Gastrointestinal Surgery

Ospedale San Raffaele

key figures 

CLINICAL SERVICES:

  • Surgery of the Gastrointestinal tract
  • Surgery of the Endocrine Glands
  • Surgery of the Abdominal Wall Defects
  • Surgery of the Spleen
  • Day and ambulatory surgery

PROCEDURES PERFORMED PER YEAR:

  • 2.000 surgical procedures of which:
    • About 700 Digestive Tract Procedures (colorectal and upper GI)
    • About 400 Endocrine Glands and Thyroids Procedures  
    • About 200 gallbladder and biliary tract
    • Abdominal wall defects, proctology
  • 5.000 outpatient services

The Gastrointestinal Surgery Unit performs approximately 2,000 procedures per year and more than 5,000 outpatient services. It has one of the largest and most consolidated Italian series in open and minimally invasive treatment of the malignant and functional diseases of the upper digestive tracts (oesophagus and stomach), of the colon, of the rectum and of the anal canal. Each oncologic case is discussed in a multidisciplinary tumour board meeting involving all specialists dedicated to this area of interest from various departments such as Oncology, Radiotherapy, Radiology, and Digestive Endoscopy in order to ensure the optimal personalized approach in accordance with the most current guidelines and with state-of-the-art therapy protocols.

In line with the development of modern surgery, most of the diseases are treated by minimally invasive approach, through laparoscopy, thoracoscopy and in selected cases with the Da Vinci robot. The Unit is one of the best known centers both nationally and in Europe.

 

treatmentS

Digestive Tract Diseases

The main field of interest of the Unit of Gastrointestinal Surgery is represented by diseases of the digestive tract. Malignant and benign diseases of the oesophagus, stomach, and colon-rectum are treated by standard open surgery as well as by minimally invasive approach.  As for cancers, a multidisciplinary tumour board meeting is held on a weekly basis and a "case manager" is in charge of planning the diagnostic pathway and keeping the patient constantly informed about the proper therapeutic plan. The department chaired by Professor Rosati is the Unit with the highest surgical volume in Italy concerning the treatment of oesophageal and gastric carcinoma.

Main Treated Diseases:

  • Oesophageal and Gastric Carcinoma
  • Benign diseases of the Foregut
    • Gastroesophageal reflux disease
    • Paraesophageal hernia
    • Achalasia
    • Oesophageal Diverticula
    • Oesophageal and Gastric Leiomyoma
    • Oesophageal Perforation
    • Oesophageal Duplication Cyst
    • Caustic Lesion
    • Swallowing Disorders
  • Large Bowel Diseases
    • Cancer of the colon and rectum
    • Cancer of the anal canal
    • Complicated diverticular disease
    • Inflammatory bowel disease (Crohn and Ulcerative Colitis)

Top Procedures:

  • Oesophagectomy (Ivor Lewis, McKeown, transhiatal)
  • Oesophagogastrostomy
  • Gastrectomy (total and subtotal)
  • Paraesophageal Hernia Repair
  • Oesophageal Myotomy and Fundoplication
  • Diverticulectomy
  • Hemicolectomy (right and left)
  • Total colectomy
  • Sigmoidectomy
  • Anterior Resection of the rectum (in selective cases with TATME – Trans Anal Total Mesorectal Excision)
  • Abdominoperineal Resections
  • Transanal resection of low rectal lesions (TAMIS)
  • Splenectomy

Day Surgery Activity

Particular attention has been dedicated to the organization of the day surgery activity. Laparoscopic cholecystectomy and hernia repair represent the most advanced ambulatory laparoscopic procedures in the unit. Open hernia repair and proctologic disorders are also treated under local anaesthesia on a day surgery basis.

Main Diseases Treated:

  • Adrenal Glands Diseases
  • Thyroid and Para-thyroid Diseases
  • Abdominal wall Defects
  • Inguinal Hernia
  • Proctologic Disorders

Top Procedures:

  • Thyroidectomy and Parathyroidectomy (through mini cervicotomy)
  • Adrenalectomy
  • Hernioplasty
  • Abdominal Wall Defects
  • Proctology
  • Cholecystectomy and bile duct explorations

 

NOTABLE ADVANCED TECHNOLOGICAL EQUIPMENT

  • Laparoscopic and Thoracoscopic Procedures
    • 3D, high definition 4K, fluorescence infra-red evaluation
  • Robotic Procedures
    • Da Vinci Robotic System