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Department of Surgery

The accredited surgical department provides modern outpatient and inpatient care in the entire range of general and colorectal surgery, traumatology, vascular surgery and urology. In all disciplines, modern mini-invasive techniques (laparoscopic approaches to acute and elective procedures, including hernia and bowel surgery) are preferred. The complete scope of intestinal surgery is guaranteed by the highest education of the surgeons - specialists (coloproctology certification-eligibility). In the surgical department, the principles of modern perioperative care (ERAS) are applied, which allow for a fast postoperative recovery and reduce surgical stress. The inpatient department is completely renovated. Patients who require intensive care are admitted to the modern equipped surgical intermediate care beds or to the beds of the multidisciplinary intensive care unit with a connection to the anaesthesiology and resuscitation department. Acute outpatients are treated in the acute surgical outpatient department of the central reception (CP) with all-day operation, chronic patients in the CHA1 outpatient department.

We provide diagnostic and therapeutic care for patients:

  • with musculoskeletal and skeletal injuries except for spinal fractures requiring osteosynthesis and skull and facial skeletal fractures associated with penetrating brain injury or requiring osteosynthesis

  • with a diagnosis or suspicion of sudden abdominal stroke

  • with gastrointestinal disease
    cholecystectomy (gallbladder removal), appendectomy (appendix removal), hernioplasty (hernia repair)

  • with abdominal injuries, chest injuries, patients with brain injuries not requiring invasive neurosurgical treatment

  • indicated for surgical treatment of malignant processes
    of the breast, digestive tract, skin

  • vascular diseases
    removal of varices, bypasses, ischemic and diabetic defects of the lower limbs

  • inflammatory lesions requiring surgical intervention or not responding satisfactorily to outpatient therapy

  • with anorectal disease
    haemorrhoids, fistulae, inflammatory affections of the rectum, tumour surgery, including low-located tumours of the rectum, using the latest equipment and evidence-based medicine

  • with diseases of the mammary gland indicated for surgical treatment

  • with non-specific GIT inflammation (IBD)
    Crohn's disease, Ulcerative colitis, indeterminate colitis
  • with diaphragmatic hernia and gastroesophageal reflux
  • with morbid obesity including treatment of diabetes and associated diseases
    (R-Y bypass surgery,mini gastric bypass,gastric tubulisation-SLEEVE gastrectomy and reoperation)

Outpatient sphere of activities:

  • Diagnosis of abdominal diseases including cancer screening
  • traumatology - treatment and control of post-traumatic conditions
  • excision of skin affections with or without a skin doctor's recommendation
  • comprehensive care of tibial ulcers and chronic wounds
  • follow-up examination and aftercare of patients after surgical procedures
  • comprehensive care of patients with non-specific intestinal inflammation
  • treatment of rectal affections, including outpatient removal of haemorrhoids

AMBULANCE

Ordering tel. no. 311 555 000

 

DEPARTMENT

Department of Surgery I tel. no.: 311 553 110
Department of Surgery II tel. no.: 311 553 010
Intermediate care (IMP) tel. no.: 311 553 013
E-mail chirurgie@nemocnice-horovice.cz

 

Ordering superior rooms

Surgical Ward I tel. no. 311 553 103
Surgical Ward II tel. no. 311 553 002

 

Patient information I 7:15 - 7:45, 14:45 - 15:00

Surgical Ward I tel. no.: 311 553 110
Surgical Ward II tel. no.: 311 553 010
Intermediate care (IMP) tel. no.: 311 553 013




 

Preoperative examination sequence

The basic pre-operative examination will be performed by your general practitioner on an outpatient basis. The examination includes blood tests, an ECG and, if necessary, an X-ray of the heart if you are a smoker or over 50 years of age. We recommend that you arrange this examination in good time (at least one week before the operation, but no more than 4 weeks if you are healthy and 2 weeks if you have a chronic illness). If you do not have the results and medical conclusion on admission, your surgery will be postponed!

