Neurosurgery

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TrueBeam is defined as a revolutionary new generation beam therapy technology in cancer treatment.&nbsp;In this system, many technical innovations are used together with robotic imaging, automatic patient positioning, motion management and a structured control system to dynamically manage the treatment.&nbsp;Thanks to the method, many types of cancer can be treated, including lung cancer, breast, prostate cancer, head and neck, which are among the most common cancer types. TrueBeam provides advantages to patients with its fast therapeutic power and precise dose rates.&nbsp;At the same time, it enables the integrated use of advanced treatment methods such as intensity modulated radiotherapy (IMRT), stereotactic body radiotherapy (SBRT) and volumetric modulated arc therapy (VMAT).&nbsp;To put it briefly, imaging and radiotherapy systems are used in an integrated manner in this method.

Overview

One of the most important advantages of this method is that the patients can be rapidly irradiated to the cancerous tissue by following the respiratory tract.&nbsp;Since the irradiation can be done by monitoring the respiratory movement, high treatment dose can be given directly to the area where the tumor is located.&nbsp;Thus, it is possible for the patients to stay on the treatment table for a shorter time, to reduce the tumor movement and thus to protect the healthy tissue at the highest level. Compared to other radiotherapy devices, it shortens the treatment time five times.&nbsp;In addition, it allows the treatment of small but risky tumors that are adjacent to important organs in the patient's body, while protecting healthy tissues at the highest level.

Decreased movement for cancerous tissue

The main feature of this linear accelerator-based method called TrueBeam is that it is a device that can apply the treatment sensitively to the movements of the patient and can only irradiate the tumor, no matter how small its size. Very small tumors in the brain can be easily treated.&nbsp;Thanks to the 'Vision Art' feature integrated into the system, since the patient's superficial body image is taken before the treatment, the treatment can be stopped at the slightest movement of the patient during the treatment.&nbsp;This feature provides an important comfort in the treatment of breast and lung patients. Because patients can breathe easily during irradiation. While the patient is breathing, the device monitors the patient's breathing or body movements, the device stops irradiation as the target area changes.&nbsp;Since only high-dose radiation can be given directly to the relevant tumor, the number of treatment days is limited to 3-5 days.&nbsp;Some cancer patients cannot be operated on because the location of the tumor and their general health conditions do not allow it. Cancerous tissue is destroyed with the help of TruBeam when it is located in vital organs and there is no possibility of surgery due to the location.

Provides precision treatment around critical organs

Fast and precise treatment with pinpointing the tumor

Organ Transplantation

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These transplants are usually performed with the cornea donation from deceased patients. Experts state that the cornea to be transplanted should be removed within the first 24 hours, while the ideal time is the first 6 hours.Cornea transplant surgeries have been performed in Turkey for many years. Although it is possible to obtain it from deceased patients without requiring permission, since it is a tissue by law, corneal transplant centers find it more appropriate to obtain permission from the families of deceased patients. &nbsp;However, since there are not enough donations, many patients are waiting with hope to get a cornea transplant.

Experts provide the following information about medical conditions that require corneal transplants:- Damage to the cells that keep the cornea transparent after eye surgery- Clouding of the cornea as a result of this damage- Conical shape of the corneal layer- Some inherited corneal diseases- Formation of scar tissue and new vascularization as a result of corneal infections- Stains and scars on the cornea after injury- Rejection and clouding of the transplanted cornea by the body after corneal transplantation

In which cases is a corneal transplant required?

Corneal transplant operations can be performed under general or local anesthesia. During this surgery, after the eyelids and their surroundings are cleaned properly, a small instrument is inserted to keep the eyelids open. The eye surgeon determines the diameter of the cornea to be used for corneal transplantation. &nbsp;&nbsp;The damaged part of the cornea is carefully removed. If cataract surgery is also required, the cataract is removed first and the intraocular lens is placed. The transparent corneal layer taken from the donor is placed on the bed and sutured to the bed using microsurgical methods. &nbsp;At the end of the operation, antibiotic ointment is applied to the eye and the eye is closed with a protective cover.

Corneal Transplantation is Performed Under General or Local Anesthesia.

- Take care to use the medicines given by your doctor carefully.- Be careful not to press or scratch your eye.- Use protective caps or goggles as recommended by your eye doctor.- Do not forget to wait patiently as it will take a few months to remove the stitches after the surgery.- Generally, all sutures are removed in the first year of transplant surgery.- It is necessary to be hopeful as vision will gradually improve within a year after the operation.- Take care not to enter the crowds, try not to hit your head.

What should we be careful about after the transplant?

