University Medical Centre of Magdeburg
The University Clinic for General, Visceral and Vascular Surgery
PATIENTS’
GUIDE
You are cordially welcome to
The University Clinic for General, Visceral and Vascular Surgery
There are more than 100 beds in our Clinic, and it has a new central operation department with the most modern medical equipment. Outpatient surgery can be done in a day hospital in all departments. Highly skilled doctors consult regularly, so patients even with rare diseases can be provided with a competent medical opinion and right treatment. The interdisciplinary Admission office is open round-the-clock
365 days a year.
In our Clinic you can receive an optimal medical care. The most modern research achievements of the employees of our University Clinic in the field of diagnostics as well as therapeutic treatment are available to patients. Our staff is a team of highly qualified doctors, nurses, operating and assisting personnel, as well as numerous volunteers. The main goal is your quickest recovery or improvement of your health. Having this in mind, we rely not only on the modern methods and high-technological medical devices, but also on the knowledge and the experience of our engaged employees: we attach great importance to the human factor.
There will be a lot of new and unusual things for you in the hospital. This guide should help you and your relatives find the better way about our Clinic.
For your quick healing process we will need, of course, your assistance. Please, inform us about everything that seems important and significant to you, and do not avoid asking us if something is still unclear. You will have to meet a lot of people during your stay in the hospital; you will find yourself in unusual surroundings with a special day rhythm to which you will have to get used. We also ask for thoughtfulness and understanding towards other patients. We wish you a pleasant stay in our Clinic and a speedy recovery!
Univ.-Prof. Dr. med. Christiane Bruns
Director of the University Clinic for General, Visceral and Vascular Surgery
TABLE OF CONTENTS
The stay in our Clinic
- Clinic for General, Visceral and Vascular Surgery - Visiting hours
- Patient's snack bar - Kiosk
- Flower shop - Information desk - Phone and television - Internet
Spiritual help service in the Clinic - Catholic church
- Evangelical church - Room of silence - Evening prayer
Voluntary medical care
The outpatient department of the Clinic for General, Visceral and Vascular Surgery
- Patients’ management office - Pediatric surgery
- Consulting hours
Central patients’ admission to hospital - Registration for the hospital treatment Admission to hospital
Regulations at the general surgical departments - Admission to the department
- Reception
- General patient’s examination by the Head Department Doctor - Special preoperative examination
- Conversation with the doctor responsible for the operation - Conversation with the anaesthetist
The operation day - Preparation
- Waiting period - Anaesthesia
- Immediately after the operation
The operation department / Surgery The stay in the Intensive Care Unit - Visiting hours
- Phone numbers
The recreational phase after the operation - Doctors’ rounds
- Discharge from the hospital and follow-up Frequently carried out operations - Overview of the abdominal cavity organs Operations in the overview
- Thyroid gland operation - Parathyroid gland operation - Adrenal gland operation - Liver transplantation - Gullet operation
- Stomach operation
- Bariatric surgery (weight-loss surgery) - Bowels operation
- Pancreas operation - Appendectomy - Hernial repair - Bile duct operation - Gallbladder operation - Liver operation
- Laparoscopic surgery
- Operation of enlargements of the belly artery - Arteriovenous fistulas
- Operation of carotid artery constriction
- Vessel revasculization in the thigh and lower leg
- Acute blood-vessel occlusion in the area of the arm or leg Campus of the University Medical Centre
Your opinion is important to us Conclusion
- Address
- Design & layout
The Stay in Our Clinic
Clinic for General, Visceral and Vascular Surgery Director: Prof., Doctor Honoris Causa, Dr. med. H. Lippert Secretary: Mrs. H. Hoffmann
Tel.: 0391 / 67 15 500 Fax: 0391 / 67 15 570 Service Management:
Qualified nurse D. Halangk Tel.: 0391 / 67 15 502 Fax: 0391 / 67 15 594
Visiting Hours
There are no strictly regulated visiting hours at the ordinary departments 1, 2 and 3.
However, it is not advisable to come after 22:00 o'clock, in order not to disturb other patients.
In the Intensive Care Units only next of kin can come for a visit.
Monday – Friday: 16:30 – 18:00
Saturday, Sunday and holidays: 15:00 – 18:00.
Patients’ Snackbar
Our snackbar is in the hall near the main entrance of the House 60a.
Opening hours:
Monday – Sunday: 07:00 –18:00.
Here you can find snacks, soft drinks, coffee, tea, buns and rolls, sweets, and newspapers as well. The snackbar can be easily reached with a wheelchair.
Kiosk
The sales place for essential goods is in the House 17.
Opening hours:
Monday – Friday: 06:00 – 18:00 Saturday and Sunday: 08:00 – 16:30.
Flower Shop
The Flower shop "Rosenstolz" is directly beside the snackbar in the House 60a.
Opening hours:
Monday – Friday: 07:00 – 18:00 Saturday: 12:00 – 16:00
Sunday: 14:00 – 16:00.
