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<h2>What is Varicocele?</h2> <p>Varicocele is the varicose of veins that drain blood of the testicles, which is encountered in 30-40% of the patients who are presented to the doctor with the problem of infertility. Varicocele is the clinical name given to the enlargement of testicle veins like varicose in the legs. Disruption of testicular temperature affects testicular function and impairs sperm and testosterone production, with toxic substances in dirty blood accumulating in the testicle and disrupting testicular blood flow.</p> <h2>What are the symptoms of varicocele?</h2> <p>Varicocele symptoms are very important for the diagnosis and treatment of the disease. Swelling on the testicle</p> <ul> <li>and pain in the testicle</li> <li>may be the symptoms of varicocele.</li> <li>Testicle pain may be a symptom.</li> </ul> <p>The dilatation of the veins may become evident enough to be seen from outside after a while and may take on an varicose-like shape on the legs. Symptoms of varicocele include swelling in the testicles, as well as sweating and a feeling of warmth. The shrinkage of the testicles, which is one of the symptoms of varicocele, can be seen in some patients, although rare.</p> <h2>Why Does Varicocele Occur?</h2> <p>The cause of varicocele is unclear. It is observed in individuals with children in the society at a rate of 15-20% even in adult ages. It is observed in 30-40% of men applying for infertility. In secondary infertility, who have had a child before and who apply again with a child request, it can be up to 60%.</p> <p>While varicocele is seen 90% in left testicle, 8-9% observed in bilateral. Its rate of being seen only on the right is 1-2%. The appearance of varicocele mostly on the left side depends on a number of anatomical factors.</p> <ul> <li>The left side testicle is slightly lower than the right side.</li> <li>The vein on the left side of the testicle is longer than the right side.</li> <li>Anatomical relationship of the left side testicle vein with other neighboring organs in the abdomen.</li> <li>Among the features such as the anatomical structure of the left side testicle vein emptying, varicocele is among the reasons why it is seen on the left side.</li> </ul> <h2>How to Understand Varicocele?</h2> <p>Careful individuals can identify the varicocele from irregularity, swelling or pain on the testicle when self-examining. Varicoceles are mostly diagnosed during the doctor&#39;s examination in applications made with infertility complaints. Also; Pain in conditions requiring effort such as long standing, sports or sexual activity may indicate varicocele. Varicocele examination is performed as part of the genital examination. The patient should be examined in a standing position at a room temperature of 21 -22 degrees. The testicles and genital area are observed while the patient is standing and standing upright. The patient is examined both in the normal position and by straining maneuvers by observation and hand. It should be determined whether there is an expansion in the vascular structure with normal and strain maneuvers. With these procedures, the presence of varicocele is clinically determined. The golden standard is physical examination in diagnosis. In addition, Scrotal Doppler ultrasonography is performed to support clinical diagnosis, to determine the degree of varicocele and to decide on surgery.</p> <h2>How is Varicocele Treatment?</h2> <p>After the diagnosis of varicocele, firstly, whether there is a difference between the testicle sizes and the consistency of the testicle should be checked. Performing semen analysis in which sperm parameters are evaluated is decisive in the treatment. If the patient&#39;s sperm parameters do not have a problem, it is controversial whether they should be operated or not.</p> <p>The factors can disrupt sperm parameters in this kind of patients;</p> <ul> <li>Eating habits</li> <li>Smoking and alcohol</li> <li>Exposure to toxic substances</li> </ul> <p>Antioxidant drugs and nutritional methods can be recommended to correct sperm parameters and the environment in which sperm are located. After the diagnosis, the question arises as to which varicocele patients will be operated. It is not a correct approach to make an operation decision by looking at the varicocele grade, that is, the grade value. In some cases, even a 1st degree (Grade 1) varicocele can be operated, while in some cases, surgery may not be decided for 3rd degree (Grade 3) varicocele. Operation decision is a situation that varies according to the patient. &nbsp;</p> <p>Supportive therapies may be recommended in the patient group who have been diagnosed with varicocele but have no infertility problem or whose impairment in sperm parameters is limited.Antioxidant agents can be given for patients who have not experienced severe sperm loss, whose sperm motion has not completely disappeared, and sperm deformity is minimal. However, surgery can be recommended in patients who have been diagnosed with varicocele and whose sperm parameters are impaired and who are infertile. In such patients, changes in exercise, diet and lifestyle are not beneficial for the elimination of the disease.