General and Emergency Surgery

Ospedale San Raffaele

key figures 

CLINICAL SERVICES:

  • Emergency Surgery
  • Major Abdominal Non- Emergency Surgery
  • Day- Surgery and Week-Surgery
  • Wound Clinics
  • Post-ED Clinics
  • Minor Surgery Clinics
  • Operating Room

PROCEDURES PERFORMED PER YEAR:

  • About 1.445 procedures performed

The General and Emergency Surgery Unit deals with the advanced management of all acute onset surgical pathologies that represent an emergency, as well as all the main pathologies of surgical relevance of the gastroenteric, hepato-biliopancreatic and of the abdominal wall. The most advanced surgical techniques are used (open surgery and laparoscopic surgery, damage control surgery for polytrauma patient management, advanced multidisciplinary management of acute and non-acute surgical patient).

The Unit prides itself on the collaboration between multidisciplinary teams that make use of advanced diagnostic and therapeutic resources. General surgeons are assisted by physicians from the traditional radiology, interventional radiology, angiography and anaesthesiologists-resuscitators, to allow for a timely diagnosis and optimal treatment of urgent and non-urgent pathologies.

The surgical staff is also distinguished for its expertise in polytrauma patient management thanks to the presence of a constantly available trauma team, with members and instructors from leading scientific societies specialized in this type of treatment. In Italy, the Unit is considered a reference point for this type of pathology.

 

treatmentS

Emergency Surgery

The clinical pathway is personalised for each patient with a multidisciplinary approach and with the use of the most advanced technologies available. This allows patients to receive the best preoperative evaluation, surgical intervention as well as management of the postoperative recovery period. For the postoperative period in particular, a team of dedicated specialists is able to provide monitoring and medical counselling at a distance, allowing the patient to be supervised and cared for even after discharge.

Main Pathologies Treated:

  • Polytraumatic patients
  • Acute appendicitis, acute cholecystitis
  • Intestinal occlusion due to tumour and / or adherence
  • Complicated inguinal hernias
  • Complicated stomach conditions
    • Bleeding or perforated gastroduodenal ulcers
    • Bleeding stomach tumours
    • Perforated or conditioning gastric stenosis
  • Complicated colon disorders
    • Bleeding tumours
    • Colonic stenosis with intestinal obstruction
    • Diverticulitis associated with peritonitis
    • Colic perforations
  • Traumatic pathology of the spleen (with laparoscopic approach if possible)
  • Complicated inflammatory bowel diseases
  • Digestive haemorrhages
  • Complicated incisional hernia

Top Surgical Procedures:

  • Laparoscopy in emergency surgery
  • Damage control surgery
  • Open abdomen management

Major Abdominal Non-Emergency Surgery

Minimally invasive laparoscopic approach is the technique of choice for the main pathologies, both in non-urgent and in emergency cases such as acute appendicitis, cholelithiasis and acute cholecystitis, intestinal obstruction, perforation of gastroduodenal ulcers, unknown peritonitis, haemorrhage from tumours stomach stromal etc. A team of specialists have a well-established surgical patient pathway (from diagnosis, through surgical procedure, to surgical follow up), combined with a patient tailored approach, and an enhanced recovery after surgery protocols (ERAS). This protocol aims at maintaining preoperative organ functions and reducing the stress response following the surgical intervention in order to achieve early recovery.

Main Pathologies Treated:

  • Upper and lower gastrointestinal disorders;
  • Pathologies of the hepatic-biliary-pancreatic system
  • Abdominal wall conditions including:
    • Incisional hernia
    • Spigelian hernia (with traditional or laparoscopic approach)
  • Spleen conditions mainly treated via laparoscopy:
    • Benign and Malignant
    • Cysts
    • Lymphomas
    • Localizations of other tumours

Top Surgical Procedures:

  • Minimally invasive colon resection
  • Total and partial stomach resections
  • Abdominal wall hernia repair

Day-Surgery and Week-Surgery  

Alongside emergency surgery (intensive care), the team deals with low and medium-intensity surgery defines as week surgery and day surgery of the General Surgery Unit, using the most advanced treatment methods (open-traditional and / or minimally invasive surgery) that are customized according to the specific characteristics of the individual patient (tailored surgery).

Main Pathologies Treated:

  • Gallstones
  • Inguinal hernia
  • Umbilical hernia
  • Proctological diseases:
    • Haemorrhoids
    • Anal fissure
    • Anal polyps
    • Fistulas
    • Perianal abscesses
  • Surgical treatment of lymph node diseases (for diagnostic-therapeutic purposes)
  • Pilonidal cyst

Top Surgical Procedures:

  • Laparoscopic cholecystectomy
  • Hernioplasty
  • Surgical excision of lipomas and cysts

 

NOTABLE ADVANCED TECHNOLOGICAL EQUIPMENT

  • Negative pressure for open abdomen management system
  • UpToDate energy surgical device (harmonic scalpel)
  • Advanced mash for hernia repair
    • Non-absorbable
    • Partially absorbable  
    • Biological
  • Advanced haemostatic tools
    • Fibrin glue
    • Platelet derivatives
  • Most recent mechanical staplers