The First 24 hour is Vital for Corneal Transplant 

Urology

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In this method, which is applied using a Thulium laser, it is entered through the external urinary hole, proceeds through the urinary canal and the abnormally enlarged prostate tissue is reached.&nbsp;The disintegrated prostate tissues are pushed into the bladder. These particles are then removed from the urinary tract with the help of a special device. Thus, less tissue and cell damage is created.&nbsp;Since the prostate tissue is completely removed from its capsule, the complaints of prostate enlargement do not recur for many years. There is no burning or bleeding in the urinary canal after the surgery.&nbsp;Patients are usually discharged within 1-2 days, and they can return to their normal lives after an average of one week of rest.&nbsp;ThuLEP laser surgeries take an average of 1-3 hours, depending on the prostate volume. The length of stay in the hospital is an average of one or two days, depending on the prostate size and the patient's age, comorbidities or use of blood thinners.&nbsp;This laser-applied method can be safely applied to patients of all age groups with prostate enlargement. It can be applied with both general and spinal anesthesia.&nbsp;The person's previous prostate surgery does not prevent the application of this method. It is possible to consume food and liquid 4-6 hours after the application. There is no need for dressing as there is no open wound or incision on the body.&nbsp;After the catheter is withdrawn, the patient urinates and is discharged.

How is the ThuLEP method implemented?

ThuLEP treatment has many advantages in prostate enlargement. While providing rapid recovery of the patient, it minimizes the risks such as bleeding, urinary incontinence and sexual dysfunction.&nbsp;Bleeding is less than conventional surgical methods. Thus, patients who have to use blood thinners are freed from a great risk. The risk of urinary incontinence after surgery is also very low, thanks to the laser shaping and cutting of the prostate tissue, and the protection of the muscles that allow urine retention.&nbsp;Erection quality is preserved because the neural structures that pass around the prostate and affect erection are exposed to less heat energy. In addition, with the preservation of the anatomical structure while the prostate tissue is removed, there is no problem in the semen output after the operation.

What are the benefits of the method?

This method is applied much more successfully, especially for large prostates. It is also used in patients with bladder stones accompanying prostate enlargement, and in people who have a catheter inserted because they cannot urinate.&nbsp;Lazar therapy ThuLep is also used as a safe method for those who have cardiovascular diseases, who have had a bypass, who have a stent inserted, and who use anticoagulants due to vascular occlusion.

For which patients ThuLEP more suitable?

The method that treats prostate enlargement with laser: ThuLEP

Oncology

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Surgical methods are used as the first choice in the prevention and treatment of cancer. In people who are genetically predisposed to some types of cancer, conservative surgery is performed if high risk is determined as a result of the tests.&nbsp;The surgeon may also remove several lymph nodes to determine if the cancer has spread. In cases of breast cancer, the entire breast tissue can be removed, and only the part containing the cancerous tissue and the surrounding tissue can be removed.&nbsp;In cases of lung cancer, too, physicians may remove part of the lung (lobectomy) or an entire lung (pneumonectomy).

There is more than one surgical method in the treatment of cancer diseases, and these methods are being developed day by day. Among the commonly used methods in cancer surgery, apart from classical surgery, are the following:

Which techniques are used in cancer surgery?

Without the need for large surgical incisions in the body, instruments with a camera at the end and operating instruments are inserted through small incisions to view the operated area. Since the image of the operated area is also viewed on the screen, the risk of error is minimized.&nbsp;Since large incisions are not made as in classical surgery, patients can recover in a shorter time. Laparoscopic surgery is used for cancer diagnosis, staging, treatment and alleviation of symptoms.

Laparoscopic surgery

In robotic surgery, the surgeon uses special robotic instruments to describe how the robot must maneuver with surgical instruments to perform the operation, by watching a screen that reflects a three-dimensional view of the operating field. Robotic surgery not only helps the surgeon perform operations in hard-to-reach areas, but also contributes to shortening the healing process.

Robotic surgery

Laser surgery, which is applied in the treatment of many types of cancer, is applied by using high-intensity beams to shrink or vaporize cancer cells.

Laser surgery

It is applied to remove cancerous tissues in sensitive areas of the skin and areas close to the eyes and to evaluate the depth of the cancer. In this method, cancerous tissues are removed layer by layer with the help of a scalpel, and each layer is examined under a microscope until it is ensured that abnormal cells are not completely left.

Mohs surgery

It is applied to the cancerous tissue using a very cold material such as a liquid nitrogen spray or a cold probe. For example, cancer cells in the cervix or cells that tend to form cancer can be frozen and destroyed with this method.

Cryosurgery

Cancerous cells can be removed by applying a high frequency electrical current. It is mostly used on the skin and lips.

Radiofrequency Ablation (RFA)

Cancer surgery is applied for both preventive and therapeutic purposes.

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In the classical chemotherapy procedure, the drug is given to the patient through the arm vein. In the TAKE method, a two-stage application is performed, namely chemotherapy and embolization.&nbsp;Unlike the classical chemotherapy method, higher-dose chemotherapy drug is injected directly from the inguinal region into the vessels feeding the tumor formed by cancerous cells.&nbsp;Thus, all the drug reaches the cancerous tissue. Since healthy tissues are protected, side effects seen in classical chemotherapy do not occur. The aim of the chemoembolization (TAKE) procedure is to prevent the blood supply of the cancerous area and to ensure the destruction of cancer cells by administering chemotherapy drugs directly into the tissue.&nbsp;Since the microspheres used during this process remain in the cancerous tissue and prevent the tissue from being fed with blood, the death of cancer cells is accelerated.&nbsp;In the embolization process, which is the second part of the treatment, the blood flow to the cancerous tissue is cut off and the feeding of the cancerous tissue is prevented.