&nbsp;</p> <p><strong>As a result;</strong></p> <ul> <li>The patients with normal sperm parameters, only radiological varicocele, no reflux or below normal vascular diameter are not required to be operated.</li> <li>Patients with impaired sperm parameters benefit more from surgery.</li> <li>It is important to perform clinical follow-up by evaluating testicular sizes and consistency in varicoceles in adulthood.</li> <li>Varicocele surgery only due to pain is not a right approach.</li> <li>After the surgery, 60-70% sperm parameters improve.</li> <li>It is important to perform the postoperative evaluation at the 6th month and to determine the change in sperm parameters.</li> <li>The accepted approach in the treatment is interventions made from the groin area by microsurgery.</li> </ul> <h2>FREQUENTLY ASKED QUESTIONS ABOUT VARICOCELE</h2> <p><strong>How is varicocele pain?</strong></p> <p>Varicocele pain is an uncomfortable blunt, distinctive pain in the testicle. This pain can be felt in the groin area and the testicle, as well as from time to time in the leg. Varicocele pain can go away with painkillers. The pain experienced can be confused with different ailments. Besides the presence of varicocele in a patient who applied for testicular pain;</p> <ul> <li>Hernia</li> <li>Urinary tract calculus (kidney calculus) that fall into the urinary tract or bladder</li> <li>Orchitis, testicular infection</li> <li>It should be evaluated whether the vascular structure of the testicle rotates around itself and causes bleeding.</li> </ul> <p>Pain caused by such ailments can be confused with varicocele pain. Some inquiries such as whether the person has a complaint in urination, whether the swelling in the testicle has increased, whether the pain begins suddenly or not, and laboratory methods can provide the differential diagnosis. Not all pain must be varicocele.</p> <p>Pain can be felt more pronounced after standing for a long time, walking, exercise, sexual activity.</p> <p><strong>How does the testicle look in the varicocele?</strong></p> <p>The varicocele does not cause any changes in the testicle. However, in advanced varicocele patients, the veins cab be seen as superficial in testicles, such as varicose veins in the legs. Varicose enlarged veins can be palpable through the skin and can be observed.</p> <p><strong>Who has varicocele mostly?</strong></p> <p>The reason for the occurrence of varicocele is unknown. However, there are some risk groups:</p> <ul> <li>Mostly overweight people</li> <li>People doing high-weight sports that increase intra-abdominal pressure</li> <li>People suffering from chronic asthma and chronic cough attacks</li> <li>People who experience chronic constipation that increases intra-abdominal pressure</li> <li>It can be considered as occupational disease as in varicose disease. Occupational groups such as teachers and police, which standing up are more common.</li> </ul> <p>Varicocele is common in people with varicose veins in the legs because it is a vein disease. Inverse of this situation, varicose disease can also be seen in people with varicocele. Since both diseases are related to veins, insufficiency of the valves in these vessels may occur due to factors such as problems in the transmission of blood.</p> <p><strong>What is Bilateral Varicocele?</strong></p> <p>While varicocele is 90% seen in the left testicle, 8-9% can be seen on both sides. The occurrence of varicocele in both sides is named as bilateral.</p> <p><strong>Are there any foods good for varicocele?</strong></p> <p>Nutrition has nothing to do with varicocele formation or treatment. Only people with chronic constipation can be evaluated in this group. Fiber or olive oil nutrition which helps eliminate constipation may benefit indirectly.</p> <p><strong>Does varicocele cause infertility?</strong></p> <p>Varicocele ranks first among the treatable infertility causes. If the varicocele causes male infertility, then an operation decision can be made. However, it should be noted that not every varicocele is the cause of infertility and there may be no improvement in sperm values in each patient after surgery.</p> <p><strong>Does varicocele prevent erection?</strong></p> <p>The testicle has two basic functions. Varicocele may cause impairment in the functions of testicles that produce sperm and hormones. Chronic varicocele may lead to a decrease in the production of the male hormone called testosterone, as well as sperm production, by causing a decrease in testicle size in the later periods. If chronic varicocele is not treated, it can cause erection and sexual desire loss along with low testosterone.</p> <p><strong>What are the varicocele grades?&nbsp;&nbsp;</strong></p> <p>According to the examination in the clinical environment, varicocele is evaluated as 3 stages, namely Grade.