The Department of Vascular Surgery was established at the Homolka Hospital in 1990. During its existence, it has been profiled as a department with national and international competence, which receives patients from all over the country and from abroad. It is the largest specialised department of vascular surgery in the Czech Republic and a training centre for vascular surgery within the framework of postgraduate training at the IPVZ. At the same time, it serves as a super-consular unit for cases of severe and complicated angiosurgical conditions. This workplace also participates in the training of Czech and foreign physicians in robotic vascular surgery and in the teaching of physicians of the 1st Faculty of Medicine of the Charles University in Prague and the 2nd Faculty of Medicine of the Charles University in Prague. Every year, 1500 - 1600 vascular operations are performed with excellent results, which are fully comparable with leading foreign centres. More than 70 percent of the department's capacity consists of operations classified as demanding vascular reconstruction procedures.
We are the centre for surgical treatment of thoracoabdominal aortic aneurysm and perform the most of these operations in the whole country. Doctors have been trained in this field in the world's largest centres in Houston TEXAS MEDICAL CENTER in the USA.
The most common diseases we treat
he largest group of patients includes patients with aneurysms of the lower limbs, aneurysms of the brain with narrowing of the arteries supplying blood to the brain and aneurysms of the vasculature. We also operate on aortic aneurysms using endovascular procedures (stengrafts), which accounts for approximately one third of the total number of operations performed in the whole country. Thoracoscopic thoracic sympathectomies, laparoscopic lumbar sympathectomies and endoscopic venous connection operations are performed as part of minimally invasive approaches. In addition to minilaparotomy, which represents a substantial reduction of the surgical wound in abdominal aortic surgery, laparoscopic aortic and pelvic artery procedures (3D laparoscopic Einstein Vision tower) and robotic vascular surgery (da Vinci Xi robotic system) are also performed. Other procedures include radiofrequency surgery for varicose veins (varix), which significantly reduces the length of hospital stay, and endoscopic harvesting of the veins themselves (vena saphena magna) used for reconstructive artery surgery, most often on the lower limbs.
We treat varicose veins (varicose veins) using the radiofrequency method
The advantage of this gentle method is short postoperative recovery and minimal pain. The only disadvantage is that the probe and the use of the generator are not yet covered by health insurance. However, the cost is offset by the patient's short or no work disability.
A number of robotic operations were performed in a world premiere.
Robotic Vascular Surgery, which launched in November 2015, represents the introduction of cutting-edge technology for our vascular patients. We are currently using the latest da Vinci Xi robotic system. The robotic vascular team has developed its own operating procedures for robotic vascular surgery and routinely performs a range of aortic and pelvic artery surgeries at our facility. To date, more than 400 robotic vascular procedures have been performed, making it a world leader in this field.
Award - prof. MUDr. Petr Štádler, Ph.D.
The Head of the Department of Vascular Surgery at Na Homolce Hospital, Prof. Petr Štádler, M.D., Ph.D., received an award in March 2013 in the USA for a set of 250 robotic vascular procedures that he and his team performed at the hospital.
Award P.A. Wettera
In 2014, the P.A. Wetter Award for the best scientific presentation on "Robotic Vascular Surgery" followed in the USA.
Our experience is adopted not only by domestic but also by foreign workplaces. We have participated in the training of doctors from Brno, but also in Mephis (USA), where the first robotic vascular surgery was performed under the leadership of Prof. Petr Štádler, M.D., Ph.D. There is a great interest in our robotic surgery not only at home but also abroad, which is evidenced by the number of our lectures and publications at the international level, as well as requests for demonstration robotic operations, which were performed in Seoul, South Korea in 2008, a year later in Moscow and in March 2011 in Wroclaw, Poland. In Poland, this was the 200th anniversary operation, which was also the Polish premiere and attracted a lot of media interest. This was followed by the first three robotic vascular surgeries at Sir Ganga Ram Hospital, New Delhi, India in April 2012 and robotic vascular surgeries in Novosibirsk, Russia in 2013 and 2016.
Another important area of vascular surgery is endovascular surgery. This mainly involves the implantation of stent grafts in the treatment of abdominal or thoracic aortic aneurysms. Implantation of stent grafts, peroperative angiography or peroperative angioplasty are normally performed in cooperation with the Radiodiagnostic Department of Na Homolce Hospital. The established team of vascular surgeons and radiologists (Petr Šedivý, M.D., Ph.D., Khaled El Samman, M.D., Helena Přindišová, M.D., Alena Šnajdrová, M.D.), who are actively involved in endovascular procedures, have been performing these procedures since 2016 in the newly built multidisciplinary hybrid theatres, where the new da Vinci Xi robotic system has been installed.
Our vascular surgery department also performs demanding procedures in the management of infections of vascular prostheses with transplantation of vascular allografts. The Vascular Surgery Department of Na Homolce Hospital is a member of the Cryopreserved Vascular Grafts Programme together with the Institute of Clinical and Experimental Medicine, the General University Hospital in Prague and the Tissue Storage Facility of the University Hospital in Hradec Králové. A number of departments from all over the country use our department as a super-consular facility for various serious vascular problems.
The outpatient component ensures the reception of patients and their initial physical and laboratory examination, basic instrumental examination, planning of more complex examination procedures and permanent postoperative follow-up. A patient may be referred to our outpatient clinic by a district physician or any specialist, but patients may also self-refer. Angiographic examinations and simpler endovascular procedures are provided in collaboration with the Radiodiagnostic Department during the patient's overnight stay at our bedside. Most other examinations such as CT, MRI, PET or sonography can also be performed on an outpatient basis; for out-of-Prague patients or patients with mobility difficulties, we group examinations into short-term diagnostic hospital stays. During the diagnostic hospitalization or in conjunction with other outpatient examinations, we perform internal preoperative examinations (PIV).
After the results of the examination are collected, the so-called indication is made, i.e. the decision on the further course of treatment is made. Depending on the type of appropriate surgical solution and the urgency of the treatment, the patient is placed on the surgical programme and invited to surgery by the department secretariat in good time. If surgery is not indicated, appropriate conservative (medical) treatment is recommended. In our inpatient ward, we have single or double rooms with facilities available for patients; at the patient's request, a stay in superior single rooms can also be ordered.