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Visceral and digestive surgery is the surgical specialty intended to treat digestive pathologies which affect the abdominal and pelvic area and the thorax with the help of bowel surgery instrument set. It is more and more practiced by minimally invasive surgery and the heavy interventions give rise to a preparation to improve the postoperative effects.
What is visceral digestive surgery?
Digestive visceral surgery refers to surgery of the digestive tract (the hollow viscera: esophagus, stomach, rectum, small intestine, colon, gall bladder) and full viscera: liver, pancreas). “If we are talking about visceral surgery in general, this also concerns surgical interventions on the thyroid, the adrenal glands and the spleen” indicates Prof. Patrick Rat, Head of the department of visceral and digestive surgery at Dijon University Hospital.
What is its principle?
“Visceral and digestive surgery often consists of an ablation for a benign or malignant disease” informs Professor Patrick Rat, Head of the department of visceral and digestive surgery at Dijon University Hospital. Visceral surgery also consists of organ transplants (liver, pancreas, and small intestine). Interventions on the abdomen can be done by laparotomy (large opening in the abdomen) or by laparoscopy. Laparoscopy involves instilling carbon dioxide to inflate the abdomen, making small incisions, and operating with a video camera.
“This allows you to work in the abdomen without opening wide” explains the surgeon. “Laparoscopy can be a robot-assisted surgery in which a robot reproduces the surgeon’s gestures. This is expanding in digestive surgery” indicates Professor Patrick Rat. This minimally invasive surgery allows for earlier recovery and shorter hospital stay.
What are the indications and pathologies treated?
“The most common procedures in visceral and digestive surgery are the removal of the appendix (appendicitis) when there is an infection and the removal of the gallbladder (when there are stones in the gallbladder). These two interventions are most often performed under laparoscopy. Interventions for intestinal obstruction are also quite frequent “informs the surgeon.
Other frequent visceral surgery; colon surgery for cancer or diverticula. Finally, a booming digestive surgery is bariatric surgery (obesity surgery: Sleeve gastrectomy, Bypass…). Surgery for hemorrhoids, fistulas or abscesses in the anal margin is also a common surgery.
How to prepare for it?
“One of the novelties in visceral and digestive surgery is the importance given to preparation before major surgery” informs Professor Patrick Rat. Prehabilitation before major digestive surgery consists of improving nutritional status and pre- and postoperative physical condition, and reducing complications by acting on 3 elements: physical activity, nutritional support and psychological support for 6 to 8 hours. weeks.
“The patient must prepare for the surgery as for a sports competition with 3 times 1 hour per week of active physical activity (brisk walking to be short of breath and sweating for example). If possible, it is also necessary to stop smoking” explains Professor Rat. This prehabilitation is articulated with the RAAC (improved recovery after surgery).
“The patients are mobilized, fed more quickly after the operation, they are made to walk. This contributes to a reduction in the length of stay in the hospital” explains the surgeon. There is a francophone group from RAAC, GRACE. Surgical teams adhere to this program.
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