Visiting hours:

Tue 8.30–10.30
Doctor:
Head of Department, Dr Pavel Horák
Dr Mariya Kengbaeva

Consultant:
Dr Noémie Derhy
Dr Vendula Bendová

Appointments:

• Telephone number for appointments: +420 26608 2249, outside surgery hours +420 26608 2740
• Appointments outside the scheduled hours can be arranged by calling +420 26608 2740, or by email: chirurgie@bulovka.cz, pavel.horak@bulovka.cz

Thoracic surgery has a long-standing tradition at Bulovka University Hospital. Currently, the number of patients treated and operations performed is increasing, and new methods of surgical treatment are being introduced (IRE*, SITS**). Through our specialist outpatient clinic for thoracic and oncological surgery, we refer patients for surgical procedures, carry out post-operative check-ups and provide follow-up care.

At the Department of Surgery, we perform all types of thoracic surgical procedures, including minimally invasive procedures and oesophageal surgery.
We treat acute conditions 24 hours a day; trauma care is provided in collaboration with the Orthopaedic Department at Bulovka University Hospital. The date of admission forsurgery and the extent of pre-operative care are determined by the referring doctor, either during an examination at our specialist outpatient clinic or during a consultation at Bulovka University Hospital.

List of required investigations:
appropriate chest X-ray, or CT scan and other imaging methods where appropriate, spirometry, a pulmonologist’s assessment regarding any potential surgery, endoscopy.

Scientific, research and other professional activities: The department provides teaching for medical students at the First Faculty of Medicine, Charles University.

*IRE is a specialised method for treating inoperable tumours.
**SITS is a minimally invasive surgical technique involving a single incision into the pleural cavity.

Consultation hours:

Mon 9.00–12.00
Dr Tomáš Vašina, Dr Vendulka Brabcová, MUDr. Pavel Ditl, MUDr. Aneta Erbenová

Booking:

• During consultation hours +420 26608 2249, outside consultation hours +420 26608 2740
• A referral from a GP is required to book an appointment at the clinic.

The clinic caters for patients with arterial and venous problems. We perform the full range of peripheral vascular surgery procedures the full spectrum, in collaboration with specialist angiology outpatient clinics within the internal medicine departments and the radiology unit, which carries out angioplasty procedures where indicated.
The range of vascular surgery at the clinic includes procedures on the arteries branching from the aortic arch, primarily those supplying the brain, and procedures on the arteries of the upper and lower limbs.
 

We also carry out reconstructive surgery following arterial injuries. In addition to arterial procedures, we carry out surgery on the veins of the lower limbs, surgery on the large veins, and surgery on blood vessels in connection with cancer. In collaboration with the dialysis centre, we create shunts for dialysis access.

Visiting hours:

Tue 9.00–13.0

Doctors:
MUDr. Daniela Engelová, MUDr. Klára Jágrová, MUDr. Natalie Harciníková

Secondary doctor:
MUDr. Anna Stefanovičová

Appointments:

• During consultation hours +420 26608 2699, +420 26608 2740

Mammology deals with the surgical treatment of breast diseases. The Breast Clinic has traditionally worked in collaboration with the oncology team for several decades, now as part of a comprehensive oncology centre. We offer patients the option of rapid, comprehensive diagnosis, i.e. clinical examination, ultrasound, mammography, and magnetic resonance imaging, with the option of taking a breast tissue sample and conducting a histological examination.

In terms of surgical procedures, we perform both radical and breast-conserving surgery, with the option of axillary-sparing surgery using ‘sentinel lymph node’ detection.

Our work also involves close collaboration with the plastic surgery department, to facilitate any reconstructive surgery covered by health insurance, and with the oncology centre, where patients subsequently receive post-operative radiotherapy or further targeted cancer treatment.

We also arrange therapy and rehabilitation at a specialist lymphatic drainage centre within the dermatology clinic. Appointment times for surgery are within 14 days of the initial consultation at our clinic

Consultation hours:

Mon 10.00 – 13.00 

Dr Filip Fröhlich

Appointments:

• During consultation hours +420 26608 2162, outside consultation hours +420 26608 2740
• A referral from a GP is required to book an appointment at the clinic.