  • If you have a chronic illness or are over 50 years of age, your GP will refer you for an internal examination.
  • If you are taking hormonal contraceptives, take them off one month before your planned surgery!!!
  • With all the results and the conclusion from the general practitioner (internal medicine doctor), you will come to the Hořovice Hospital, to the surgical reception (ground floor opposite the orthopaedic outpatient clinic), where an anaesthetic pre-operative examination will be carried out.
  • After evaluating the results and talking to you, the anaesthesiologist will recommend the type of anaesthesia that is most suitable for you. It is possible that the doctor may want to repeat some tests or add others. The examinations will be completed during the day in the inpatient ward or in the specialist outpatient clinics of the NH. The anaesthetist will come back to the ward to assess the additional tests and write a 'premedication' (administration of medication before anaesthesia). Pre-operative preparation for surgery aims to prevent serious complications (thrombosis, embolism, allergic reaction,...) .

What to take with you to the hospital

  • pyjamas
  • underwear
  • dressing gown
  • change of clothes
  • personal hygiene items
  • towel, washcloth
  • health insurance documents
  • hernia belt (for hernia surgery), which you will need after the operation (the voucher will be written by your doctor in advance), crutches, canes if you are going for surgery with DK
  • medications to be taken (for the expected duration of the hospital stay)
  • Valuable items and money: you can store valuable items and money in the hospital's central safe. You will receive a written proof of safekeeping against which the items will be released to you on discharge from the hospital. The hospital is not responsible for the loss of loose items stored off-site. We recommend that you do not take large sums of money and valuable items to the hospital in your own interest
  • Clothes and personal items.
  • Medication: during your hospital stay, all medications are prescribed by your attending physician and supplied by the nurse. If you are taking certain medications to treat a specific condition, please take them with you to the hospital and give them to the nurse on arrival at the ward. Your doctor will include them in the range of medicines that will be given to you during your hospital treatment. As it is very important to coordinate your overall treatment, please do not take any medicines during your hospital stay that your doctor does not know about - even those you normally take at home (prescription or purchased). You will receive all necessary medications from the nurses at the prescribed dose and time.

Receiving

On the day of your scheduled admission, come to the NH Surgical Intake on the 2nd floor.

If you are having surgery on the day of your admission, arrive by 8:00 AM on your fasting day.

If you have surgery scheduled for the following day just arrive between 10:00 am - 12:00 pm.

If you are having surgery on a Monday, you must arrive at the reception on Friday. Once you have completed all the necessary admission requirements (see above), you can go home (on your pass) and report to the ward on Sunday between 5pm - 6pm (you can eat and drink!) or on Monday at 7am on a fasting day. Everything is by appointment with the doctor on reception.

Pre-operative examination sequence

The basic pre-operative examination will be carried out by your general practitioner on an outpatient basis. The examination includes:

  • blood tests,
  • ECG,
  • if necessary, an X-ray of the heart if you are a smoker or over 50 years of age.

We recommend that you arrange this examination in good time (at least one week before the operation, but no more than 4 weeks if you are healthy and 2 weeks if you have a chronic illness). If you do not have the results and medical conclusion on admission, your surgery will be postponed!

  • If you have a chronic illness or are over 50 years of age, your GP will refer you for an internal examination.
  • If you are taking hormonal contraceptives, take them off one month before your planned surgery!!!
  • With all the results and the conclusion from the general practitioner (internal medicine) you will come to the Hospital Hořovice, to the anaesthesiology outpatient clinic (ground floor opposite the orthopaedic outpatient clinic), where an anaesthetic pre-operative examination will be carried out.
  • The anaesthesiologist will recommend the type of anaesthesia that is best for you after evaluating the results and talking to you. It is possible that the doctor may want to repeat some tests or add others. The examinations will be completed during the day in the inpatient ward or in the specialist outpatient clinics of the NH. The anaesthetist will come back to the ward to assess the additional tests and write a 'premedication' (administration of medication before anaesthesia). Pre-operative preparation for surgery aims to prevent serious complications (thrombosis, embolism, allergic reaction

Rooms:

The ward includes standard and superior single rooms with private bathroom facilities. Room equipment.

