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Foregut surgery is frequently performed to cure persistent ulcers, lessen symptoms, prevent major health issues, and improve quality of life. It is also performed to treat underlying upper digestive system anatomical or functional problems that do not respond to medicines. The primary goals of surgery are to restore normal swallowing and digesting while reducing recurrence of symptoms. It also helps prevent long-term consequences such bleeding, scarring, narrowing (stricture), and reflux-related damage.
Consult a doctor- if you experience persistent or worsening symptoms related to the digestive system, especially if they relate with your daily life routine. For example- frequent heartburn, difficulty or pain while swallowing and nausea or vomiting etc. Additionally, if you feel like food is caught in your throat, lose your appetite, or experience unexplained weight loss, you should get medical help. If you experience severe chest discomfort, blood in your vomit, black stools, or frequent vomiting, you should see a doctor very far away.Early assessment facilitates accurate diagnosis and prompt treatment to prevent problems.
Proper preparation prior to foregut surgery is critical for a successful procedure and recovery. Patients typically go through a medical evaluation, have their medications reviewed, and given dietary recommendations, including fasting rules, as well as advise to stop drinking and smoking, before surgery. On the day of the procedure, patients should wear comfortable clothing, take only the medications given by the physician with a little sip of water, and take off their contact lenses, jewellery, and nail polish.
The procedure is performed under anaesthesia, after which the surgeon chooses the best surgical technique and corrects the underlying problem; if necessary, reconstruction is performed, and the surgical site is closed.
Foregut surgery typically takes two to four hours for laparoscopic/robotic procedures and three to five hours for open procedures, depending on the type of surgical technique and the intricacy of the case. While the average hospital stay is between two and four days for minimally invasive surgery and five to seven days for open surgery, basic recuperation normally takes one to two weeks. The majority of individuals who have minimally invasive foregut surgery recover more quickly and experience less discomfort and problems.
Some common risk:-
- Pain
- Bloating,nausea and vomiting
- Weakness or fatigue
- Difficulty in swallowing
- Blood clots in the lungs and leg
- Severe infection or sepsis
- Reaction of anaesthesia
It includes long-term relief from acid reflux and heartburn, improved swallowing with reduced chest pain, improved quality of life, better nutrient absorption, and prevention of serious complications.
Recovery after surgery is determined by the type of procedure and surgical method, and in many cases, patients recover well with good care and continuous follow-up. You will be monitored in a recovery area following surgery until the anaesthesia wears off. Medication is used to treat mild pain and discomfort in the throat. It is advised to start with fluids before gradually reintroducing meals as tolerated.
The success rate of surgery depends on the type of the surgery being done andMost elective foregut surgeries (like fundoplication or hernia repair) have a high success rate approximately 85-95% symptom relief.
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Bayindir Healthcare Group
Ankara, Turkey
Bayindir Healthcare Group located in Ankara, Turkey is accredited by ISO, JCI. Also listed below are some of the most prominent infrastructural details:
- Bayindir Healthcare Group comprises 3 hospitals, 6 Dental special clinics and 1 Medical Center.
- Sogutozu Hospital
- Icerenkoy Hospital
- Kavaklidere Hospital
- Levent Medical Center
- Fenerbahce Dental Clinic
- Besiktas Dental Clinic
- Icerenkoy Dental Clinic
- Is Tower Dental Clinic
- Sirinevler Dental Clinic
- Alsancak Dental Clinic
- The International Patient Center was set up in 2010. It is a resource for doctors and the available healthcare services, arranging for consultations and appointments. Also, it manages the travel, transfer, accommodation, visa and insurance resources and translation for international medical travellers.
- Networking with physicians from various countries to ensure knowledge and know how growth and implementation work towards the benefit of patients.
Medicana Sivas Hospital
Sivas, Turkey
Medicana Sivas Hospital located in Sivas, Turkey is accredited by ISO, JCI. Also listed below are some of the most prominent infrastructural details:
- 24/7 Emergency Department
- 28.000 m2 Closed Area
- Capacity of 219 beds
- 7 Operating rooms
- 49 intensive care beds
- 15 newborn intensive care beds
- 5 Cardiovascular intensive care beds
- 4 coronary intensive care beds
- 28 observation beds
- It has started to serve with a capacity of 15 beds in the newborn intensive care unit with the investment of physicians and devices it has made, recently
- Hospitality services include- Standard and Suite rooms, fully-equipped with TV, Air conditioning system at room level, hairdresser, dialysis services, cafeteria, Place of worship, etc.
- Car Parking with a capacity of 75 vehicles
- The hospital cafeteria provides both cafe and food service in the hospital
Max Super Speciality Hospital, Saket
Delhi, India
Max Smart Super Speciality Hospital, Saket, is a 250-bed tertiary care hospital awarded NABH accreditation, which provides advanced medical care in various specialities such as Cardiac Sciences, Orthopaedics, Neurology, Urology, Kidney Transplant, Paediatrics, and Obstetrics & Gynaecology. The hospital provides quality, safe, integrated, and patient-centric medical care using modular OTs, ICUs, Cath Labs, CT, MRI and Dialysis units.