For further information please contact the nursing staff or our employees at the Information Desk.
Information Desk
The Information Desk is situated in the foyer just in front of the main entrance of the House 60a. There you can be told how to find the way to the patients’ admission room, departments, outpatients’ clinic, patient examination rooms or other destinations (also beyond the House 60a), as well as information about the patients.
Here you can leave your remarks and suggestions.
Phone and Television
Patients’ rooms at the departments are all equipped with television devices and phones. To use the phone (in accordance with a set rate) you should buy an electronic chip card; you can receive incoming calls as well then. You can watch the television for free.
Internet
As far as your medical treatment permits it, you can use your private notebook. A free Internet access through the Clinical patient gateway is available for you. If you have any further questions how to use Internet, please ask the medical staff at your department.
Spiritual Help Service in the Clinic
When a person is ill one has to pay attention not only to his body but also to his soul.
If you need to talk about your life or God, if you need to have your say and be listened to, if you need somebody to pray with, to accompany you during your stay in the hospital, you can find such help here. If you want to get in contact with a confessor of our Clinic, please call one of the following phone numbers. All necessary information can be found at your department or just ask the medical staff.
Evangelical Church Pastor Margitta Quast Telephone: 0391 / 61 73 142 Catholic Church
Confessor Barbara Haas Telephone: 0391 / 67 14 016
Confessor pastor Stephan Bernstein Telephone: 0391 / 67 14 220
Room of Silence
It can be found in the hall of the House 60a. You can enter it at any time 7 days a week to:
• regain inner peace and quiet
• think
• pray
This room is an oasis in the everyday life of the Clinic.
Evening Prayer
20 minutes of text and music take place on Mondays at 17:00.
Voluntary Medical Care
The University Medical Centre of Magdeburg provides its patients not only with the spiritual help service, but also with the service „Green Ladies and Gentlemen”.
During several years they are enthusiastically engaged in the work of Clinic as volunteers. They have got their name due to the green uniform, in which they can be better seen and recognized. This service is free of charge, and you can use it if you like during your stay in the Clinic.
What can „Green Ladies and Gentlemen“ do for you?
They can give you their time and offer the following services:
• conversations
• shopping (newspapers, phone chip cards, soft drinks and snacks, etc.)
• escort (to examination, for a walk, church service, etc.)
• assistance in getting in contact with a social service or a confessor.
These volunteers work independent, on their own responsibility, 3 hours a week.
Definitely they are obliged to keep your privacy.
If you are interested in the service of our “Green Ladies and Gentlemen”, please ask the medical staff.
The Outpatient Department of the Clinic for General, Visceral and Vascular Surgery
The Outpatient Department of the Clinic for General, Visceral and Vascular Surgery is located on the ground floor of the House 60a.
Tel.: 0391 / 67 21 405 Head of Department – Dr. med. Niklas Bien.
Head nurse – Kathleen Angermann.
General surgeons consult patients with the family doctor’s referral from Monday to Friday.
Our main goal is to make the first competent friendly contact with you. Please bring all your medical reports along. If you happen not to have any or some of them with you, we will be able to replace the necessary medical results through the Radiology Clinic, Surgical Endoscopy and other Clinics collaborating with us. In case you have all necessary medical papers, you will get an appointment of admission to a hospital.
It is important for us that you know exactly what will happen to you during your stay in the Clinic, that you receive answers to all your questions, that you feel that you are in good hands, and feel safe.
Please don’t hesitate to ask if something is still unclear to you!
Patients’ Management Office
You can get an appointment card for hospitalization and operation at the Clinic for General, Visceral and Vascular Surgery at the Patients’ Management Office. Qualified employees are responsible for planning the patients’ admission to a hospital, operation and following discharge, and are ready to consult you about medical treatment and care. You can address yourself to the Patients’ Management Office through your family doctor or our other Clinics.
Pediatric Surgery
Head of Department – Dr. med. Hardy Krause.
Head nurse – Anke Schulz.
Pediatric Surgery Department of the Clinic for General, Visceral and Vascular Surgery can be found on the 4th floor of the House 60a. There are 9 double rooms with toilets at the Department. They are painted and furnished according to the child’s taste and needs. Children can be treated as in- or out-patients. Diagnostic and operative services can be provided for prematurely born and newborn babies, and infants with congenital anomalies; emergency surgery can be done to children who are directed to a hospital for an urgent operation. Surgical operations for infants are done at the Perinatal Centre of the University Gynaecology Clinic. Children with specific congenital or acquired surgical diseases can also be treated as in-patients. Within the limits of the regular Children’s Cancer conferences, tumour operations are planned and performed as well. Another main focus of the Pediatric Surgery Department is highly specialized surgical and conservative treatment in the field of Children's Traumatology. Parents can visit their children and take care of them any time they like.
Consulting Hours
Here you can find the information about the consulting hours of the medical specialists.