</p> <ol> <li>Grade (Grade 1): This is a situation in which the patient who is examined as standing up does not have any symptoms, however, the varicocele is detected by palpation when the patient strains.</li> <li>Grade (Grade 2): Varicocele can be slightly observed when the patient is standing up. This is a situation in which the veins become visible and palpable after the patient strains.</li> <li>Grade (Grade 3): This is a situation in which the vessels are visible without straining on the patient who is examined as standing up and this image becomes more evident at the end of the straining maneuver. &nbsp;</li> </ol> <p><strong>For which patients, varicocele surgery decision is made?</strong></p> <p>In order to decide on varicocele surgery, it is necessary to reveal the presence of varicocele and have infertility in the patient. In patients with this condition, surgery can be decided with the support of the following criteria:</p> <ul> <li>Shrinkage in testicle size, softening in testicular consistency</li> <li>More than 3 mm vascular dilation with Doppler ultrasonography</li> <li>Determination of blood backflow in Doppler examination</li> <li>Impaired sperm parameters in semen analysis</li> </ul> <p>In addition, in the patients who has varicocele and who have previously undergone assisted reproductive methods but failed, treatment of varicocele may be recommended as a risk factor before a new application if the failure is known to be caused by sperm factor.</p> <p>It is not correct to make an operation decision in people only with testicular pain.</p> <p><strong>How is varicocele surgery performed?</strong></p> <p>Varicocele surgery is performed by microsurgery. The testicle veins are reached by entering through a 2 cm incision in the groin area. Under the microscope, the enlarged veins are separated from other vessels and connected.</p> <p><strong>How long does varicocele surgery take?</strong></p> <p>Since varicocele surgery is performed with microsurgery methods, all the vessels in that area must be connected. Depending on whether the operation is unilateral or bilateral and the number of vessels connected, the duration may vary between 1-2.5 hours.</p> <p><strong>Are there any risks of varicocele surgery?</strong></p> <p>Since varicocele surgery is performed by microsurgery method, the complication rate is extremely low. The most important risk is the attachment of the testicular artery and associated post-operative testicular shrinkage and impaired blood supply. However, since the surgery is performed by microsurgery, the arterial and vein distinction can be made very clearly. The probability of experiencing such a complication is extremely low today. The likelihood of fluid accumulation around the testicle, namely hydrocele, is also extremely reduced. Apart from this, risks such as postoperative infection development and bleeding formation that may occur in all surgeries should not be ignored. With precautions such as attention to sterilization and hemostasis, possible problems are minimized.</p> <p><strong>Are there different treatment methods for varicocele?</strong></p> <p>Treatment of varicocele is performed by using different surgical and radiological methods.</p> <p><strong>Varicocele embolization;</strong> Interventional radiology methods can be used for entering through the groin and an occlusive substance injection can be made into the enlarged veins. However, in this method, side effects such as mobilization of the occlusive substance, that is, going to other places, loss of effectiveness of the substance over time, pain and allergic reaction can be experienced. This treatment approach is not highly recommended in international guidelines.</p> <p>There are also surgical methods applied other than microsurgery.There are approaches from the groin area, high groin area or laparoscopic. However, surgery under the microscope from the lower groin area is considered as the golden standard.</p> <p><strong>Does varicocele reoccur?</strong></p> <p>There are different treatment methods of varicocele, but the probability of recurrence is almost zero in surgeries performed with microsurgery.</p> <p><strong>How long is the healing time of varicocele?</strong></p> <p>After the surgery performed with the microsurgery method, the patient can return to his normal activity within 2-3 days and to routine business life within 1 week and 10 days. It may take 4-6 weeks to perform activities that require heavy effort and exercise.</p> <p><strong>When do sperm improve after varicocele surgery?