General Surgery

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Department of General Surgery
Our department was established in June 2010 by attempts of Dr. K. Koray Baş, followed by Dr. Hasan Besim. In February 2011, Dr. Koral Çağman joined the academic staff, as a part time staff. We are planning to recruit assistants through the Medical Specialty Aptitude Test (TUS examination) period in April, 2012.

At the moment, Dr. Hasan Besim is working as a professor, Dr. K. Koray Baş as an assistant professor, and Dr. Koral Çağman as a part time specialist. At the same time, Prof. Dr. Hasan Besim and Assist. Prof. Dr. Koray Baş are also working as editors of the Near East Medical Journal (NEMJ).

The Department of General Surgery aims to increase the public’s knowledge on health issues, and thus make contributions to general understanding of public health. In this regard, the Department is regularly taking part in broadcasts of local TV stations and in the written press. Moreover, the department also provides in service training on health issues for staff of health for both private and state sectors.

The Department of General Surgery is on duty on 24/7 basis with its polyclinic, local treatment unit, interventional surgical endoscopy unit, operating theatre, ambulatory surgery, inpatient services, intensive care and emergency surgery unit.

Polyclinic and Local Treatment Unit
Approximately 400 patients are treated at our policlinic, monthly. In order to diagnose the exact problems of the patients, the first medical examination is carried out within 30 minutes, the control process taking about 15 minutes. The Local Treatment Unit is designed in accordance with the design of an operating theatre. In this unit, it is possible to carry out every kind of interventional surgery. Furthermore, there is a patient consultant, a nurse and a surgical technician to provide comprehensive assistance to the patients who seek help from this unit.

Interventional Surgical Endoscopy Unit
At the Unit of Interventional Surgical Endoscopy, there are flexible and video endoscopes. These are utilized in the endoscopic processes for diagnosis of illnesses as esophagoscopy, gastroscopy, duodenoscopy, colonoscopy and rectoscopy.

In addition, interventional surgical endoscopy, many advanced endoscopic procedures are successfully applied to the patients. These include; collection of biopsies from suspicious areas detected during endoscopy, taking out of polyps, stopping the bleeding of regions, such as gastro-intestinal regions, without a need for surgery, the measurement of the acidity (PH metre) of the oesophagus through the use of wireless technology in patients which have oesophageal reflux and procedures of placing a balloon for the treatment of oesophageal stricture.

All of the endoscopic procedures are carried out by taking patients under sedation. By this way, patients do not suffer from any pain during the endoscopic procedures. PEG- Percutaneous endoscopic gastrostomy is applied to patients which have difficulty in feeding through the mouth; such as patients suffering from neurological diseases or chronic brain diseases. PEG is and endoscopic medical procedurein which a tube is passed into a patient’s stomach through the abdominal wall, most commonly to provide a means of feeding when oral intake is not adequate. Interventional endoscopy encompasses a variety of endoscopic procedures and Endospic Retrograde Cholangiopancreatography (ERCP) is one of them. This procedure is successfully applied to patients suffering from the congestion of the bile tract, with gallstones and mud, and is applied in the diagnosis and treatment of tumour problems. The ERCP is facilitated in an operating theatre, so as to provide the opportunity for necessary surgical applications to be proceeded, without any delay, to patients who are not responding to the treatment of ERCP.

Applications of Operating Theatre
The operating theatre is specifically designed to implement general surgeries and is fully equipped with contemporary technological equipment. Besides standard conventional and general surgical applications, advanced applications of MIS (minimally invasive surgery) are successfully applied. These are applications such as; key-hole surgery facilitated for the removal of the gall bladder through an incision (usually 0.5-1.5 cm), hernia in the belly button, inguinal hernia, operations of hernia which may develop after surgical applications, and anti-reflux operations facilitated to patients suffering from reflux.

Compared to standard open surgeries, minimal invasive surgeries, utilizing laparoscopic methods, ease the patients’ after effects by lessening pain, scar problems and decreasing the time spent in the hospital. Cancer operations on organs such as liver, bile tract, pancreas, colon and rectum and all other abdominal organs are successfully facilitated by our highly qualified staff. Removal of liver mass is carried out with collaborative work with the department of radiology. This collaboration involves the use of Radiofrequency Ablation (RFA), which is an image-guided technique that heats and destroys cancer cells. Surgeries of endocrine organs such as breast thyroid, parathyroid and suprarenal gland are carried out with the use of contemporary methods. These methods include: Biopsy of the sentinel lymph node, breast- conserving surgery; removal of the breast tissue during surgery, as opposed to the entire breast, mammographically guided stereotactic breast biopsy which is preformed when the abnormal area in the breast is too small to be detected, making it difficult to locate the lesion by hand. For patients who are required to take chemotherapy due to cancer, the structure of the blood vessels deform after taking chemotherapy for some time. For these patients, a chemotherapy port is inserted into the patients, with the use of ultrasound and angiography device so as to protect the patients’ arms from the side effects of chemotherapy. The insertion of the port is facilitated with a local anaesthesia and the process takes approximately 30 minutes.