Kind Consulting
Hours Doctor Telephone
General Surgery Monday - Thursday:
8:00 – 15:00, Friday:
8:00 - 13:00, by appointment
Dr. Bien 0391 / 67 21 405
Vascular Surgery Tuesday and Friday: 8:00 – 12:00, by appointment
Private lecturer, attending physician Dr. Halloul,
attending physician Dr. Weber, Rappe
0391 / 67 21 405 or 0391 / 67 21 412
Struma Thursday: 11:00 – 13:00, by appointment
Dr. Jannasch, Dr. Stübs, Dr. Petersen
0391 / 67 21 405 or 0391 / 67 15 529
Minimal Invasive
Surgery Tuesday: 12:00 – 15:00, by
appointment
Private lecturer, attending physician Dr. Schubert, Dr. Dalicho, Dr. Granowski, Dr. Benedix
0391 / 67 21 405 or 0391 / 67 15 529
Centre for Obesity Monday: 10:00 – 13:00, by
appointment
Prof., attending physician Dr. Wolff, Dr. Benedix,
Dr. Arend
0391 / 67 21 405 or 0391 / 67 15 529
Liver and
Pancreas Wednesday:
12:00 – 14:00, by appointment
Prof., attending physician Dr. Schulz, Prof., attending physician Dr. Meyer, Dr. Jannasch, Dr. Wex
0391 / 67 21 405 or 0391 / 67 15 529
Transplantation Monday: 08:00 – 10:00, by
appointment
Prof., attending physician Dr. Wolff, Dr. Arend
0391 / 67 21 405 or 0391 / 67 15 529
Wounds Monday : 09:00 – 11:00, by appointment
Dr. Jannasch 0391 / 67 21 410
Ostomal Therapy Thursday: 09:00
– 11:00, by Dr. Bien 0391 / 67 21 410 (Nurse Regine)
appointment Chemotherapy Wednesday:
08:00 – 12:00, by appointment
Dr. Stübs,
Dr. Garlipp 0391 / 67 15 645 (Outpatients' Department) Proctology Wednesday:
08:00 – 12:00, by appointment
Private lecturer, attending physician Dr. Mroczkowski, Dr. Bien, P. Büschel, Dr. Schittek
0391 / 67 21 405 or 0391 / 67 15 667
Surgical
Endoscopy by appointment at the Proctology Department or UICCC (The United International Colorectal Cancer Centre)
Dr. Bien
UICCC (The United International Colorectal Cancer Centre
Thursday: 08:00 – 12:00, by appointment
Private lecturer, attending physician Dr. Mroczkowski, Dr. Petersen, P. Büschel
0391 / 67 21 405 or 0391 / 67 15 667
Fax: 0391 / 67 29 01 87
E-mail:
uiccc@med.ovgu.
de Prof. Lippert’ s
private consulting hours
Wednesday: 13:00 – 14:30, by
appointment 0391 / 67 15 500
(Secretary:
Mrs. Hoffmann)
Central Patients’ Admission to Hospital
Registration for the Hospital Treatment
On the day of your admission to a hospital please refer with your medical referral to the Central Patients’ Admission Office, which is to be found on the ground floor of the House 60a.
Consulting hours are from Monday to Friday: 7:00 – 17:00.
If you’d like to receive some additional services during your stay at the Clinic, please let us know about it, as in this case a special contract should be made.
The following documents are necessary to be admitted to a hospital:
- Medical referral to a hospital treatment - Insurance policy
- Passport
- Patient’s card (if any)
If you are not able to go to the Office yourself, your relatives can do it on your behalf.
In exceptional cases or accidents a patient can be registrated for the hospital treatment by our employees. We guarantee the confidentiality of your private data according to the Data Protection Act.
Admission to a Hospital
All three surgical departments are located on the 4th floor of the House 60a, which you can reach with an elevator.
Department 1 General Surgery: House 60a, 4th floor, Tel.: 0391 / 67 15 522 Head of Department: Private lecturer, attending physician Dr. D. Schubert Department Manager: Vera Krusche
Department 2A General Surgery: House 60a, 4th floor, Tel.: 0391 / 67 15 526 Head of Department: Prof., attending physician Dr. S. Wolff
Department Manager: Marco Kiontke
Department 2B Vascular Surgery: House 60a, 4th floor, Tel.: 0391 / 67 15 526 Head of Department: Private lecturer, attending physician Dr. Z. Halloul
Department Manager: Marco Kiontke
Department 3A General Surgery: House 60a, 4th floor, Tel.: 0391 / 67 15 527 Head of Department: Prof., attending physician Dr. F. Meyer
Department Manager: Christina Hannemann
Department 3B General Surgery: House 60a, 4th floor, Tel.: 0391 / 67 15 527 Head of Department: Private lecturer, attending physician Dr. P. Mroczkowski
Department Manager: Christina Hannemann
Regulations at the General Surgical Departments
Admission to the Department
You will need the following daily necessities during your stay in a hospital:
Toilet articles Underclothes House slippers
Pyjamas and dressing gown Hand and bath towels Bath sponge
Insurance policy
Blood type certificate (if any) Allergic certificate (if any) Vaccination card (if any)
List of medicine you regularly take (if any) Medical examinations results (if any)
Please don’t bring any valuables or big amounts of money with you.