</strong></p> <p>To evaluate the effect of varicocele surgery on sperm, sperm production time should be considered. The time from the main germ cell to the production of mature sperm in the testicle is considered to be an average of 90 days. So sperm parameters are checked every 3 months after surgery. The best recovery in terms of sperm production after varicocele occurs at the 6th month. If there is an improvement in sperm parameters at the 6th month, the 9th and 12th months should be expected when the increase becomes more evident. However, if there is no change in sperm parameters 6 months after the operation, an additional improvement due to the operation should not be expected in the patient. It is necessary to direct the patient to other treatment alternatives. After the operation, an improvement in the sperm parameters of the patient is observed in 60-70%. While 30 - 40% of the patients do not see any improvement, less than 1% of patients may experience worsening after varicocele surgery. This very rare condition occurs mostly in patients experiencing bilateral varicocele.</p> <p><strong>What are the conditions that patients should pay attention to after the operation?</strong></p> <p>After varicocele surgery, it is necessary to stay away from sportive activity, heavy exercise and sexual activity by following the doctor&#39;s recommendation in the early period. It is appropriate to wait 15-20 days for sexual activity and 4-6 weeks for exercises that require effort ans sports. Apart from these, it is necessary to follow the treatment methods recommended by the doctor.</p> <p><strong>Is there pain in the testicles after surgery?</strong></p> <p>In varicocele surgery, which is a surgical procedure, there may be some kind of neuralgia pain, especially due to damage to the nervous tissues in the testicle area. In addition, it is not the right approach to operate patients suffering from only testicular pain. There may be many underlying causes of pain in such patients. Pain continues after surgery in such patients. The most important reason for failed surgery is patients who do not have infertility, but experience pain alone.</p> <p><strong>Does swelling occur after varicocele surgery?</strong></p> <p>Post-operative testicular connective tissue release may result in testicular sagging on the operated side. However, swelling is the increase of fluid that is normal around the testicle, that is, the development of Hydrocele. It is a more experienced situation in the methods applied outside the microsurgery method. It is a problem seen less than 1% in operations performed with microsurgery method. Since the lymphatic vessels are clearly demonstrated and no operations such as connection or burning are performed, the lymphatic circulation is not affected, so there is no swelling and swelling around the testicle after surgery.</p> <p><strong>Can those who have varicocele surgery have children?</strong></p> <p>After the operation, sperm parameters improve in 60-70% of the patients. If there is no improvement in sperm parameters in the 6th month, it is useful to direct the patient to methods such as vaccination or in vitro fertilization according to the sperm parameters of the patient, taking into account the conditions such as age factor and female factor. If a young patient who comes to the doctor to evaluate the general condition and has a diagnosis of varicocele with impaired sperm parameters and wants to have children in normal ways, varicocele surgery may be recommended. However, in the older patients with the same diagnosis, instead of wasting time with varicocele surgery, it is more appropriate to refer them with to treatments such as IVF or vaccination. Here, the clinical condition and age of the patients are taken into consideration. Infertility should be evaluated bilaterally not only as the condition of the individual but also as the condition of the couple.</p> <p><strong>What happens if varicocele is not treated?</strong></p> <p>Varicocele is a chronic condition and does not heal on its own. If left untreated, it can progressively cause decrease in testicle size, enlargement in varicocele size, further decrease in sperm parameters, and hormonal disruption in the testicle in the future. Also, none of these may happen and the patient can have it as standard for life. There is no such thing as the operation of every varicocele.</p> <p><strong>Does varicocele occur in young people and children?</strong></p> <p>An important problem of varicocele is its observed in young people. Varicocele, which is less than 1% in the child age group, is observed by 15% in the 13-15 age group. It is very difficult to evaluate the effect of varicocele on the testicle in the 16-17 age group. Since sperm production has not started completely in this age group, it is not very healthy to evaluate sperm function. In addition, it is not ethically correct to perform semen analysis in young people in this age range. In young people whose surgery decision is difficult to make; when evaluating testicle sizes and testicular consistency, it is necessary to determine the degree of varicocele radiologically. Surgery may be considered if the varicocele causes differences and shrinkage in the size of the testicles. However, in young people who do not have a difference in testicle size and consistency, it is more appropriate to decide on surgery by evaluating sperm parameters by semen analysis when the patient at least reaches the age of adolescence.</p>