Another contemporary approach to surgery is applied to patients undergoing a dialysis treatment due to renal failure. Before connecting patients to the dialysis device, a vascular access (Arterio Venous fistula= AV) should be prepared. In order to accomplish vascular access, vascular mapping is formed with the use of Doppler Ultrasound. This enables the location of the arteries and veins to be defined, besides enabling the determination of the diameters of the arteries and veins. A surgeon creates an AV fistula by connecting an artery to a vein, which causes more blood to flow into the vein. As a result, the vein grows larger and stronger, making repeated needle insertion for haemodialysis treatments easier. For fistulas which do not function at the expected level, an access that connects an artery to a vein using a synthetic tube, or graft, is implanted under the skin. The graft becomes an artificial vein that can be used repeatedly for needle placement and blood transfusion during haemodialysis. These processes prolong the use of the patient’s vein and meet the permanent catheter need of the patients.

We are making the necessary legal acts regarding organ transplant surgeries and are working on the relevant infrastructure so as to carry out these surgeries.

Outpatient Surgery Applications
Due to the spread of laparoscopic surgery, the length of hospital stay is decreased. A decreased length of stay at the hospital has many advantages: First of all, the risk of post surgery problems, such as infection, is decreased. Moreover, the hospital costs are lowered, thus making a great contribution to the national economy. These are the reasons why appropriate patient surgeries are facilitated and their treatments and follow ups are all completed on the same day. The relevant control examinations of these patients are carried out at the polyclinic, on the following days to surgery.

Inpatient services
The Hospital of NEU is designed in accordance with the standards and necessities of the Joint Commission International (JCI), along with a concept of contemporary hospital designs. The inpatient service has 20 wards provided to the patients for 24/7, with the assistance of nurses and health personnel. The patient wards are 12 m2, which are en-suite, equipped with a TV, central air conditioning and internet connection. They are also designed as such that patients have the opportunity to have a hospital attendant with them, upon their wish. There are also VIP rooms which have additional equipment and comfort. Furthermore, we have a staff of dieticians who facilitate nutrition appropriate o the health conditions of the patients.

Surgical Intensive Care Unit
The intensive care unit provides services through a fully equipped ward, with a capacity of 12 patients. There are also 2 isolation rooms facilitated for special circumstances of patients. Many applications such as; x-rays, ultrasound/Doppler ultrasound, hemofiltration and dialysis processes, interventional endoscopy, etc. are all applicable in the intensive care unit. These applications, diagnosis and treatment are facilitated at the patients’ bedside, without a need to mobilize them. Patients which have a high risk of infection are placed within isolation rooms, making them isolated of other patients in the intensive care. A single isolation room with appropriate air handling and ventilation is particularly important for reducing the risk of airborne transmission of microorganisms from a source patient to susceptible patients and other persons in a hospital. In addition, a multi-disciplinary approach is required for the treatment of patients in intensive care. Therefore, all branches, mainly anaesthesia and reanimation clinics, provide services for the intensive care unit.

Emergency Service Unit
We provide services of emergency general surgery to all patients in need for 24/7. Basic and advanced imaging technology services and all types of biochemistry laboratory services are available throughout the day. Moreover, the blood bank provides all types of blood to the emergency patients in need. There is an operating theatre and reanimation rooms which are kept ready for use for the patients which require emergency action.

Educational Activities
Department of General Surgery facilitates seminars, article hours and case discussion councils twice a week. Moreover, mortality-morbidity meetings are held, in collaboration with departments of pathology, radiology, and oncology. In addition to the above, general surgery basics and clinical applications courses are provided to the students of Faculty of Medicine of our university. Informative educational programs, on contemporary developments and applications in general surgery are facilitated within the scope of in service training to the health personnel of our hospital and other health centres.

Scientific Research and Academic Activities
In the academic year of 2010-2011, a total of 10 articles of our department have been published by 5 journals classified in Science Citation Index (SCI), 2 SCI- Expanded journals, 1 international refereed journal, and 2 national refereed journals. Furthermore, our studies are being evaluated and are at a stage of editorial approval by various international and national journals. We have made contributions to 2 papers published at national and international levels. We are currently continuing 3 prospective clinic studies which are approved by NEU Scientific Research Ethical Evaluation Committee.