Reception
You will be received at the Department Post and guided to your ward. The medical staff will show you, for example, a closet for your personal belongings, a bath room, etc., and explain how to use the phone, TV set and Internet. We ask you for some patience if the room is not ready yet by the time of your arrival as it takes a little time to finish its cleaning.
The University Clinic of Magdeburg is a hospital with a high level of medical service.
One of our tasks is to coach the students – future doctors and nurses, and we participate in scientific researches as well. In accordance to this it is possible that students will take part in the doctors’ daily rounds and help doctors to give you the necessary medical treatment.
General Patient’s Examination by the Doctor in Charge
An assistant doctor and, probably, a medical student will have a detailed conversation with you about your actual disease, diseases you had before, operations that had already been performed on you, and medicine that you take regularly. You will be of considerable assistance to doctors if you are able to give the precise important information about your health verbally or in writing. Then you will be examined, the blood test will be done, as the actual findings are necessary for the coming operation.
In the first days of your stay in the hospital the medical staff, which takes care of you, will talk to you regularly as well, in order to find out how you overcome your disease, what kind of help you need. In addition, you will be informed daily about the order of the present day, if any tests or examinations are to be done and at what time.
Special Preoperative Examination
According to the kind and content of operation, some types of examinations may be done to you on the day of your admission to the Clinic, if they were not already done before (e.g. by family doctor). On one hand, they can help to estimate the possible risk of operation, on the other – they provide the necessary information for the operation.
If you happen to need a number of examinations, they will be done within a few days.
You will be of considerable assistance if you stay in your ward and be within easy reach at any time or let the medical staff at the Department Post know if you go out.
Most of examinations are done in short time, but there can be a delay between some of them, which we try to minimize.
Conversation with the Doctor Responsible for the Operation
A large number of doctors (Head department doctor, doctor in charge, surgeon), whom you are going to meet, may cause you some embarrassment at the beginning.
Their task is to inform you about the exact course and possible risk of the operation, postoperative treatment, and answer all your questions. Also you will be told where you will be placed after the operation: either in your ward or in the Intensive Care Unit if the operation is complicated. Then you will get a brief written summery of the conversation, which you will have to sign as your consent to the operation.
After your recovery from anaesthesia the Head department doctor will tell you about the outcome of the operation. In case you wish to share this information with some of your relatives, please let us know about it beforehand, so that we can arrange a general meeting at the time most convenient for all.
Conversation with the Anaesthetist
This doctor is responsible for your sleep during the operation, that you don’t feel any pain, and provides the monitoring of your state. Before anaesthesia is induced you will be asked important questions about your health again: if you have any heart or lung diseases, allergy, and about any previous anaesthesias.
The Operation Day
Preparation
Please don’t eat or drink anything and don’t smoke from the midnight, as it all can cause some complications for the operation. Please take a shower in the morning and put on a fresh hospital robe and compression stockings. Approximately one hour before you are taken to the operating room you will receive medicine prescribed by the anaesthetist. This medicine should be taken before the anaesthesia: it will help you to calm down and make you sleepy.
Waiting Period
In the event your operation is not scheduled first on an operation day, you will be told how long you approximately have to wait. Your operation can be delayed due to the duration of the preceding one. As emergency operations must be performed urgently and as a priority, it may mean that your operation will be postponed until the following day.
Anaesthesia
Anaesthesia and all necessary measures are produced by Professor Dr. Th.
Hachenberg, Director of the University Clinic for Anaesthesia and Intensive Care, and its doctors. Due to our Clinics close cooperation with highly-qualified anaesthetists it is possible to provide the optimal medical service to a patient during and after the operation.
Immediately after the Operation
In the first hours after the operation the constant monitoring of the activity of your cardiovascular system, lungs and kidneys is necessary, so you will be placed in the Intensive Care Unit or High Dependency Recovery Unit. Your surgeon and anaesthetist will keep a close eye on your progress; you will get an oxygen mask if necessary. Soon after the end of the operation you will be given a dose of a highly- effective painkiller. In case you feel the pain again you will immediately receive further help. As soon as the activity of your cardiovascular system stabilizes, you will be moved back to your ward.
The Operation Department / Surgery
On the operation day after all preparatory measures you will be taken to the Operation Department on the 1st floor. There you will be received in the preoperative chamber by a qualified nurse. After all important documents are checked you will be put on the operating table, which will be prepared especially for you. Just before the beginning of the operation the papers will be checked once again: your identity will be verified and a plan of operation formulated as well.