<p>Polycystic ovary syndrome (PCOS), which is very common in women of reproductive age, is among the most important causes of infertility, as it reveals the problem of not being able to ovulate. Benign cysts that form in the ovaries cause hairiness, excess weight gain and acne along with menstrual irregularity. This disease can be combated with diet and exercise under the control of a dietitian, and appropriate drug treatment.</p> <h2>What is polycystic ovary syndrome?</h2> <p>Polycystic ovary syndrome, which is an important ovulation problem in women, is seen in one of every 10 women. This problem, which is common in women of reproductive age, manifests itself as benign cysts that occur in the ovaries. Polycystic ovarian syndrome, which is diagnosed with the appearance of more than 10 cysts smaller than 1 centimeter in ultrasonography, which is a imaging technique, can lead to infertility, diabetes, coronary artery diseases and blood pressure disorders if not treated in women of reproductive age.</p> <h2>How does polycystic ovary syndrome develop?</h2> <p>Two ovaries, which are for reproduction in the female body, develop a mature egg suitable for fertilization in one menstrual period. The egg develops and matures in a vesicle filled with fluid called follicle. A follicle is selected every month in women, it grows and ovulates. In women with polycystic ovarian syndrome, this follicle cannot be selected and therefore there is no ovulation every month. In the ultrasound examination, the ovaries are seen as many vesicles with undeveloped eggs, that is, many cysts.</p> <h2>Which situations should be suspected?</h2> <p>It turns out that about 20% of women who apply to IVF centers have a problem of ovulation. Polycystic ovarian syndrome is the leading problem of ovulation in women who are examined by specialist physicians to have children. Women who have menstrual irregularities, overweight and hairiness problems should be diagnosed after physical examination and ultrasound to be performed. During adolescence, sometimes menstrual irregularity occurs as a normal condition. However, the presence of this disease in adolescent girls with menstrual irregularities can be&nbsp;revealed thanks to laboratory tests as well as imaging techniques.</p> <h2>What are the symptoms?</h2> <p>In adolescence, after one or two periods no menstruation, irregular menstruation (menstruation less rare than 35 days), unusual bleeding.</p> <p>Excessive pimples on the face and back, visible changes in skin tissue, maculation on the hand. Polycystic ovary syndrome is mostly the cause of recurrent acne, especially in the 20s.</p> <p>As a result of this disease, excessive hair growth and deepening of the voice in the body are thought to be due to the male hormone (androgens). The hormone testosterone, which is present in a certain proportion in every woman, increases during this period, causing hairiness and thickening of the voice.</p> <p>Male hormone, the level of which increases in the body due to polycystic ovary syndrome, can adhere to the receptors in the hair follicles (receptor) and cause male pattern hair loss.</p> <p>Especially as a result of decreasing female hormones and increasing male hormone, breast sizes may reduce over time.</p> <p>Difficulty or infertility in getting pregnant is an important symptom. This problem, which is seen in 10% of young women, is one of the most important causes of infertility.</p> <p>Excessive weight gain. Half of the women with polycystic ovaries were found to be obese.</p> <h2>What causes polycystic ovary syndrome?</h2> <p>Despite numerous clinical and experimental studies, it is not known exactly what caused the disease. However, the disease is thought to be caused by the &#39;insulin&#39; hormone that regulates carbohydrate metabolism. It is thought that excess weight causes insulin resistance and insulin resistance triggers polycystic ovary syndrome. Insulin, the main hormone that enables sugar, the main food source in the body, to enter the body cells (muscle, fat and liver cells) from the blood to provide energy, is secreted from beta cells in the pancreas. Secretion of high levels of insulin that occur in the body with insulin resistance increase the production of male hormone (androgens) in the ovaries.</p> <h2>How is the treatment of the disease?</h2> <p>When planning treatment, these patients should be reduced to ideal weight under the supervision of a dietician. If necessary, &#39;metformin&#39; drug treatment used in diabetics to break the insulin resistance is used in this period. As a result of medical treatment and weight loss, there may be a significant improvement in the number, and sometimes the pregnancy may occur spontaneously when the ovulation problem disappears. However, if menstrual irregularity persists after these procedures, ovulation stimulating drugs and hormone needles can be applied. Pregnancy is tried to be created by suggesting a normal intercourse from the eggs that develop as a result of these follow-ups or by vaccination method. If pregnancy could not be achieved with 3-4 times follow-up and vaccination, it is recommended to switch to IVF.