Manipal Hospital, Hebbal
Bangalore, India
Manipal Hospitals, a group of Manipal Education Medical Group, is India’s leading multi-speciality network, comprising over 650 beds. Dedicated to clinical excellence, patient-centric care and ethical practices, it provides sophisticated diagnostics, surgery and home care services to both domestic and international patients, while also improving access to affordable healthcare for underprivileged communities.
Clear Medi Hospital, Karkardooma
Delhi, India
Clear Medi Hospital, Karkardooma located in New Delhi, India is accredited by ISO. Also listed below are some of the most prominent infrastructural details:
- There are 12 Linear Accelerators in all hospitals of Clear Medi Hospital, Delhi, India and more in the development stage.
- Over 25 surgical and medical specialties across all Clear Medi Hospitals
- Care Medi is one of the biggest Oncology care organisations in India.
- Hospital management solutions provided to over 15 partner healthcare organisations managing more than 300 beds.
- The organisation consists of offerings such as clinical manpower management and equipment management.
- Advanced radiology and nuclear medicine centres
- Professionally managed international patient care
- Clear Medi Hospital, Delhi has a capacity of 100 beds.
- Clear Medi is a multispecialty hospital.
- It is a NABH (National Accreditation Board for Hospitals & Healthcare providers) certified hospital.
- It has Oncology and Cardiac departments with an Intensive Care Unit.
- It also has fully equipped Operation Theatres.
- Clear Medi Hospital ensures coordination with patients and International Patient assistance
- It has an online Tumor Board with a number of Medical, Surgical and Radiation Oncologists.
Sheba Medical Center
Ramat Gan, Israel
Sheba Medical Center located in Tel-Hashomer, Israel is accredited by JCI. Also listed below are some of the most prominent infrastructural details:
- Sheba Medical Center has a 1900 bed capacity.
- It also consists of as many as 120 departments and clinics.
- Sheba treats a large number of national and international patients from many Asian and European countries among others.
- International patient care services in Sheba are very strong, this also includes the travel, stay, transfer related coordination with translator services.
- The healthcare personnel working in Sheba Medical Center are fluent in English, documents are also available in this common denominator language.
- Rehabilitation services are available for long term recovery and return back to a normal life and activity. This could include conditions related to Orthopedics, Neurology, psychiatry, old age and injuries etc.
Acibadem Altunizade Hospital
Istanbul, Turkey
Acibadem Altunizade Hospital located in Istanbul, Turkey is accredited by JCI. Also listed below are some of the most prominent infrastructural details:
- The indoor area of Acibadem Hastanesi - Altunizade, Istanbul, Turkey is one of the largest at 98,000 square meters.
- There are 550 beds and as many parking spots.
- 75 of the beds are in the intensive care unit.
- A hybrid operating room which has 3 diagnostic units at one location which is an amazing concept as at one time surgeries can be performed in 3 operating theatres.
- International patients are serviced well through a particular center for them where services related to therapy and diagnostics are done.
- Healthcare delivery in this part of the hospital can be availed in 16 different languages.
- Robotic Surgery and Cell Therapy Unit are representative of the high standards of technology present in the hospital.
Burjeel Hospital, Abu Dhabi
Abu Dhabi, United Arab Emirates
Burjeel Hospital, Abu Dhabi located in Abu Dhabi, United Arab Emirates is accredited by JCI. Also listed below are some of the most prominent infrastructural details:
- 209 bed capacity 14-beds in the Intensive Care Unit
- 64 Slice CT, High End MRI, Neuro-navigation Surgical Systems
- 3.0 Tesla MRI
- Neuro-physiology
- Specialized physiotherapy
- Well managed rehabilitation services
- 10 operating theatres
- Royal Suites and Presidential Suites available
- It comprises the most advanced treatment related equipment.
- It is adorned with cutting edge diagnostic equipment.
- Personal attention is given and there is an empathetic approach to healing, the hospital terms it the 'art of healing'.
- Customised services are provided to International patients.
- Centers of excellence
- Cardiology
- Pediatrics
- Ophthalmology
- Oncology
- IVF
- Gynecology & obstetrics
- Orthopedics & sports medicine
- Shoulder and upper limb unit
- Burjeel vascular centre
- Bariatric & metabolic surgery
VPS Rockland Hospital
Gurgaon, India
VPS Rockland Hospital located in Gurugram, India is accredited by NABH, NABL. Also listed below are some of the most prominent infrastructural details:
- Well-designed compact 103-bed hospital expanding over120,000 square feet
- Well equipped modular operation theatres, intensive care unit, interventional Cath lab, and in-patient rooms ranging from economy to luxury
- Offers a bouquet of services like Internal Medicine, Obstetrics & Gynaecology, Surgery, Pediatrics
- High-end diagnostic services like 1.5 T MRI and 128 slice CT Scan
- Advanced non-invasive assessment with echo & TMT machines
- State of the art cardiac Cath-Lab
- Appointment Scheduling
- Treatment packages
- Accommodation arrangement for the accompanying attendant
- Customized diet for patient and attendant
- Laundry services
- Prayer room
- Visa assistance
- Pick and drop facility from/to the Airport
- Foreign exchange facility
- Registration with the Foreigners Regional Registration Office
- Dedicated Neuro-Intensive care unit managed by expert intensivists
- Accommodation arrangements post discharge
- Highly advanced instruments for deep brain stimulation, stereotaxy, micro-neurosurgery, pediatric neurosurgery & neurophysiology
- Most advanced dialysis machines and advanced diagnostic and therapeutic facilities
- Renal replacement therapy for hemo-dynamically unstable patient
- Technologically advanced endoscopy suite
- Wi-Fi/internet service in the room
- Travel arrangement for patient & attendant post discharge
- Tele-consults post discharge
- Dialysis beds
- 24x7 ‘Trauma & Emergency Center
- Dedicated blood bank
- 24x7 comprehensive patient care.