During the operation your safety will be constantly under control. Two surgeon’s assistants take part in the operation along with the surgeon. The anaesthetist and his qualified assistant are responsible for anaesthesia; one assistant is in charge of surgical instruments, another one – of delivery of all necessary things during the operation. After the operation you will be put on a clean wheeled bed and taken to the ward where you will recover from anaesthesia under close surveillance.
The Stay in the Intensive Care Unit
In some cases after the operation it can be necessary to monitor the activity of your cardiovascular system for some time, and you may need artificial ventilation. If that is the case you can be taken to the Intensive Care Unit. You will be connected to a monitor, which will regularly record your heartbeat, blood pressure and blood oxygen level. Being under artificial ventilation you will not be able to speak. The amount time you spend in the hospital can be shortened if you engage in breathing exercises and try to get up and about with the nurses’ help as soon as possible. You can do this only if you don’t feel any pain. You will regularly receive painkillers from nurses or through an electronic pump, which can be attached to you. It may be automatically on, or you may have a hand control with a button to press to give yourself extra painkillers, as you need them (i.e. patient controlled analgesia). Your nurse will constantly ask if you still have pain, so that to increase the dose of the painkiller if necessary.
During your stay in the Intensive Care Unit you will need your toilet articles and personal belongings, such as house slippers, glasses, and also denture and otophone if any. All these articles can be brought from your ward by a nurse or your relatives.
As many patients’ examinations take place directly in the Intensive Care Unit and patients need more medical care, the visiting hours are limited there. On the operation day your relatives can naturally visit you for some time. Please let them know the visiting hours in the Intensive Care Unit.
Visiting Hours:
Monday - Friday: 16:30 – 18:00
Weekends and holidays: 15:00 – 18:00.
On the operation day your nearest relatives can inquire after your state and even speak with you, calling one of the following telephone numbers. If you wish to be visited on this day, it is also possible. We would appreciate if you let us know the name of the person, who would receive all the necessary information about you, so they can give it to the other members of your family; as we can not give this information to your distant relatives and acquaintances, as we have to observe patients’ rights.
Telephone Numbers:
Intensive Care Unit: 0391 / 67 15 521
High Dependency Recovery Unit: 0391 / 67 21 123
The Recreational Phase after the Operation
Doctors’ Rounds
Doctors’ rounds take place daily between 7:00 and 07:30; nurses and students participate in them as well. The doctor in charge constantly reports to the head department doctor about all important results of patients’ examinations and prescriptions of medicine or treatment procedures. Besides, the head department doctor, department manager and a team of doctors in charge, nurses and students make their rounds weekly.
If your health is insured by a private insurance company, and if you have chosen an option “Head Department Doctor’s Service”, then this doctor or his assistant will visit you daily.
The result of the microscopic and histological analysis of ablated tissue will be ready approximately in 3-5 days after the operation. An oncologist (medicamental treatment cancer specialist) or a radiooncologist (radiation therapy cancer specialist) will be involved, if any further treatment is necessary (e.g. if a patient has some definite kind of tumour), so that you, a surgeon and an oncologist could discuss it together.
Discharge from the Hospital and Follow-up
The doctor in charge will talk to you about your discharge in advance. Please find out beforehand the information about recommended medicine, physical activity limit, and following medical treatment. Also, a diet and medical care at home will be advised if necessary. Moreover it will be mentioned if you need a so-called supplemental treatment till your complete recovery. Both for you and for doctors, as well for social service workers it is important that you take care of this in advance. If neither you nor your relatives are able to arrange further medical care, you could ask for help from social services. Before you are discharged from the hospital you will receive a case record, which you should give to your family doctor. It will contain all important information about the operation, your stay in the hospital, and further medical treatment and care will be recommended as well. If your family doctor has any further questions about your stay in the hospital, he/she can always ask your doctor in charge of our Clinic for more information.
Frequently Carried Out Operations
Thyroid gland Parathyroid gland
Gullet Liver Spleen
Stomach Gall bladder Pancreas
Large intestine (Large bowels) Small intestine (Small bowels)
Appendix Rectum
Overview of the Abdominal Cavity Organs
Here is a brief overview of the abdominal cavity organs, gullet and thyroid glands.
Some operations and, accordingly, diseases, are covered in detail in the booklets of the Clinic; there you can find information about anaesthesia as well. Please ask the nurses or your doctor in charge at the Department for further information.
Operations in the Overview
Thyroid Gland Operation
To examine the thyroid gland is necessary to make scintigrafy (a small safe amount of radioactive liquid is injected into the gland, which then can be better seen by the camera), blood test to determine the thyroid hormone, and, if necessary, tissue analysis (puncture). Before the operation and in 2-3 days after it a speculum examination of vocal folds (chords) is necessary. An incision 4-6 cm long is made across the front of the neck. Affected tissue of the thyroid gland is removed. To compensate for the lower thyroxine or the complete lack of thyroine that will therefore be produced after partial or complete remove of the gland, the patient is given thyroxine tablets. It is also necessary to avoid a relapse. Already on the operation day you can drink some tea, and the following day you can have your meals as usual. In 2-3 days after surgery you can be discharged from the hospital.
