Organization - Gastrointestinal Surgery Service

The Gastrointestinal Surgery Service participates in the Unit of:

The Service focuses its healthcare activity on the treatment of various comnditions and diseases:

• Obesity. Obesity surgery aims to improve the patient's health and avoid the comorbidities associated with this condition, such as high blood pressure, diabetes and obstructive sleep apnea. In this area of healthcare, an individual assessment is made of each patient and the appropriate treatment is prescribed. A multidisciplinary group of professionals including surgeons, endocrinologists, dieticians and psychologists participate in the treatment of obesity. There are currently several surgical techniques, such as gastric bypass, tubular gastrectomy and duodenal crossing, which can be performed laparoscopically in the Gastrointestinal Surgery Service. This minimally invasive approach avoids such   complications as those associated with a large incision or those resulting from prolonged immobility.
• Proctological diseases. The professionals of the Service are dedicated to the diagnosis and treatment of conditions and processes originating at the rectal and anal level. Most consultations are concerning anal fissures and hemorrhoids, both internal and external, although they are not the only ailments treated in this area. The Service also treats a wide range of disorders including anal fistulas, complex perianal Crohn's disease, anal cancer, anal prolapse and faecal incontinence, among others. For all of these, an individualized diagnosis and minimally invasive treatment is carried out.
• Abdominal wall. The Service offers surgical treatment for defects and afflictions of the abdominal wall. Along with other ailments, the Service treats hernias and postoperative eventrations, as well as significant abdominal wall deficits that require a separation of components or the use of complex surgeries. Problems created due to complications of other surgical operations, such as infections, necrosis of the wall, extraction of meshes, etc. are also resolved. In this field, priority is given to the use of minimally invasive techniques to minimize pain and hospital stays, which allows the patient to return their daily living in the shortest possible time.
• Peritoneal carcinomatosis. Peritoneal carcinomatosis is the intraperitoneal dissemination of oncological diseases, especially those tumors of digestive and gynecological origin. Together with other specialties, the professionals of the Gastrointestinal Surgery Service are dedicated to the management of patients with peritoneal carcinomatosis. The treatment includes everything from cytoreductive surgery to the application of intraperitoneal chemotherapy (EPIC, HIPEC, PIPAC), with the aim of eradicating the peritoneal disease. It is a complex pathology that requires multidisciplinary work, where the role of medical oncologists, radiologists, pathologists, pharmacologists and many other specialists is essential for providing the best benefits to each patient in an individualized way. In order to eradicate all peritoneal disease, conventional open surgery is often required, with hospital stays of 7-10 days. However, there are some selected cases in which the operation can be carried out laparoscopically, which allows the benefit of a faster recovery.

The Gastrointestinal Surgery Service also develops activity in the following areas:

• Esophagogastric cancer
• Colorectal cancer
• Endometriosis

For the performance of advanced laparoscopic and robotic techniques, the surgical activity of the Gastrointestinal Surgery Service is carried out in high-tech, or 'intelligent', operating rooms. These spaces allow highly complex laparoscopic surgery to be performed, both via the abdominal and transanal routes. Thus, the service uses the Da Vinci Xi robotic system to perform different colorectal surgery techniques. These operating theaters are equipped with videoconferencing systems for the dissemination of the various techniques, as well as 3D technology.

For years, the vast majority of colorectal operations have been performed laparoscopically —with all the advantages this has for the patient's recovery—, from the treatment of cancer (in early and advanced stages) to benign diseases. This practice has meant that laparoscopy has been progressively applied to other subspecialties, such as esophagogastric and bariatric surgery.