At which patients is it used?

In order to perform the TACE procedure, the patient is hospitalized and taken to the angiography room. In order to prevent pain and reduce anxiety, relaxing drugs are given through the arm vein.&nbsp;Then, the angiography procedure is started by entering through the groin. A thin tube called a catheter is inserted into the hepatic artery and angiography of all the vessels of the liver is drawn. In this way, the vessels that feed the cancerous tissue in the liver are determined.&nbsp;Through a thinner catheter, microspheres, that is, drugs contained in special particles, are given to the tissue that feeds the tumor. Microspheres, which allow chemotherapy drugs to reach cells, reach the tumor formed by cancer cells and close the vessels that feed the tissue.

How is it applied?

After the completion of the TAKE procedure, the patient needs to rest in the hospital for 4-6 hours. After the chemoembolization procedure, the patient may develop 'postembolization syndrome' with abdominal pain, weakness, fatigue, nausea, vomiting and fever. While this situation lasts for a short time in some patients, it can last for 3-4 days in others.&nbsp;Complications such as abscess formation and liver failure may occur rarely. Various treatments are applied to eliminate these problems. In the first month after the chemoembolization procedure, a control examination is made and the liver is examined. After 3 months, CT, MR or PET-CT are taken to understand how well the tumor responds to the treatment.&nbsp;Some special blood tests are also performed to monitor liver enzymes.

Patients stay in hospital for only one night

The method that cuts the path of cancerous cells: TAKE

Diagnostics

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Whole body MR imaging is suitable for people in the risk group for cancer, cancer patients and people who want to have a general purpose body scan. With this method, tumor formations in the body are diagnosed at an early stage in patients who are in the risk group for cancer. It is possible to evaluate the stage of the disease and to determine whether it has metastasized with the whole-body MRI, which is also preferred by cancer patients. In addition, it is also used in the evaluation of responses to treatment in patients undergoing cancer treatment. People who want to have their general health checked once a year can also have many procedures covered by general health screening done in a single session, thanks to whole-body MRI. This method, which analyses the entire body in approximately 50 minutes, helps diagnose tumors in many organs at an early stage. With MRI, a wide area is examined, including the brain, rib cage, trunk, neck, spine and legs up to the knee. But there are also cases where this method cannot be used. For example, whole body MRI technique cannot be used in the evaluation of joints such as knees and shoulders, imaging of the breast and prostate, and evaluation of neck, back and waist hernias, as special shots are required in these cases.

Who should get a whole-body MRI?

There is no radiation exposure to the body in MRI examinations, it can be used safely in children and pregnant women after 3 months of gestation. Thanks to this method, the whole body can be imaged in a single session, no radiation is taken, and no contrast material is used during the examination. &nbsp;&nbsp;There is no need for entering the examination with an empty stomach and there is no need to drink plenty of water to ensure bladder congestion before the exam. While the areas scanned with classical radiological methods are limited, a wide area can be examined with the whole-body MRI. Early detection of tumors and tumor-like lesions is ensured. It can be applied to all age groups as it carries no risk and side effects.&nbsp;During this examination, the person is dressed in a metal-free clothing suitable for MRI. A device with receiving antennas is placed on the patient, and while the person is stationary, shots are taken in sequence, starting from the brain, to other regions, thanks to the moving table of the MRI device. &nbsp;&nbsp;The person needs to lie still on the MRI table for 50 minutes. During the shooting of the abdomen and chest regions, the person undergoing the MRI is asked to hold their breath for no more than 20 seconds.

Is the patient exposed to radiation during the Whole-Body MRI?

Whole-body MRI provides detailed imaging of tumors

Neurology

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Among these diseases, blood sugar irregularities, rhythm disorders that disrupt the working order of the heart, vascular occlusions that affect the blood supply of the brain, some eye problems, changes in the blood table and some intracranial tumors also cause vertigo.When vertigo occurs, individuals report feeling dizzy, having difficulty maintaining balance, and feeling as if the ground is slipping under their feet. &nbsp;&nbsp;There is a very complex mechanism that keeps our body in balance. In order to achieve this balance, the signals coming from the balance channels in the inner ear, the eye and the musculoskeletal system need to harmonize in the balance center of the brain. If this harmony is disturbed, dizziness problems arise. &nbsp;&nbsp;While sitting in a place or lying in bed, the person may experience a constant dizziness, as if traveling on a ship caught in a storm.

Experts state that there are 2 types of vertigo disease, 'peripheral' and 'central'. In peripheral vertigo, balance problems are experienced due to diseases caused by the 6 balance channels in the inner ear. In central vertigo, it includes all disorders that cause vertigo outside the inner ear canals. &nbsp;&nbsp;These disorders include many diseases such as blood sugar irregularities, arrhythmias that disrupt the working order of the heart, vascular occlusions that disrupt the blood supply of the brain, some eye disorders, changes in the blood table, and some intracranial tumors.