Parathyroid Gland Operation
The parathyroid glands control the body’s calcium levels, producing so-called parathhormone. Sometimes one or all four parathyroid glands with functional disorders should be removed. Examinations, surgery incision, a whole course of operation and a possible risk are the same (see Thyroid Gland Operation). In our Clinic it is possible to perform such operation using the minimal incision technique.
However, this can not be done to all patients, and depends on the disease.
If it is necessary to remove all four parathyroid glands, a part of a parathyroid gland is transplanted into the crus muscle, so that calcium level in blood would not drop dramatically. The parathhormone level will be measured already during the surgery;
it helps to prognosticate success of operation. Regular checks on the calcium level are required during few days after a parathyroid gland operation, and a patient should take calcium tablets if necessary. A patient can be discharged from the hospital only when these indices come to normal, and if the family doctor, endocrinologist or nephrologist is able to make further regular checks.
Adrenal Gland Operation
Increased adrenal hormone production or enlargement of the organ often requires an operation. Tumours can be removed using the minimal invasive technologies. An individual plan of operation, elaborated together with endocrinologists and anaesthetists of the Clinic can guarantee the normal hormone level in case if the adrenal gland is removed.
Liver Transplantation
Liver transplantation is made on the last phases of disease, when nothing else can be done. The decision can be taken at the council of gastroenterologists and transplantation surgeons after a detailed medical examination. In accordance with this, during a patient’s stay in hospital they are required to undergo numerous necessary examinations. The transplantation can take place at any time (day or night)
as soon as a required organ can be delivered, so it is important that a patient can be always easily reached. After transplantation a long hospital stay in the Intensive Care Unit is required; hygienic rules should be strictly obeyed. To avoid the rejection of the transplant a patient should take medicine for the rest of his/her life.
Patients with transplants can come for a consultation to the Clinic on special visiting hours.
Gullet Operation
Gullet operation is required when there is a tumour there, or when the organ is injured. A long vertical incision is made across the abdomen. If necessary the incision can also be made both on the right side of the chest, and on the lower left side part of the neck. The gullet can be replaced with large or small bowels, or a stomach can be pulled up. A surgeon will explain to you in detail what will happen during the operation. After surgery, depending on its result, you will get artificial ventilation for 24-48 hours, so that your lungs could have enough time to stretch again and return to their normal shape. Because of this you will have to stay in the Intensive Care Unit for a few days. On the 5th day after the operation, before you are allowed to start eating, you may have an X-ray with a contrast dye just to make sure there are no leaks there.
Stomach Operation
Stomach operation is often required if there is a tumour there or if a gastric ulcer causes bleedings or rupture of the stomach wall. A long incision is made across the middle of the abdomen (see Gullet Operation), and a bleeding part or a rupture of the stomach wall is sutured. If there is a tumour there, the stomach is removed partly or completely. As far as possible a new stomach can be made out of the small bowels.
A person can live without a stomach. In this case you have to eat little and often.
Bariatric surgery (weight-loss surgery)
These operations are performed on people who are obese. The operations cause significant long-term loss of weight, and, as a rule, can be done laparoscopic, i.e.
without long incisions. Among such operations are the following: gastric banding, reducing of the size of the stomach, gastric bypass surgery.
Such operations can be performed on condition that the medical insurance company is ready to bear the expenses. A patient stays in the hospital for approx. 8-10 days.
Afterwards a patient is followed-up at our Centre for Obesity, where he/she is surveyed every six months.
Bowels Operation
During the operation a long incision is made across the abdomen. This operation is required if there is an intestinal obstruction, inflammation, rupture or tumour in the bowels. Sometimes it is enough to suture if there is a rupture there, but more often a part of large or small intestine has to be removed. Food is digested in the small intestine, so only a small part of this organ can be removed. Large intestine can be removed partly or completely. The body can adjust to the new state, but in the first
few weeks after surgery you may suffer from diarrhea. The bowels will be immediately sutured as far as possible. Sometimes, however, it is rational to bring out a stoma, so that the stitched bowels could recover sooner. If such an operation is done to you, you can consult with the stomatherapeutist and ask your questions.
During this conversation the doctor will find the best place for a stoma and mark it on your skin. After the operation the stomatherapeutist will show you how to handle the stoma without assistance. Of course your relatives can get such a training as well.
Supplementary information and consultations will help you to adjust quicker to the changes in your body’s functioning. Approximately in 2 months a small operation can be done in order to remove the stoma.
Pancreas Operation
With all your questions considering various diseases (tumours, acute and chronic pancreas inflammation), which require surgery, and possible techniques of operation, please consult the Head doctor Prof. H.–U. Schulz.