- Deployed high-end technologies & smart digital system
- Robust Hospital Information Systems to meet complex medical needs of patients
- Robotic-assisted surgeries
- International Patients Lounge
Acibadem University Hospital Atakent
Istanbul, Turkey
Acibadem University Hospital Atakent located in Istanbul, Turkey is accredited by JCI. Also listed below are some of the most prominent infrastructural details:
- Spread over an area of 60,000 square meters
- It has 300 wards with 8 operating rooms
- It has an inpatient treatment capacity of 278
- Intensive care unit bed capacity is of 29 beds
- The healthcare organisation has several kinds of infrastructure for services such as free parking, cafeteria, Wi-Fi, hairdressing salon, ATM, ergonomic hospital beds, and prayer rooms.
- The hospital has both standard single rooms and double rooms (24 in number) for the patients.
- The hospital wards are also equipped with metal handrails, emergency cords, and call buttons for patients with mobility issues.
- The latest medical technology is present here to treat patients such as MR-LINAC linear accelerator, The da Vinci robot, and TrueBeam Linear Accelerator.
- The diagnostic department of the hospital has the following equipments:
- MRI 3 Tesla
- Full-body MRI
- Spect CT
- Flash-CT
- Ductoscopy (early diagnosis of breast duct cancer)
- DSA digital angiography
- Endoultrasonography (EUS)
- Ultrasonic echography
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+99Process Involved for Foregut Surgery
Initial evaluation (stage 1)
● Detailed medical history
● Physical examination
● Review of previous medical condition and treatment
Diagnostic work up ( stage 2)
● Upper Gi endoscopy
● Barium swallow study
Medical and lifestyle management (stage 3)
Surgical intervention (stage 4)
- Gastroesophageal Reflux disease
- Hiatal Hernia
- Achalasia Cardia
- Esophageal Motility Disorders
- Peptic Ulcer Disease
- Gastric Outlet Obstruction
- Esophageal strictures
- Foregut Tumors
- Esophageal Injuries
- Gastroparesis
- Fundoplication
- Hiatal hernia repair
- Esophageal surgery
- Gastric surgery
- Bariatric related foregut procedures
- Minimally invasive approaches
- Informed consent
- Pre-surgical documentation
- Licensing requirements
- Legal consideration during surgery
- Post operative legal requirements
- Minors (<18 years): Consent must be given by parents/guardians.
- Emergency surgery: If the patient is unconscious or unstable, surgery can be done in life-threatening situations under the principle of implied consent.
- Confirmed diagnosis of a foregut condition (GERD, hiatal hernia, esophageal cancer, ulcers, etc.) through tests like endoscopy, pH monitoring, or imaging.
- Symptoms not relieved by medications (e.g., proton pump inhibitors for GERD) or lifestyle measures.
- Good overall health to withstand surgery and anesthesia.
- No severe uncontrolled medical conditions like advanced heart disease, kidney failure, or severe lung disease.
- Patient commitment to post-operative care and lifestyle changes.
Mesh implants
● Synthetic mash
● Biological mesh
Esophageal stents
● Self expanding metal stents
● Self expanding plastic stents
● Biodegradable stents
Gastric and intestinal anastomotic devices
Reconstructive and support implant
- Surgical (wrap based)valve : Nissen fundoplication, Toupet fundoplication, Dor fundoplication
- Magnetic valve system : LINX device
- Ring magnetic titanium beads: it opens while swallowing and closes during acid reflux
- Endoscopic valve techniques
- Natural valve
Procedures commonly associated with anti reflux surgery
● Hiatal hernia repair
● Fundoplication
● Mesh reinforcement
● Gastropexy
Procedure associated with esophageal surgery
● Lymph node dissection
● Gastric pull up
● Chest drain placement
- Long term relief from acid reflux and heartburn
- Improvement in swallowing difficulty
- Reduction in chest pain
- Better sleep
- Prevent esophagitis and ulcers
- Relief from vomiting
- Improved ability to eat normally
- Long term relief from symptoms such as acid reflux, heartburn, chest pain, and regurgitation.
- Improved swallowing and easier digestion
- Healing or prevention of complications like ulcers and bleeding
- Better sleep,appetite and daily comfort
- Successful removal of tumors and lowering the risk of recurrence
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