</p> <h2>What should be recommended to women?</h2> <p>It is absolutely important for women with polycystic ovary syndrome skip gynecological follow-ups after pregnancy and to continue annual examinations. In these patients, some diseases, especially diabetes, may occur in older ages. To prevent this, excess weight gain should be prevented, regular exercise should be recommended and if necessary, regular menstruation should be provided with medications.</p> <h2>FREQUENTLY ASKED QUESTIONS ON POLYCYSTIC OVARY SYNDROME</h2> <p><strong>I use a drug used in diabetics, is there any harm to the body?</strong></p> <p>The drug called metformin used in diabetes is given to many women diagnosed with polycystic ovary syndrome to provide ovulation. In addition, studies have shown that this drug reduces the risk of miscarriage in pregnant women.</p> <p><strong>Is there a cure for the disease?</strong></p> <p>There is no definitive cure for polycystic ovary syndrome. In the disease that occurs due to many parameters, complaints are reduced by weight control to be achieved with drug therapy and diet.</p> <p><strong>Besides infertility, does this disease have other negative consequences?</strong></p> <p>One of the most important consequences of polycystic ovarian syndrome is that the body develops resistance to insulin. Due to the long duration of insulin resistance, many women become diabetics in the long term. It has been determined that the risk of high blood pressure and heart diseases arises due to the disease.</p> <p><strong>Is there any harm in irregular or absent menstruation?</strong></p> <p>The body is exposed to high estrogen effects for a long time because ovulation is rare or absent in women with rare menstruation due to this disease. Progesterone secreted after ovulation will suppress the effects of estrogen, resulting in the possibility of uterine cancer.</p> <p><strong>Is there a good side of this disease?</strong></p> <p>In the studies conducted, it was determined that the number of ovaries in women with PCOS is better (AMH values are higher) and that these patients maintain their egg count better than other women and menopause age is advanced even in the later ages.</p>

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What is Robotic Prosthetic Surgery?

<p>Thanks to its three main units, consisting of &quot;Robotic Prosthesis Surgery,&quot; computerized control and guidance module, camera, and display, the physician has the possibility to obtain the same result after each case and, moreover, to perform a correct and sensitive operation by doing special planning for the patient before the case.</p> <p><strong><em>For which diseases/conditions is robotic prosthetic surgery used?</em></strong></p> <p>In the field of orthopedics and traumatology, robot technology can now be used in all total hip,&nbsp;half-knee prosthesis&nbsp;surgeries called unicondylar knee prosthesis and patella-femoral knee cap prosthesis operations. However, it is expected to be used in shoulder, spine, and tumor surgeries in the near future.</p> <p><strong><em>What are the advantages of Robotic Prosthetic Surgery?</em></strong></p> <ul> <li><strong>Advanced Planning:</strong>&nbsp;It is possible to develop patient-specific advanced preoperative planning on the 3-dimensional model created from the patient&#39;s own CT (Computed Tomography) scan. This way helps position the implant most accurately with the patient within the plan. Compared to the conventional (classical) method, it provides more protection for the patient&#39;s soft tissues due to predictable preoperative planning.</li> <li><strong>Dynamic joint balancing:</strong>&nbsp;Enables precise joint balancing controlled by the physician to ensure the best possible placement of the implant (prosthesis). &nbsp;</li> <li><strong>Robotic arm-assisted bone preparation:</strong>&nbsp;<em>Haptic Feedback</em> technology allows the bone saw to cut very precisely and accurately within the planned area on the 3-dimensional model created from the patient&#39;s CT scan without the need for traditional incision blocks. Thanks to the advanced haptic feedback technology for doctors, incorrect and additional cuts are avoided, and the doctor himself gets a more precise control and a sense of security.</li> <li>After surgery, the goal is for patients to achieve better functional goals than with traditional (manual) surgical methods.</li> <li>The survival rate of implants placed in the patient may be higher than in conventional cases. In other words, the risk of wear and loosening of the prosthesis may be lower.</li> <li>Because the robotic arm-assisted orthopedic surgical system causes less soft tissue damage than the classic (manual) technique, fewer analgesics are used in the postoperative period, and patient satisfaction may be higher.