More often a long vertical incision across the abdomen is made. According to the type of disease, duodenum and gastric outlet can be removed together with a part of pancreas.
If there is an acute pancreas inflammation, a drainage tube will be put into your stomach for 2-4 weeks just after the surgery.
Appendectomy
This is an emergency operation, as a rule. To make a right decision a doctor has to examine abdominal cavity, make a blood test and ultrasonography. During the operation a 10 cm long incision is made in the lower part of abdomen on the right side. Sometimes a laparoscopic appendectomy is done: caecum, which is a short extension of the large intestine, can be often removed by this minimal invasive way.
After such an operation you will recover soon, and will leave the Clinic in 3-4 days.
Hernial Repair
A hernia is the protrusion of an organ (more often the bowels) through the wall of the cavity that normally contains it. The most common hernias are the so-called inguinal hernias (the bowels pushes through a weak spot in the back wall of the inguinal canal). When a hernia is not repaired, there is a danger that part of the intestine be caught in the hernia cutting off blood supply to the tissue.
Hernias are repaired by pushing back, or "reducing", the herniated tissue, and then mending the weakness in muscle tissue. If the wall of the abdomen cavity is too weak, it is reinforced with synthetic materials (a mesh prosthesis).
Bile Duct Operation
To perform such an operation an incision is made. If there is the common bile duct stenosis or if it is clogged by gallstones after the removal of the gall bladder, the common bile duct is cut and sutured to the intestinal loop. If there are tumours in the bile ducts, a part of the damaged organ is removed; sometimes a damaged tissue of
the liver, or the half of it should be removed as well. If a removal is not possible, then a surgical bypass system for bile may be done to provide the bile outflow from the liver into the bowels. Before such an operation a supplementary examination of the liver functions and ultrasonography of the liver vessels may be done.
Gall Bladder Operation
If there is a cholelithiasis, the gall bladder has to be removed in order to avoid complications. The gall bladder accumulates and stores bile. After surgical removal of the gall bladder, nothing prevents normal bile outflow into the bowels, i.e. a special diet is not necessary.
This is a laparoscopic operation. The gall bladder is separated from the liver, and then it is removed. If laparoscopic surgery is not possible, the gall bladder is removed through the incision along the lower rib on the right side.
Liver Operation
An incision along the both lower ribs is made. Liver operation is usually required if there are tumours (both benign and malignant) in there. Liver tumour is, as a rule, the spread of a disease from another organ, so-called metastases; tumours in the liver itself grow rather seldom. During the operation a tumour is removed completely, healthy tissue of the liver is preserved or a half of organ is removed (one lobe of liver).
If a tumour is expanded, then the damaged tissue of the organ is not removed. In some cases a thin tube connected with a reservoir, which is placed under the skin, can be inserted into a liver large blood vessel; it is possible to give a limited chemotherapy through this system afterwards. Before this complicated surgery, the liver function is examined, so that to minimize the risk of developing its hypofunction after the operation.
Laparoscopic Surgery (Minimal Invasive Surgery)
Such operations, as inguinal and diaphragmatic hernias repair, gallstones, liver cyst and tumour of adrenal gland removal, pathologic overweight operation, and appendectomy can be done laparoscopic, i.e. without long incisions. A small incision approx. 3 cm long is made to insert a camera into the abdomen cavity; through other 2-4 supplemental tiny incisions medical instruments are inserted. Laparoscopic surgery has some sufficient advantages over abdominal operations, but in some cases it cannot be performed. The optimal method of surgery will be offered to a patient according to the peculiarities of the disease. Sometimes a surgeon has to change from laparoscopic operation to abdominal operation during the course of the surgery.
Operation of Enlargements of the Belly Artery
Endovascular aortic repair, a type of endovascular surgery used to treat an abdominal aortic aneurysm, may be done. In this case a catheter with a covered stent (stent graft, an elastic metal or plastic tube), is inserted into the artery in the groin under local anaesthesia under X-ray fluoroscopic guidance. A stent graft is placed so, that to cover completely the enlarged part of the belly artery, and acts as a false lumen for
blood to travel through, instead of flowing into the aneurysm sack. In this case a rupture of the belly artery can’t happen. There are some advantages of such a surgery, such as: a small incision, a short patient’s stay in hospital and its better tolerance.
However, such an operation is not always possible: it depends on the volume and form of aorta damage. A covered stent can be also placed into the enlarged thoracal artery.
Arteriovenous Fistulas
Patients with a chronic kidney disease, who are treated with dialysis, need a big blood vessel with lots of blood rushing through, and which can be easily punctured. It helps a dialyzer to filter a big amount of blood within a certain time. In this case a so-called arteriovenous fistula, i.e. an abnormal connection or passageway between an artery and a vein, is surgically created in the arm below the elbow.
Operation of Carotid Artery Constriction
Medical service of patients is done together with the University Clinic of Neurology.