Room Reservations:
Superior rooms are widely used by patients and therefore must be booked in advance by calling 311 553 110 or 311 553 010, at least 14 days in advance.

The price of superior rooms is 1200CZK/night.

Billing and payment:
The final amount for the superior room is paid at the end of the hospitalization at the NH cash desk. You can pay on working days until 15:30 by credit card or cash. Outside working hours, on weekends and on holidays when the cash desk is closed, pay the bill at the ward (cash only). In both cases, you will receive a receipt for payment.

IMPORTANT NOTE: The superior room service only includes the superior standard of hotel services. It does not in any way imply a different treatment of patients by the attending staff.

Health information for the patient's relatives

Health information is confidential and may only be disclosed by us with the patient's consent to persons designated in writing by the patient at the time of admission to the hospital in the Consent for Hospitalization. It will be provided by the attending physician in the morning 7:15am-7:45am or in the afternoon 2:45pm-3:00pm. Or by prior arrangement with the ward nurses.

Daily schedule

6:00 - 6:30 a.m. Handover of service and nurse debriefing
6:30 - 7:30 a.m. toileting; bed preparation; collection of biological material; measurement of physiological functions; dressings; serving breakfast
7:30 - 10:30 medical rounds; insulin administration; medication and breakfast administration; room cleaning
8:30 - 10:00 Processing of physician's orders; administration of infusions, injections; rehabilitation; maintenance of nursing records
10:30 a.m. - 1:00 p.m. Processing patient admissions; administering ATB, lunch medication and lunch
13:00 - 15:00 processing of patient appointments and admissions; administration of injections, ATBs; afternoon toileting; bed making
15:00 - 17:00 Filling clinics; measuring physiological functions; serving snacks; laundry collection; visiting hours
17:00 - 17:45 administration of medication and dinner
17:45 - 18:00 handover of service and nurse debriefing
18:00 - 19:00 medical rounds; processing of doctor's orders
19:00 - 21:00 evening toileting; bed making
9:30 p.m. - 5:00 a.m. night rest; ongoing patient check
10:00 p.m. - 6:00 a.m. night rest; ongoing patient check

 

Medical rounds daily 7:00-7:45 a.m.; 6:00-7:00 p.m.

Primary care rounds
CHIR 1: Tuesdays 7:15 a.m.
CHIR 2: Thursday 7:05 a.m.

 

 

 

 

 

Visits are possible daily. Due to the treatment regime and the ward's regime, we recommend visiting between 14.00 and 18.00. Please note that visitors may be asked to leave the patient's room in the case of bedside procedures, personal hygiene or medical appointments. Visitors under the age of 10 are not appropriate.

In case of isolation of the patient due to infectious disease, the visitor is required to equip himself/herself with personal protective equipment (drape, gloves, empire) before entering the room according to the instructions of the ward staff.

In case of hospitalization of the patient in the intermediate care room (IMP), visits of maximum 1 person to the patient's bed are possible. Please respect the staff's recommendation on the appropriate length of visit.

Bariatrická ambulance

Make an appointment: recepce@nemocnice-horovice.cz

Now treating: MUDr. Michael Vraný

Léčba obezity včetně přidružených onemocnění (zejména cukrovky) chirurgickými metodami.

Obezita je závažné chronické onemocnění, které musí být léčeno, aby se předešlo dalšímu poškození zdraví. Léčba může probíhat konzervativně nebo chirurgicky (prostřednictvím operačního zákroku). Bylo prokázáno, že vhodně zvolený chirurgický zákrok významně pomáhá snížení hmotnosti, a dochází k výraznému zlepšení až vyléčení přidružených onemocnění (komorbidit). Tato onemocnění jsou součástí tzv. metabolického syndromu.