Surgical and pharmacological treatment of patients with Crohn’s disease and ulcerative colitis.
A full range of surgical treatments is provided, including specialised procedures such as the removal of the entire large intestine with the creation of a replacement rectum – known as a proctocolectomy withileo-pouch-anal anastomosis in the case of ulcerative colitis, or bowel-preserving surgery for Crohn’s disease. We use a combination of surgical and conservative treatment when caring for patients with the perianal fistula-forming form of Crohn’s disease.
Following surgery, patients are monitored and treated conservatively, including nutritional care.
We recommend that you bring all your complete medical records to your scheduled consultation (results of endoscopic examinations, radiological examinations – preferably on a CD – and a report on previous medication).

• Surgical treatment of patients with FAP – Familial adenomatous polyposis
  We provide consultations and determine the need forsurgery for patients with the above diagnosis. For most patients, the solution is an operation involvingremoval of the entire large bowel and the creation of a replacement rectum – known as a proctocolectomy with ileo-pouch-anal anastomosis (IPAA), enabling life without a stoma.
• Surgical treatment of anal fistulas
  For our patients, we perform most surgical procedures in the rectal area (removal of haemorrhoids, surgical treatment of intestinal fistulas and fissures). We specialise in rectal conditions associated with Crohn’s disease.
• Colorectal oncological surgery
  We carry out operations for colorectal cancer, including surgical treatment of advanced stages requiring major surgery such as the removal of pelvic organs (pelvic exenteration).
• Stoma care
  As part of our outpatient clinic, we provide consultations and treatment for complications in patients with a stoma. A stoma nurse is available every Thursday and Friday (daily in acute cases) from 8 am to 12 noon, by prior telephone appointment on 266 082 698.
• “FAST TRACK” – A modern approach to post-operative recovery.

We apply this procedure to patients awaiting abdominal surgery. It consists of a set of measures designed to reduce surgical stress, post-operative complications and the length of hospital stay, based on evidence-based medicine (EBM). The perioperative period is much more comfortable for patients than with the conventional approach:
Patients do not fast on the day before surgery but eat as normal; in the evening they drink a special carbohydrate-based anti-stress cocktail, which they also drink on the morning of the operation, two hours before surgery.
Bowel preparation with laxatives is not necessary in most cases.
Great emphasis is placed on post-operative pain management. Ideally, an epidural catheter (in the space around the spine) is inserted by an anaesthetist before the operation. Well-managed pain allows the patient to walk and get out of bed as early as the day of the operation.
Another key principle is early oral intake of food, so that patients can begin a soft diet on the day of the operation, subject to tolerance.

Consultation hours:

Wed 8.40–10.20 
Dr Petr Šlauf
Appointments: +420 26608 2249

Thu 8.30–11.00 
Dr Jan Pertlíček
Appointments: +420 26608 2249

Thu 12.00–14.00
Dr Dita Benešová
Appointments: +420 26608 2162

Fri 9.00–12.00 
MUDr. Josef Marx

Appointments:

• Outside the doctor’s consultation hours: +420 26608 2740
• A referral from a GP is required to book an appointment at the clinic.

Proctology and colorectal surgery deal with faecal incontinence, pelvic floor disorders and anal fistulas. Diagnosis and treatment (both surgical and conservative) of faecal incontinence and other pelvic floor disorders (rectal prolapse, rectocele, enterocele, rectal evacuation disorders, etc.)

Diagnostic procedures include: anorectal manometry, endoanal and endorectal ultrasonography. The following are also carried out within the hospital: defecography, CT and MRI scans of the pelvic floor. As part of the conservative treatment of mild faecal incontinence and the treatment of rectal evacuation disorders, special exercises known as biofeedback can be carried out.
The success rate of surgical reconstruction of the anal sphincters for faecal incontinence is 89 per cent (see Rozhl. Chir., 2008, vol. 87, no. 8, pp. 426–431). We perform permanent sacral nerve stimulation – a new method of treating faecal incontinence introduced by the F Surgical Clinic NB as the first in the Czech Republic in 2010. Results to date show a 93 per cent success rate! Surgical management of complicated anorectal and rectovaginal fistulas.

Consultation hours:

• by prior appointment
  Doctor: Prof. MUDr. Robert Gürlich, Csc.
• Thu 11.30–14.00
  Doctor: MUDr Jozef Varga

Appointments:

• During consultation hours +420 26608 2249, Appointments outside consultation hours: +420 26608 2740
• A referral from a GP is required to book an appointment at the clinic.