There are 2 Main Types of Vertigo

Since central vertigo includes many diseases, it is of interest to ear nose and throat physicians as well as medical branches such as neurology, ophthalmology, internal medicine, cardiology, neurosurgery and psychiatry. &nbsp;&nbsp;For example, dizziness can occur even with the side effects of antidepressant drugs used in the treatment of psychiatric diseases. Dizziness may occur during the initiation and discontinuation of these drugs.

Vertigo is Dealt in 7 Different Health Branches 

The first evaluation of patients with vertigo is made by otolaryngologists. During the examination, it is investigated whether the disease is caused by the inner ear or other diseases. &nbsp;&nbsp;If it originates from the inner ear, it is being tried to determine which type of inner ear disease it occurs. If there are central causes, investigations are made for the suspected disease. In cases of vertigo of neurological origin, the disease can be detected by neurological examination and brain MRI. &nbsp;&nbsp;Cause-oriented treatments are given in vertigo clinics in some hospitals. If there is a condition originating from the inner ear, it should be accompanied by dizziness and nausea. It is very important to find the cause for an effective treatment in vertigo. For this, some laboratory tests specific to the disease are performed. &nbsp;&nbsp;As a result of these tests, two situations usually arise: the first is the movement of the crystals in the inner ear, and the second is ear pressure called Meniere's. &nbsp;&nbsp;When the direction of the crystal play is determined, these structures, which have come out of their own channel with maneuver treatment, are sent to where they belong. If there is ear pressure called Meniere's, medication and diet therapy are applied. Contrary to popular belief, vertigo is not a lifelong disease.&nbsp;If the cause is treated, patients can regain their health and return to their daily lives.&nbsp;

First, the Type of Vertigo is determined

Not Only One, Many Diseases Cause 'Vertigo' 

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Before the application of hot chemotherapy (HIPEC), evaluations are made to determine whether the patients are suitable for this treatment.&nbsp;If it is found to be suitable, the appropriate dose of chemotherapy drug prepared in varying doses according to the tumor type of each patient is determined. All tumors that have spread into the abdomen are removed with surgery.&nbsp;Then, the prepared chemotherapy drug is emptied into the abdomen with the help of a special machine. The drug is expected to circulate in the abdomen for close to an hour.&nbsp;After this process is completed, the patient is taken to an intensive follow-up and treatment program. In patients receiving standard chemotherapy for cancer treatment, treatment can be started after surgery and healing of the wounds.&nbsp;However, in the application of hot chemotherapy, hot chemotherapy is applied during the operation in tumors that are not visible during surgery and cannot be surgically removed.

Since it is accepted that hot chemotherapy is not effective in cancer patients with non-abdominal and distant metastases, it cannot be used in these patients.&nbsp;In intraperitoneal membrane cancers such as Hot Chemotherapy (HIPEC), large intestine-rectum cancers, ovarian cancer, appendix cancer, some stomach cancers and malignant mesothelioma, all tumors are removed by surgery.&nbsp;Small tumor cells that cannot be seen with hot chemotherapy are destroyed by poisoning with chemotherapy.

At which patients can Hot Chemotherapy (HIPEC) not be used?

Although very high doses of chemotherapy are given to the body in the treatment of HIPEC, there is no toxic effect because the drugs are not given to the bloodstream.&nbsp;Chemotherapy drugs are heated to about 42 degrees. Since cancerous cells are more sensitive to heat than healthy cells, drugs can enter cells more easily due to high temperature. This helps the treatment to be applied better.&nbsp;The HIPEC procedure is a procedure that should be performed by specialist physicians in the hospital setting. HIPEC is performed under general anesthesia.&nbsp;First, the general surgeon cuts out the tumorous organ and organs where it has spread into the abdomen and the peritoneum. This step is called cytoreductive surgery or CRS. It is then filled with heated fluid containing chemotherapy drugs into the abdomen to target any remaining cancerous cells.&nbsp;Oncology specialists in the operating room during the surgery decide on the exact combination of drugs and the duration of stay in the body. This time is usually between 30-90 minutes. The surgical team places a drain in the appropriate position so that the drugs are distributed in the abdomen.&nbsp;Warm chemotherapy is applied to the abdomen with the help of the HIPEC device through these drains. After sufficient time has passed, the drugs are discharged from the abdomen.&nbsp;The patient's body temperature is monitored by anesthesiologists by administering appropriate fluid therapy during the operation. The effectiveness of HIPEC treatment varies depending on the type of cancer and the extent of its spread to the peritoneum.&nbsp;This treatment can be very effective in ovarian, appendix and peritoneal tumors.

HIPEC has no toxic effects on the body

HIPEC 'warm chemotherapy' for advanced cancer patients

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Breast cancer, which is seen in one of every 8 women today, is one of the leading causes of cancer-related death in women. The diagnosis of breast cancer, which is treatable and can be cured when detected at an early stage with regular screening, can be diagnosed using technological diagnostic methods. Digital mammography, which is one of the scanning methods, allows to see nodules that are too small to be touched, and enables the masses that cannot be seen even in ultrasound to be marked and removed. &nbsp;&nbsp;&nbsp;<img src="https://res.cloudinary.com/dxqhh15dp/image/upload/v1672136756/b1_f90c3d1869.svg" alt="b1.svg"> &nbsp;Images obtained from digital mammography, taken with a lower dose of radiation compared to normal mammography, can be examined in much more detail on the screen, since they are done in a very high resolution. Digital mammography is a low-dose X-ray imaging method used in breast cancer screening and early detection. Thanks to digital mammography, cancerous cells can be detected when they are very small and at a stage that can be easily treated. Despite all its advantages, small masses cannot be seen with digital mammography in those with dense breast tissue. In these cases, the radiologist may request additional imaging methods such as ultrasonography, tomosynthesis and breast MRI.