Nejvýznamnějšími z těchto onemocnění jsou:

  • cukrovka 2. typu (diabetes mellitus 2. typu),
  • zvýšený krevní tlak (hypertenze),
  • ztučnělá játra nebo z nich vzniklý chronický zánět jater (steatóza jater, steatohepatitis),
  • zvýšené tuky v krvi nebo jejich nepříznivý poměr (hyperlipidemie, dyslipidemie),
  • zástava dechu ve spánku (syndrom spánkové apnoe),
  • u žen pak hormonální změny, které se podílí na tvorbě mnohočetných cyst vaječníků (syndrom polycystických ovárií) a které znemožňují těhotenství, do této skupiny patří také dna, která je způsobena vysokou kyselinou močovou.

Při chirurgické léčbě proto klademe důraz právě na metabolickou část. Tzv. metabolicko-bariatrická chirurgie je zejména efektivní při léčbě cukrovky 2. typu. Většina pacientů závislých na léčbě inzulinem je propuštěna pouze s medikamentózní léčbou.

Dobře provedený chirurgický výkon a jeho správný výběr pro konkrétního pacienta je samozřejmou podmínkou úspěchu, není však jeho garancí. Pacientova spolupráce je nejdůležitější a nezbytnou podmínkou.

Pacient bere na vědomí, že:

  • na něm závisí výsledek celé léčby,
  • bude spolupracovat s ošetřujícími lékaři a dbát jejich pokynů,
  • bude pracovat na změně životního stylu včetně stravovacích návyků, složení stravy, fyzické aktivity. přijetí sebe sama

Pacienti vhodní k bariatrické operaci:

  • obézní s BMI > 40 kg/m2
  • obézní s BMI 35 - 40 kg/m2 +
  • obézní s komorbiditami, zejména některým z projevů metabolického syndromu (diabetes)
  • obézní s psychologickou nebo psychiatrickou indikací
  • obézní s nutností snížení hmotnosti před ortopedickou operací
  • obézní s nutností snížení hmotnosti před kardiochirurgickou operací
  • obézní s nutností snížení hmotnosti z důvodů onkologických (zejména karcinomu prsu)
  • obézní s nutností snížení hmotnosti po selhání primární operace, zejména po gastrické bandáži, gastrické plikaci, ale také po sleeve gastrektomii, gastrických bypassech nebo u pacientů, kteří nedosáhli požadovaného snížení hmotnosti po jakémkoliv typu operace
  • řešení gastroesofageálního refluxu (vracení žaludečních šťáv) vč. hiátových hernií při nebo po bariatrické operaci

Kalkulačka pro výpočet BMI

Objednání na konzultaci

Pokud vám obezita znesnadňuje život, způsobuje zdravotní potíže a jste rozhodnutí ji řešit, pak neváhejte a poraďte se o možnostech její léčby s MUDr. Michaelem Vraným. Konzultace je hrazená zdravotními pojišťovnami a není k jejímu absolvování nutné doporučení od praktického či jiného ošetřujícího lékaře.

Pro objednání na konzultaci vyplňte tento on-line formulář. Po odeslání formuláře vás budeme kontaktovat.

Kontaktní e-maily: 

recepce@nemocnice-horovice.cz

barikoordinator@nemocnice-horovice.cz

 

Základní typy operací

  • gastrický bypass s jedním spojením (OAGB) – tzv. minigastrický bypass
  • gastrický bypass R-Y (dvě spojení)
  • sleeve gastrektomie – odstranění větší části žaludku – tzv. tuba
  • SADI-S – gastrický bypass s jedním spojením, navazuje na sleeve gastrektomii v jedné nebo dvou dobách
  • přeměna typu operace po předchozím výkonu – není dosaženo předpokládaného snížení hmotnosti nebo je opětovné přibírání na váze tzv. „redo“ operace
  • další typy operací, méně často prováděné

Personnel


Office hours

Day Hours
MUDr. Michael Vraný We 12:00 – 18:00*
* Pouze dle domluvy