We provide surgical treatment for both benign and malignant conditions.
As part of our specialist outpatient service, we refer patients for surgical procedures, carry out post-operative check-ups and provide follow-up care.
We carry out pre-operative gastroscopic examinations, followed by regular post-operative gastroscopic examinations as part of our follow-up care.
We work closely with the gastroenterology department at FNB, as well as with the oncology department as part of the pre-operative oncological surgery seminar.
We recommend that you bring all your medical records with you to your scheduled consultation (results of endoscopic examinations and radiological examinations, preferably on a CD).
We now refer patients with primarily inoperable tumours, where indicated, for treatment using the IRE method with the Nano Knife (for further details, see the thoracic surgery section).

Consultation hours:

Tue 9.00 – 11.00 Dr Veronika Nevídalová

Wed 7.00 – 8.00 MUDr. Zdeněk Janeček

Fri 9.00 – 12.00 MUDr. Josef Marx

Appointments:

• During surgery hours +420 26608 2162 (Tue), +420 26608 2249 (Wed, Fri)
• Appointments are required for the clinic.

Hernia surgery at FNB has a long-standing tradition. Close monitoring of patients at the hernia clinic enables us to reduce the incidence of post-operative recurrences and to manage even more complex cases. Surgical procedures for hernia repair are in line with the latest guidelines from the European Hernia Society (EHS) from 2009.

Which hernias we operate on and how:

• Inguinal and femoral hernias – open repair without mesh, with mesh (depending on the size of the defect), laparoscopic repair (TAPP)
• Umbilical hernias, abdominal wall (ventral) and in the scar following previous abdominal surgery (laparotomy) – open repair without mesh (mainly small umbilical hernias) – conventional repair with mesh (most other hernias)
• Diaphragmatic hernias – laparoscopic repair of the diaphragmatic defect + fundoplication

Waiting times for surgery are up to 14 days from the first consultation at our clinic.

What else we offer:

• consultations – assessment of the medical condition relating to the local finding, assessment of the most suitable solution
• prescription of hernia trusses – selection of a suitable, made-to-measure truss
• regular follow-up – post-operative monitoring for a period of 2 years + assessment of clinical condition

Consultation hours:

Fri 12:00 – 13:00 
Dr Josef Marx

Appointments:

• During consultation hours +420 26608 2429
• You must book an appointment to visit the clinic.

Our clinic is the only centre in the Czech Republic specialising in this field. Combined surgery with concurrent hyperthermic chemotherapy is the global gold standard for the treatment of rare tumours (pseudomyxoma and peritoneal mesothelioma), but it is also used for disseminated intestinal or gynaecological tumours.

Hemico-rectomy

• This involves the surgical removal of the lower half of the body in very rare cases of otherwise untreatable chronic sepsis (blood poisoning) caused by extensive inflammation of the soft tissues and bony skeleton of the pelvis. We are the only centre in the Czech Republic – and probably in Europe as well – to perform this rare operation at our clinic.

IRE/NanoKnife New unique tumor surgery in electric field. In August 2011, the first lung cancer surgery in this way was performed at Bulovka Hospital. The Surgical Clinic of the 1st Faculty of Surgery of the Charles University and FNB is one of the few workplaces in the world where IRE has been successfully used in human medicine and the first workplace in the Czech Republic to use the method for treatment of lung cancer. The IRE can treat lung, pancreatic and liver tumours up to a maximum size of 5 cm.

TUE 12.00-14.00 MUDr. Martin Šnajdauf, Ph.D.

Dr Vendula Bendová

Wed 9.00–14.00 every even-numbered Wednesday of the month

Important notice:

• We do not remove growths on the face, neck, genitals or shins.
• A referral from your GP is required for every procedure.
• For birthmarks, an examination and referral from a dermatologist are also required.
• If you are taking anticoagulant therapy, please consult your treating doctor (GP, general practitioner, internist, cardiologist) well in advance to find out whether you need to stop or change your treatment. We cannot treat patients on anticoagulant therapy due to the increased risk of bleeding during an outpatient procedure!
• Stitches are removed 1–2 weeks after the procedure, depending on the size and location of the treatment.
• After the procedure, the excised tissue is sent for histological examination.

Appointments can be made on any weekday between 7.30 am and 2.30 pm on +420 266 08 2740