Oncology


Surgical oncology in Switzerland

Numerous specialized centers in the country study patterns of the disease, methods of fighting it and offer preventive treatment of cancerous growths. Most clinics have oncology departments.

Swiss clinics successfully use surgical treatment to fight cancer. It remains one of the most widely used methods in oncotherapy. To eliminate the tumor nidus, doctors resort to salvage and radical treatment. The former option is used when full elimination of the nidus is impossible or inadvisable, for instance, in case of widespread metastases. This kind of surgery prolongs patient’s life and improves his general health condition. With radical surgery, tumor nidus is fully removed, which gives patient a chance of full recovery.

Surgical procedures in Swiss clinics are carried out by means of unique devices, such as the da Vince robotic system and the Gamma Knife. At times, radical surgery can be followed by a reconstructive operation, removing cosmetic defects such as those left by breast or facial surgery. The use of such devices reduces the amount and probability of post-surgery complications, reduces rehabilitation period and increases patient’s chances of survival.

Robot-assisted surgery in oncotherapy in Switzerland

Laparoscopic operations reduce patient’s pain and post-surgery rehabilitation. In a laparoscopic operation, microsurgical endoscopic instruments equipped with miniature cameras are placed into the abdomen cavity through trocars (tube-like medical devices) inserted into small abdominal incisions. Extremely complex surgical procedures are carried out by means of various laparoscopes.

Such surgery however also has certain limitations, surgeon having no direct contact with the organ. All surgical manipulations are carried out only on the basis of the information supplied by video cameras. In terms of limited manipulability, laparoscopy is rather a complex procedure but doctors in Swiss clinics handle it easily. Robot-assisted surgery, ever growing in popularity these days, is what comes to their rescue in a challenging situation.

First robots designed to assist surgeons during operations were built as far back as in the early 1990s. Those devices were far from perfect and therefore used only by a few specialists. However, in time, the noticeable progress in their functionality and precision made them reliable and easy-to-use tools.

The da Vinci robotic surgical system designed in the USA is the most famous and particularly successful performance-wise. The system operates on the laparoscopic principle, i.e. using microsurgical tools inserted through trocars, but their use is substantially different from manual operations.

The system consists of several key components:
  • Surgeon’s console;
  • Patient-side cart equipped with robotic arms for taking and manipulating tools;
  • Vision system through which to follow the progress of surgery.

The console shows the surgeon a maximally realistic 3D image of the operating field. If necessary, high definition miniature cameras can magnify the image. Surgeon’s working area is ergonomically designed, as it is meant for prolonged operations.

Surgeon controls the movement of the robotic arms’ via the special system. The system translates the surgeon’s hand, wrist and finger movements into precise, real-time movements of surgical instruments. The use of such a system rules out possible trembling of surgeon’s hand affecting the instrument during conventional laparoscopy. All instruments are picked functionally and accurately.

Oncologists in Swiss clinics use the robotic installation to treat various tumors in the chest area, in lungs, uterus, kidneys, intestines and stomach. The system is particularly effective in the treatment of prostate cancer. It is also used to treat kidney cancer by partial nephrectomy.

Conventional types of oncological operations in Switzerland

Classic types of oncological operations are:
  • Surgical treatment of liver cancer;
  • Subtotal and total gastrectomy (partial or complete removal of the stomach);
  • Pancreatomy (removal of the pancreas);
  • Partial or complete removal of the thyroid gland;
  • Surgical treatment of ovarian tumors;
  • Surgical treatment of vaginal tumors;
  • Surgical treatment of breast tumors;
  • Surgical treatment of bladder tumors;
  • Surgical treatment of prostate tumors;
  • Organ resection for lung cancer;
  • Surgical treatment of skin cancer;
  • Surgical treatment of colon cancer;

Hepatectomy (partial resection of the liver) is effective when a tumor reaches large size and spreads to the lymph nodes or other organs. The tumor is surgically removed, so are the nearby tissues.

Liver transplantation can be performed for any stage liver cancer. The transplant is taken from a deceased donor (whole liver) or from a healthy donor (part of the liver).

Surgical treatment of stomach cancer in Swiss clinics

Surgical treatment is required when a tumor is located in the middle or upper third of the stomach. Patients with infiltrating tumors are also eligible for surgical treatment, regardless of tumor location. Surgeon performs upper midline laparotomy and a thorough revision of abdominal organs to determine the scope of surgery and the rate of tumor growth.

Pancreatectomy (surgical removal of the pancreas) in Swiss clinics

Pancreatectomy involves the following surgical procedures:
  • Removal of the duodenum;
  • Resection of the nearby blood vessels;
  • Total resection of the pancreas.

Distal pancreatectomy is partial removal of nearby lymph nodes and the spleen, as well as the right lobe of the pancreas.

Lobectomy (removal of the lobe) of the thyroid or thyroidectomy (complete removal of the thyroid) in Swiss clinics

Thyroidectomy is complete removal of the thyroid gland through an incision in the neck area. In case of papillary or follicular thyroid carcinoma, only part of the gland is removed, its isthmus and one of the lobes.

Surgical treatment of ovarian cancer in Swiss clinics

The most common treatment of ovarian cancer is surgical operation. The scope of surgical procedure depends on the size and type of tumor and the spreading of the pathological process.

Surgical treatment of vaginal tumors in Swiss clinics

Surgical treatment of vaginal cancer involves removal of the cervix and the body of the uterus, with nearby tissues (parametrium and uterosacral ligaments) kept intact. The vaginal orifice and lymph nodes of the lesser pelvis are not dissected, the ovaries and uterine tubes are not affected either.

Surgical treatment of breast tumors in Switzerland — mastectomy

Surgery is the most common treatment of breast cancer. The procedure called mastectomy involves complete removal of one or both breasts. In some cases, surgeon preserves the skin above the gland, removing the glandular tissue through an incision around the areola.

Cystectomy for bladder cancer in Switzerland

Methods used in surgical treatment of bladder tumors are open surgery and transurethral resection. In transurethral resection, surgeon removes the tumor with a special instrument called a resectoscope. The instrument is placed into the bladder through the urethra, and the tumor is removed without any cuts to the skin. The surgery is performed under spinal or general anesthesia.

Surgical treatment of prostate tumors in Switzerland

The surgical procedure called prostatectomy can be performed at any stage of prostate cancer and involves removal of all or part of the prostate gland, depending on the type and severity of the disease. To determine how far the cancer spread, nearby lymph nodes are examined. If metastases are found in the lymph nodes, it can be confirmed that the disease spread to other organs, in which case different methods of treatment are required.

Pulmonary resection for lung cancer in Switzerland

A resection is performed for early stage lung cancer, when the tumor has not yet grown too much.

Contraindications:
  • Tumor is close to the throat;
  • Tumor is close to the heart;
  • Tumor is close to the major blood vessels;
  • Tumor is close to the esophagus.

Follow-up examinations are always performed before the operation to check patient’s physical readiness for surgery.

Surgical treatment of skin cancer in Switzerland

Surgeon removes not only cancerous skin cells but also nearby tissues, significantly reducing the risk of cancer reappearing in the same spot. A number of methods can be used to surgically treat skin cancer. The choice of method depends on the type, size and location of cancer.

Colonoscopy for colon cancer in Switzerland

Colonoscopy makes it possible to remove small malignant polyps in the colon and rectum without cutting the skin. If a pathology is located in the lower part of the rectum, the procedure can be performed through the anus without the use of colonoscope.