If a woman notices a palpable mass in the breasts, if there is a collapse in the nipple, if the breast skin is hard, if there is fluid coming from the breast and if there is a breast implant, mammography can be performed for diagnostic purposes. If there is a family history of breast cancer, it is important to have it done at an earlier age. &nbsp;&nbsp;The advantages of digital mammography include the high resolution of images, the detection of cancer cells microscopically, the detection of calcification areas, the detection of nodules that are too small to be palpable, and the ability to mark and remove masses that cannot be seen even on ultrasound.<img src="https://res.cloudinary.com/dxqhh15dp/image/upload/v1672136780/b2_2903d88d79.png" alt="b2.png">Among the advantages of digital mammography are the high resolution of the images, the detection of cancer cells microscopically, the detection of calcification areas, the detection of nodules that are too small to be palpable, and the ability to mark and remove masses that cannot be seen even on ultrasound.&nbsp;During this examination, images of each breast are obtained from the front and the side in two different positions. If there is a suspicious finding, some additional images can be taken for diagnosis. In people with sensitive breast tissue, digital mammography should not be performed in the premenstrual period as it will increase the pain because the breast is compressed. It is important to take a bath before the mammography examination, and not to use occlusive substances such as deodorant, talcum powder and lotion on the armpits. Before the examination, it is necessary to inform about the diseases in the family, whether there is a history of surgery, the possibility of pregnancy, and previous breast scan images must be shown to the doctor too.&nbsp;

For which patient group is digital mammography applied?

A pressure may be felt in the breast during the digital mammogram procedure. There is no ongoing pain after the procedure. The reason for this feeling of pressure is due to the compression of the breast tissue between the two plates of the mammography device. &nbsp;&nbsp;<img src="https://res.cloudinary.com/dxqhh15dp/image/upload/v1672136802/b3_5b1c567f77.png" alt="b3.png"> Performing the compression process accurately and sufficiently increases the diagnostic value. Adequate compression provides a clearer imaging opportunity, especially in women with dense breast structure, by allowing the tissue layers to separate one from another.&nbsp;

Is digital mammography a painful procedure?

Women over 40 should undergo a mammography once a year

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. In patients who are faced with the fact that breast tissue is removed as a result of breast cancer, the nipple and breast skin are preserved, and the breast tissue damaged by cancer is removed, and the breast is reconstructed by placing a prosthesis.Today, both the tumor is removed and the prosthesis is placed in a single operation. Thus, after breast cancer, patients lose both their aesthetic appearance and the breast tissues necessary for the healthy posture of the spine, so they can get through the process more easily without feeling depressed. &nbsp;&nbsp;In classical mastectomy surgery, the entire breast skin and breast tissue are removed, so a straight line is formed in the chest. This causes some aesthetic concerns in women. Now, this method of mastectomy is applied only in cases where the tumor has invaded the entire breast skin. &nbsp;&nbsp;Therefore, it is very important to detect breast cancer at an early stage. If it is caught at an early stage, after the tumor is removed, women can also have aesthetic breast surgery.Catching breast cancer at an early stage and performing breast-conserving surgery also affect women's breastfeeding. Since the breast tissue is not damaged after the breast prosthesis is placed for aesthetic purposes only, there are no problems with breastfeeding. &nbsp; &nbsp;However, since breast integrity cannot be preserved in patients whose cancerous breast tissue is removed by mastectomy, breastfeeding is affected whether or not a prosthesis is placed. Today, in patients with early diagnosis, since only the affected part of the breast tissue is removed by preserving the nipple, it is possible for patients with prosthesis to breastfeed.

Patients can see how the breast will look after the surgery, digitally in 3D before the surgery. This also reduces stress for them. &nbsp;&nbsp;After the pre-operative planning is made, the general surgeon and plastic surgeon go into the operation together. General surgeon performs nipple and breast skin sparing mastectomy. &nbsp;&nbsp;Sampling of lymph nodes from the armpit is then performed. If the result is clear, it means that the patient will not receive radiotherapy. If they will not receive radiotherapy and the breast will be protected, prosthesis is applied to these patients.

The patient is able to see the new breast in 3D before the operation.

After the surgery, the patients only have scars as if they had a breast reduction or lift surgery. It is important for patients to rest for a week, after about 3 weeks, it is possible to return to their daily work, and they can do sports within 6 weeks. &nbsp;&nbsp;For this reason, it is necessary to prepare for the age of 40 with breast examination and ultrasound examinations after the age of 20. It is important to come to the age of 40 with ultrasound and examination from the age of 20, and to have examination, mammography and ultrasonography once a year at the age of 40-50. &nbsp;&nbsp;Since the risk increases 17 times in women with a family history of breast cancer, examinations should not be delayed from a very young age.

