stones from the gall bladder enter the common bile duct and cause a cholestasis (bile stagnation). Furthermore, gallstones can also lead to a valve-like closure of excretory duct of the pancreas which can cause an inflammation of the pancreas (so-called pancreatitis).

Further details about the therapy...

The surgical treatment of a symptomatic stone gall bladder consists of the removal of the gall bladder (so-called cholecystectomy). This procedure is usually performed using the minimally invasive technique with several small incisions (buttonhole surgery). By now, however, I offer to perform this procedure standardly in SILS technique (Single Incision Laparoscopic Surgery – minimally invasive surgery via an incision in the navel; so-called scarless surgery). The removal of stones from the bile ducts is usually performed endoscopically (see also the endoscopy of the gastrointestinal tract/ ERCP).

Endoscopy of the gastrointestinal tract

Painless endoscopy (gastrointestinal endoscopy) – removal of polyps (incl. narrow-band-imaging and chromoendoscopy) – interventions for the treatment of narrowings in the gastrointestinal tract (balloon dilatation, stent).

Impedance measurement (outpatient 24-hour measurement to clarify reflux disease)

You can find further information about the endoscopic method here...

ERCP (Endoscopic retrograde cholangiopancreatography): endoscopic method by which therapeutic procedures on the bile ducts and the pancreatic duct can be performed. During the examination, the joint orifice of the bile duct and the pancreatic duct (so-called “Papilla duodeni major”) is explored with a side-view endoscope. By administering X-ray contrast medium via the probe, the duct systems are made visible to make it possible to identify abnormal changes. After the Vater’s ampulla has been extended via incision (so-called papillotomy) a balloon for stretching the narrowings or a wire basket for crushing or retrieving stones can be inserted. Plastic or metal stents can be inserted to ensure safe drainage.

 

Oncology and aftercare

The best possible drug treatment for advanced malignant diseases is just as important as the well-executed surgery itself. In the course of an interdisciplinary session, a treatment plan in collaboration with oncological internists, radiologists and pathologists will be tailored to your individual needs and afterwards discussed with you. In the case of malignant diseases of the gastrointestinal tract, regular laboratory and X-ray examinations as well as endoscopic check-ups are part of an adequate aftercare. With the help of a reliable contact person, who takes care of examination intervals and the evaluation of all findings, a lot of pressure can be taken from the already stressful situation.

Hand Surgery

A ganglion is a spheroid tight-elastic evagination originating from the joint capsule or the tendon sheath in the area of the hand or fingers. They are not tumours in the conventional sense (neoformation and proliferation of cells), but cysts filled with fluid. Malignant degenerations do not occur, but ganglions can be painful and perceived as very distracting in your daily work. The surgical treatment consists in the removal of the ganglion. Operations on ganglia on the fingers can be performed under local anaesthesia, wrist ganglia are operated under general anaesthesia.

Other core areas of hand surgery (trigger finger, carpal tunnel syndrome, Dupuytren's contracture)...

A Trigger Finger (so-called Tendovaginitis stenosans) is when a “snapping” or “snagging” of a finger occurs when bending or opening the hand. The disease is caused by a thickened flexor tendon, which can no longer slide freely through the ring ligament in the base joint of the finger (A1 ring ligament). The surgical treatment consists of the splitting of the A1 ring ligament through a small cut in the area of the palm of the hand. Ring ligament splitting can be performed under local anaesthesia as well as general anaesthesia.

The Carpal Tunnel Syndrome (CTS) is characterised by the occurrence of pain in the area of the hand, especially at night, discomfort in the area of the thumb, index and middle finger, weakness in the grip and reduction of the sense of touch, all of which might result in an increasing clumsiness. If the conservative treatment with a night splint is not successful, the channel in which the affected nerve runs (so-called median nerve) can be widened by the splitting of a transverse band. The procedure is usually performed under general anaesthesia, but can also be done under a local anaesthesia of the median nerve (using a so-called median nerve block).

A Dupuytren’s Contracture is a benign disorder of the connective tissue of the middle of the palm (palmar aponeurosis). Cords and knots occur at the palmar aponeurosis and this might lead to restriction of movement in the area of the finger base- and middle joints (flexion contracture). The surgical treatment consists of the removal of the affected connective tissue under general anaesthesia.

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