The narrowing of the carotid artery, caused by the buildup of plaque, results in a carotid stenosis that reduces the flow of blood and nutrients to the brain, which can lead to a stroke. That is why a surgery is required on some stage of disease.
Ultrasonography helps to determine amount of carotid artery narrowing. Surgery is performed under local anaesthesia. The carotid artery is opened, an incision along the constricted part of it is made, and it is cleaned with a vascular spatula; afterwards sutures are inserted, and it is covered with a tiny „ patch“. The following 24 hours a patient stays in the Intensive Care Unit under a close eye. Afterwards a patient is followed-up, and gets necessary treatment at the department of the Vascular Surgery and at the Clinic of Neurology.
Vessel Revasculization in the Thigh and Lower Leg
Bypass surgery may be performed on the progressive stage of the peripheral vascular disease of the legs, i.e. an alternate or additional route for blood flow is created by moving blood vessels or implanting synthetic tubing. (Vessels frequently used for the bypass are large veins taken from the patient's leg.)
Acute Blood-Vessel Occlusion in the Area of the Arm or Leg
When there is an acute vascular occlusion of arm or leg a patient feels suddenly some coolness or numbness in the limbs. In such cases a circulation should be urgently restored (within 6 hours). An artery may be opened in a particular part of the body (e.g. elbow or groin area), and a balloon catheter may be placed there: when it is deep enough, it is inflated and taken carefully out. So, a blood clot may be removed from the vessel. The place, where a balloon catheter (Fogarty catheter) was inserted, is sutured.
University Clinic Campus
Clinics
General, Visceral and Vascular Surgery
Outpatient Clinic, Departments 1, 2, 3 - House 60 a Experimental Operative Medicine - House 15 Anaesthesiology and Intensive Therapy
Outpatient Clinic, Intensive Care Unit 2 - House 60 a Outpatient Acute Pain Clinic - House 39
Ophthalmology
Outpatient Clinic, Department 10 - House 60 b Dermatology and Venerology
Outpatient Clinic, Departments 1, 2, Day Hospital - House 14 Diagnostic Radiology Department 8 a -
House 8, 60 a Endocrinology and Metabolic Diseases Outpatient Clinic, Department 11 - House 60 b Gastroenterology and
Hepatology Outpatient Clinic, Department 4 - House 60 a Department 8 - House 40
Haematology and Oncology Outpatient Clinic - House 39 Department 6 - House 40 Otolaryngology
Outpatient Clinic - House 9 Departments 1, 2, 3, 4 - House 8
Cardiac and Thoracic Surgery (Surgery of Chest)
Outpatient Clinic, Department 1 (Intensive Care Unit), 2 - House 5 b Therapy, Intensive Care 3 - House 60 a
Cardiology, Angiology and Pneumology Outpatient Clinic, Departments 1, 2 - House 3 a, 5 Departments 3, 4 - House 3
Respiratory Therapy Centre - House 60 b Pediatric Surgery
Outpatient Clinic - House 60 a Pediatric Surgery
Department 9 - House 60 b Pediatrics - House 10 Facial Surgery
Outpatient Clinic, Department 1 - House 19 Neurosurgery
Outpatient Clinic, Intensive Care Unit 4 - House 60 a Department 15 - House 60 b
Neurology
Outpatient Clinic - House 60 a, 60 b
Departments 11, 12, Stroke Unit - House 60 b Renal Medicine and Hypertonia
Outpatient Clinic - House 60 b Station 7 - House 60 a
Radiology
Outpatient Clinic, Department 2 - House 40 Orthopaedics
Outpatient Clinic, Department 1, 2, 3 - House 8
Plastic and Aesthetic Surgery
Outpatient Clinic, Department 6 - House 60 a
Psychiatry, Psychotherapy and Psychosomatic Medicine Departments 4, 6 - House 19
Outpatient Clinic, Departments 1, 2, 3 - House 4 Radiation Therapy
Outpatient Clinic - House 23 Department 1 - House 40 Accident Surgery
Outpatient Clinic, Department 5 - House 60 a Urology
Outpatient Clinic, Departments 8, 8 b - House 60 a Central Emergency Hospitalization - House 60 a
Dear patients,
We hope that this information can be useful for you during your stay in our Clinic.
With our best wishes,
The team of doctors and nurses
Your opinion is important to us
We would appreciate if you fill in a form and drop it in the box at your department.
We wish you a nice stay at our Clinic as far as possible and a quick recovery.
Address
The Clinic for General, Visceral and Vascular Surgery The University Clinic of Magdeburg
Leipziger Straße 44 39120 Magdeburg Telephone: 0391/ 67 01 www.med.uni-magdeburg.de
Design & layout
H. Lippert / D. Halangk / D. Trefflich / J. Beyer Photographs: Th. Jonczyk-Weber / M. Dybiona Print: Meilingdruck
2nd edition, 2012
With the friendly support of The University Clinic of Heidelberg Special gratitude to Prof. Dr. Markus W. Büchler