It is possible to return to daily life 3 weeks after the operation.

During breast cancer treatment, a new breast is made to the patient within the same session.

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As a result of this, controls are made and it is decided which of the couples has a problem, the degree of this problem and the treatment methods to be applied. If it is decided to do IVF, it is time to choose the right center.Couples often do not know what conditions should be present in an IVF centre, and which is the right IVF centre. The opening of many centers as a result of the widespread use of IVF treatments in recent years makes this choice difficult for couples. &nbsp;&nbsp;Choosing the right IVF center is important in terms of both the patient's health and the financial possibilities of the couples. Due to the mistakes made by the IVF center, couples are hesitant to try these treatments again, and their financial means are also decreasing. &nbsp;&nbsp;For this reason, it is possible to list the main points that patients who are decided to have IVF treatment should pay attention to before choosing the right center:- What is the live birth rate in the IVF center?- How long has the IVF center been in operation?- How long has the team been working together?- Do they inform you accurately and in detail?- Do they do embryo freezing?- What are the pregnancy rates?- What is the success rate in frozen embryos?- Does the IVF center have its own genetic laboratory?- Does your center have Turkish and foreign standard work certificates such as ISO?Apart from all these, the doctors who perform the IVF application in the IVF center you will go to must be embryologists who are experts in their field. &nbsp;&nbsp;It is also important to be able to meet with people who have received IVF treatment in this center before, and that the center is close to where you live. The full documentation and physical qualifications of the said IVF center should be among the criteria sought. &nbsp;&nbsp;Since the couples will have placed all their hopes on the treatment service they will receive from the center, investigating all the conditions to the smallest detail and the comments of the couples who reported positive opinions after the IVF application will also help to make this choice.

One of the features you should pay attention to when choosing an IVF center is that the IVF center is close to your home and easily accessible. In addition to the cost of IVF, this is also important in order not to add travel costs and to overcome conditions such as traffic jams. &nbsp;The proximity to your home will be an advantage as you will have to visit these centers frequently for examinations, vaccines, vitamins and injection supplements required for treatment.

The IVF Center Should be Located Near to Where you Stay 

Choose the right IVF center to relieve the longing for a child

Check-Up

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For this reason, experts state that it is absolutely necessary to have a general health check at least once a year in accordance with conditions such as age group, gender and current familial risks.

Regular and regular health check-ups prevent some health problems before they occur. Early diagnosis of some diseases is effective in obtaining successful results by shortening the treatment process.&nbsp;For this reason, even if individuals do not have any complaints, it is important that they consult a doctor at regular intervals and obtain information about their general health status.&nbsp;Although it is recommended to undergo a general health check-up once a year on average, this frequency varies according to the age, gender, various diseases in their families and the risk factors related to these diseases.&nbsp;For example, it is possible to detect cancers of the cervix, ovary, breast, prostate and large intestine at an early stage with tests to be performed every 6 months.&nbsp;Early and accurate diagnosis of many diseases such as coronary artery diseases, cancer and hypertension, which are the diseases of our age, is extremely important in terms of life expectancy and quality.

These 5 Diseases can be Determined Early

Early diagnosis and regular treatment are of great importance in diseases such as hypertension, high cholesterol and diabetes, which cause damage to vital organs such as the heart, brain and kidneys, which usually progress insidiously without causing any symptoms and without causing any complaints in the patient.&nbsp;Early diagnosis of some common cancers such as liver disease, breast, uterus, large intestine, bladder and prostate is also possible thanks to regular check-ups.

Take precautions against insidious diseases that do not show any symptoms

Women between the ages of 20-40:&nbsp;They should have a general doctor examination, basic blood tests, urine analysis, chest X-ray, breast control, gynecological control every two years.Women after the age of 40:&nbsp;Women should have a general doctor examination, basic blood tests and urine analysis, EKG, chest X-ray, mammography, stool occult blood test, gynecological control and smear test once a year, starting from the age of 40.Men between the ages of 20-40:&nbsp;They should pay attention to have a general doctor examination, basic blood tests, urinalysis and chest X-ray every two years.Men after the age of 40:&nbsp;It is important for men to have a general doctor's examination, basic blood tests and urine analysis, ECG, chest X-ray, stool occult blood test, urological control and PSA test every year from the age of 40.Both men and women after the age of 50: In addition to the above, both women and men should have colonoscopy and endoscopy, and regularly monitor their health according to the results, even if they do not have any complaints. &nbsp;&nbsp;In addition, it is recommended that people who smoke, have a family history of chronic diseases, and have health problems such as diabetes or high blood pressure should have an exercise ECG and cardiology check every 2 years after the age of 40 at the latest.

What checks should be done at what age?

Have a Check-up Once a Year to Learn about the Hidden Diseases in Advance

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In TARE treatment, the tumor located in the liver is shrunk and made to be treated with surgery. By destroying cancerous cells, the patient gains time for organ transplantation.&nbsp;Since some cancer patients cannot benefit from chemotherapy, this method provides relief of symptoms. In TARE treatment, microspheres pass through the vessels and reach the tumor area in the liver.&nbsp;The radioactive substance in the microspheres does not harm healthy parts of the body to reach cancer cells, as in other radiation treatments.

