MINIMALLY INVASIVE NEUROSURGERY

One of the areas in which Greece has been breaking new ground is in innovative spinal surgery, even drawing the attention of the US medical community. What is of particular interest is the focus on “small-incision” surgery that allows patients more rapid recovery, often seeing them up and about the day after surgery. This minimally invasive approach achieves results that are as good if not better than classic neurosurgery, with the advantage of a smaller entry incision, which means significantly less destruction of the natural tissue in order to reach the affected area.

This particular surgical method is being used increasingly to treat spinal ailments in children, giving young patients facing the gravest of health challenges a chance to lead an active and normal life. The surgeries performed on children are often carried out to repair congenital defects, while in adults the approach is used to tackle either age-related problems or those resulting from autoimmune diseases, such as rheumatoid arthritis. 

In the field of neurosurgery, the future lies in the repair of injured neurons. Surgery will deal with the consequences of the injury, while the recovery of the nervous system will be achieved with drugs or with other treatment protocols, such as those involving stem cells.

It is worth noting the Greek presence in this field by highlighting the work of the team of professor and neurosurgeon Vasilios A. Zerris in the recent breakthrough procedure that involved implanting a chip in the brain of severely paralyzed patients; by “reading” their thoughts, the chip helps them move a computer cursor to propel a wheelchair or control a robotic arm.

INTERVENTIONAL RADIOLOGY

Interventional radiology is an innovative area that uses the imaging possibilities of radiology to treat a number of illnesses without surgical intervention. This method of treatment can replace certain surgical procedures, reducing risk for patients and minimizing their stay in hospital.

Interventional radiologists invented both angioplasty and the first stent to be inserted by catheter, originally used to spare patients with vascular disease from having their lower limbs amputated or operated on in some other manner. Today, they use imaging technologies such as X-ray, ultrasound, computed tomography and magnetic resonance imaging to see inside patients’ bodies, pinpoint problem areas and then come up with a plan to reach that area without having to make a large incision. Instead, they insert catheters through the vascular system or the skin via a pencil-tip-sized cut of just 1-2 centimeters, treating diseases or growths directly in the affected area with the help of images that reveal the internal anatomy of the body. 

Interventional radiology allows doctors to treat patients with hardening or narrowing of the carotid arteries; patients who present with prostate enlargement; patients with uterine fibroids, liver cancer, varicocele or problems with the bile duct; and patients who have suffered an acute stroke.

The G. Genimmatas General Hospital in Athens has one of the few Interventional Radiology Units in Greece, and carries out all of the procedures mentioned above.

CLINICAL DENTISTRY

The objective of clinical dentistry, and of the medical sciences more generally, is to achieve the best possible result, both in terms of treatment outcome and appearance, with the minimum degree of intervention. Thanks to advances in technology, clinical dentists in Greece are now in a position to execute any treatment plan with precision, safety and speed.

Digital photography and imaging (including cone beam computed tomography) allows us to collect all of the necessary data concerning the patient – clinical picture and microscopic anatomy included – in 3D and then feed this information into planning software and design the desired intervention/restoration virtually.

Once this process has been completed and the expectations and needs of the patients are accounted for, the clinical dentist will choose the necessary surgical or prosthetic options – digitally guided dentistry can be applied in surgical procedures as well as in prosthetic restorations – so that the treatment plan can be implemented safely and precisely. 

Today, digital computing technology in dentistry is in use all over the country and Greece’s clinical dentists, who already had a well deserved reputation for doing excellent work, are taking full advantage of these technological advancements to responds to the needs and requests of their patients.

NEW APPLICATIONS OF LAPAROSCOPIC SURGERY

Bariatrics, or the treatment of obesity, is one area where laparoscopic surgery has become standard worldwide. Procedures are normally carried out on adults who suffer from extreme obesity, are under 65, haven’t responded to more conservative methods of dealing with this disease – mainly diet and exercise – and whose situation has remained unchanged for at least two years.

There are three approaches in bariatric surgery; all are now carried out laparoscopically, according to guidelines established by the International Federation for the Surgery of Obesity (IFSO).

Malabsorption procedures like enterectomy or bowel resection drastically reduce the absorption of food but they also transform the anatomy of the digestive tract so that the absorption of nutrients is seriously curtailed as well. Mixed procedures such as long and mini-gastric bypass and biolopancreatic diversion reduce stomach capacity, but they, too, curtail the ability to absorb nutrients from food.

Restrictive surgical prodcedures involving gastric banding, gastric balloons, stapling, vertical gastroplasty and sleeve gastroplasty, however, limit the stomach’s ability to take in a large amount of food. In effect, they restrict the quantity of food that can be consumed in a single meal so that the feeling of being full occurs earlier and earlier. 

Another area in which Greek hospitals are approaching the achievements of the world’s greatest medical centers – in terms of methodology – is in living-donor kidney transplants. Since February 2015, laparoscopic surgery has opened new paths for living transplants in Greece, after the country’s first laparoscopic kidney removal from a live donor was carried out at Athen’s Evangelismos Hospital. This procedure involved taking a kidney out of a 75-year-old man and transplanting it into his son, 42, who was suffering from kidney failure. This was a milestone in Greek medicine; it signaled the start of a program for the removal of kidney transplants via the laparoscopic method, an approach which allows the donor to leave the hospital after just three days and to return to his or her normal activities within two weeks. The method has since been adopted with great success.