The most important factor in cancer treatments is which treatment method will be applied to which patient. Before all treatments, the patient's history is taken in detail, and necessary examinations and tests are performed.&nbsp;The decision of TARE treatment is made by the meeting of physicians from various branches. In this evaluation, which we can describe as a multidisciplinary approach, physicians in the branches of oncology, nuclear medicine, radiology, general surgery, gastroenterology and pathology evaluate patients.&nbsp;Before the treatment, the first angiography procedure is performed by an interventional radiologist. During this procedure, the vessel or veins that feed the tumor are detected. It is checked whether the liver tumor has spread to other organs.&nbsp;In addition, calculations of the Y90 microsphere dose to be given to the patient are made. In this procedure, a dye called contrast and a substance called Tc-99m MAA are given by nuclear medicine specialists.&nbsp;Afterwards, scintigraphy film is taken to calculate the required dose in the Nuclear Medicine Department. Thus, the Y90 microsphere dose is calculated.

Which patients are suitable for the TARE method?

In order to apply the TARE method, two separate angiograms are performed. 10-15 days after the first angiography, in the second angiography, the inguinal region is anesthetized and a small incision is made.&nbsp;By entering through the artery through this incision, the liver artery is reached, and from there the artery feeding the tumor is reached. With the help of the catheter, Y90 microspheres are sent into the cancerous tissue.&nbsp;Y90 microsphere radioactive material is dispersed in the tumor tissue, but it has very little effect on normal liver tissue, that is, it does not harm healthy tissues. This method, which is applied for the target, can take 1-3 hours.&nbsp;The duration of the procedure is determined by how many tumors are treated and the location of these tumors. After the treatment, the patient is kept under observation in the hospital for 1 night, and the next day, blood tests are checked and discharged, and then he is called for control in about 10 days.&nbsp;One month after the TARE application, blood tests are performed as well as examinations such as CT, MRI or PET-CT, and the response to the treatment is evaluated. Since this procedure can only be applied to one lobe of the liver, if it is necessary to treat the other lobe, a separate planning is made.&nbsp;After the procedure, patients may experience fatigue, fever, nausea and vomiting, groin pain or bruising, and mild abdominal pain. However, with the application of treatments to eliminate these side effects, improvement is achieved within a week.&nbsp;After TARE treatment, patients can return to their daily lives within 1-2 days.

How long does the process take?

'Microsphere' therapy with TARE in liver cancer

Orthopedics & Traumatology

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Many of the orthopedic problems that occur in adulthood are caused by childhood orthopedic diseases that were not diagnosed in childhood, were not adequately treated and followed up properly. For this reason, these diseases can be diagnosed while still in the womb, thanks to advanced technological facilities and detailed tests.Orthopedic problems that arise in children at birth or during developmental stages worry families. However, identifying problems at an early stage also increases the success of treatment.Although the orthopedic diseases seen in this period are very diverse, the treatment of each requires different approaches. &nbsp;Among the orthopedic disorders seen in children, it is possible to count the following: "Structural disorders and shortness of the bones, orthopedic problems caused by neurological diseases, congenital and developmental extremity anomalies, pediatric foot and ankle problems, hip problems, fractures and problems related to fractures, spinal problems, genetic and metabolic bone diseases."&nbsp;

As we have listed above, a wide variety of congenital orthopedic problems occur in children. However, some are more common. We can say the following about the most common congenital orthopedic problems and treatment approaches:

Congenital orthopedic diseases can be treated

Children with congenital hip dislocation walk late. Early diagnosis is very important in the treatment of hip dislocation. If treatment is started from the moment of diagnosis in the first months after birth, the problem is solved with the help of simple devices and bandages.

Hip dislocation

It is predicted that the foot will take its normal shape after 3-4 years of age in children. In children born with congenital flat feet, the feet appear longer than they are because there is no arch of the foot. It is much easier to treat at an early age. If the problem still persists in adolescence, it is important to consult a physician for treatment.

Flat feet

The congenital inward pressing problem of children's feet can usually resolve spontaneously until the age of 8 years. If it does not improve, the problem can be resolved with surgical treatment.

Inward pressing of the foot:

The orthopedic problem, which usually occurs with complaints such as limping and limping, definitely requires treatment. If there is constant pain and limping in the hip or knee of the child, it is important to consult a pediatric orthopedic specialist as soon as possible.

Perthes disease

In children with clubbed feet, the toes and heel turn inwards. In addition to this deformity in the foot, the legs are also thinner and shorter than normal. Crooked feet can be completely healed with the appropriate treatment method.

Clubfoot problem

It is understood when the baby's neck is tilted to one side at the time of birth. In the initial treatment, special exercises are performed several times a day. The head is turned to the opposite side and the neck is tilted to the opposite side. &nbsp;&nbsp;In this way, the length of the muscle is elongated. With appropriate exercise treatments, this problem is usually expected to resolve within a year. If there is no improvement, it can be corrected surgically.

Curved neck surgery

Congenital orthopedic diseases are diagnosed during pregnancy

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Adult idiopathic scoliosis, which is painless in childhood, can cause pain problems in adults. Patients apply to the doctor by noticing the deformity and balance problems in their bodies.&nbsp;At the same time, he can notice the curvature with findings such as shortening in height, lack of clothes or not standing well on him.&nbsp;In particular, patients who have problems in their daily life due to low back pain and disability also experience problems such as severe pain in the intermediate joints, respiratory functions due to excessive deformity that may occur in the rib cage.&nbsp;Since adult degenerative scoliosis develops with the aging of the spine, it usually occurs above the age of 50, and its frequency increases considerably over the age of 60-65.

Respiratory functions are impaired

Spinal curvature can also occur due to osteoporosis. Since osteoporosis is the weakening of the bone seen with a decrease in calcium in the bone, it causes the curvature of the spine to increase further. Although degenerative scoliosis, which occurs with wear, mostly affects the waist region, it also causes complaints in the neck and back region.&nbsp;Since the spine curves sideways and rotates around itself, deviations cause asymmetrical appearances around the waist, hips and shoulders.

Bone loss also causes spinal curvature

For more detailed imaging of the bone, physicians may request 'Computerized tomography (CT) - MyeloCT' examination. MyeloCT is performed to better visualize the spinal cord and nerves in patients who have had previous surgery and have metallic implants in their spine.&nbsp;Apart from these, this test is also performed to understand the level of pressure on the nerves, especially in patients with pain in their legs.&nbsp;

How is it diagnosed?

In surgical treatment, it is aimed to correct the curvature of the spine to the extent that it provides body balance. This can be achieved by fusing the vertebrae and eliminating nerve compression.&nbsp;The 'decompression' process can be applied at different levels and to different parts of the spine. The doctor decides the level of surgery to be performed. After the surgery, the patients are kept in the intensive care unit for the first night. Then the patient is given leg exercises.&nbsp;The patient starts walking the day after the surgery. Depending on the size of the surgery, the patient needs to be monitored in the hospital for about a week.&nbsp;After discharge, it is aimed to return to normal life by taking an exercise program. Apart from the surgery option, corset treatment can be given to suitable patients.Corset treatment is given to eligible patients However, corset treatment should be considered as an adjunct to exercise and physical therapy and should be considered in the short term.&nbsp;Long-term use of corsets can do more harm than good. Along with physical therapy and exercise therapy, patients are also given painkillers to help with pain control. Non-steroidal anti-inflammatory (NSAID) drugs can also be added to the treatment to relieve the irritation caused by nerve compression.&nbsp;These treatments, other than the surgical option, can be applied individually or together. A detailed examination is required to determine which treatment is appropriate for which patient.

What is done during the treatment?

Curvature of the spine causes pain and respiratory disorders

General Surgery

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Since the sternum of the patients was cut before the heart surgery performed with classical surgery, the recovery took longer after the operation and the patients faced difficulties in their daily lives. &nbsp;&nbsp;They had to be careful to spend the postoperative period at home, to stay away from crowds, and not to bump into something even while walking around the house. Moreover, since the sternum was cut, they had to show patience in wound healing. Thanks to robotic heart surgery, it is possible for patients to return to their normal lives shortly after the surgery.

Robotic surgery operations are frequently used in the repair or replacement of mitral and tricuspid valve diseases in the heart, in the treatment of atrial fibrillation that causes heart rhythm disorders, cryoablation also called freezing. &nbsp;In addition, surgeries can be performed with robotic surgery technique in coronary artery surgery, in the treatment of intracardiac tumors called myxoma, and in the treatment of congenital heart holes called atrial septal.

Which surgeries are done with robots?

There is a technical distinction between heart surgery performed by robot and heart surgery performed by open surgery. In open surgery, direct hands and hand held instruments are used. In robotic surgery, the physician performs the intervention using the tool held by the robot. &nbsp;The arms of the robot can move 540 degrees. In other words, there is a much wider range of motion than a normal human wrist. In addition, it is possible to enlarge the image of the surgical field 10-12 times. Since heart surgery operations take too long, the risk of the surgeon getting tired and therefore shaking hands is eliminated. &nbsp;Although the surgeon's hand trembles, the tool held by the robot eliminates this tremor through a computer program. Thanks to the robotic arms, a comfortable operation is provided for the patient and the physician on a very sensitive organ such as the heart.

What are the advantages of robotic surgery?

Thanks to robotic surgery, mistakes to be made due to human hands in surgical interventions in very risky areas are greatly reduced. In addition, the blood loss is much less in the surgeries performed with the robotic surgery system. Since the surgical operation area is entered with smaller incisions, bleeding is also less. &nbsp;&nbsp;Since surgeons usually stand during heart surgery operations, fatigue occurs in cases where the operation takes longer than normal. In surgeries performed with robotic surgery, the surgeon is in a sitting position and since he manages the operation with the help of the console opposite, muscle pain due to physical fatigue is also reduced, and the surgeon can perform the operation more easily because he is under less stress.&nbsp;Since the surgeon's focus on the surgery increases, there is no question of making any mistakes.

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