</li> <li>Compared to conventional operations, the robotic arm-assisted orthopedic surgical system offers significant advantages to both the patient and the physician. Patients may have more functional joints than with conventional methods. On the other hand, doctors can perform more controlled surgeries thanks to the robotic arm.</li> <li>The quality of life in the recovery process is higher, and the return to everyday life is shorter.</li> </ul> <p>Compared to the classical method, in robotic prosthetic surgery and knee and hip replacement surgery:</p> <ul> <li>Return to daily life occurs in a shorter time.</li> <li>Discharge time is shorter.</li> <li>There is less risk of blood loss.</li> <li>The patient&#39;s need for pain medication after surgery decreases.</li> <li>The life of the prosthesis may be longer.</li> </ul> <p><strong><em>How is Robotic Prosthetic Surgery applied?</em></strong></p> <p>It is determined how the operation will be performed, where the incisions will be made, which type and size of prosthesis will be used, and fine adjustments are made on the tomography taken before the operation, using special software under the control of the physician. The operation begins with the initial work performed in the surgery, and the patient&#39;s actual bone structure is introduced to the robot via sensors, final modifications are made, and incisions are made by determining the incision degrees. The control of the ligament balance is then rehearsed on the patient with both virtual and trial prostheses. Finally, the necessary final adjustments that the physician deems appropriate are made, and the prosthesis is implanted.</p> <p>There is no different preparation process for the patient than for a normal operation. Robotic devices are designed to allow the physician to move more comfortably during the procedure, causing less damage to the patient&#39;s tissues and thus making the postoperative process more comfortable.</p> <p><strong><em>Frequently asked questions about Robotic Prosthetic Surgery</em></strong></p> <p><strong>Is Robotic Prosthetic Surgery suitable for all patients?</strong></p> <p>All patients who require a hip or knee prosthesis can benefit from robotic prosthesis surgery. There are no restrictions for patients undergoing Robotic Arm-Assisted Orthopedic Surgery.</p> <p>In addition to the lack of patient restriction, it is possible to perform prosthetic surgery in accordance with the patient&#39;s existing anatomy in a single session, whereas prosthetic surgery requires two surgeries for patients who have had previous deformities due to fractures or congenital bone structure problems.</p> <p>&nbsp;</p>


<p>Contact Us</p> <p>Add to Favorites</p> <p>PET / CT, which is a method that increases success in the fight against cancer in order to identify cancerous tissues, treatment planning and evaluation of the process, is considered as one of the most important technologies for many patients to have a healthy life.</p> <p>&nbsp;</p> <p>Contents</p> <p>What is PET / CT?</p> <p>What are the application areas of PET / CT?</p> <p>What are the features of PET / CT that make the difference?</p> <p>How is PET / CT operation performed?</p> <p>Frequently asked questions</p> <p>What is PET / CT?</p> <p>Positron emission tomography (PET-CT) technology, combined with computed tomography (CT), is an important technology medical imaging method that enables the diagnosis of many diseases. PET / CT is widely used in the diagnosis and staging of cancer. In addition, its effectiveness is utilized in the diagnosis of &quot;undiagnosable diseases&quot; such as fever of unknown cause, detection of infection foci, detection of living tissue in cardiac patients, and differentiation of Alzheimer&#39;s and dementia. In particular, all stages are carried out with a PET / CT device for the initial diagnosis, staging, determination of the prevalence and the correct treatment plan of the cancer. A road map of cancer treatment with PET / CT makes a significant contribution to the fight against the disease.</p> <p>&nbsp;</p> <p>It is used in Memorial Şişli Hospital, Memorial Bah&ccedil;elievler Hospital, Memorial Ankara Hospital, Memorial Diyarbakır Hospital and Memorial Health Group Medstar Antalya Hospital.</p> <p>&nbsp;</p> <p>What are the application areas of PET / CT?</p> <p>PET / CT, which guides cancer treatment, is used in the following stages of diagnosis and treatment;</p> <p>&nbsp;</p> <p>It determines the metabolism of the tissue with cancer suspicion.</p> <p>It reveals whether the masses detected by various imaging methods show cancer metabolism. If the mass is PET / CT positive, this mass consumes too much glucose and the probability of cancer is high.</p> <p>It is directive in taking biopsy from the correct and least disturbing area of the tissue with cancer suspicion. Cancerous tissue can also damage its own structure due to uncontrolled proliferation. Sufficient cells may not be obtained for diagnosis from tissue fragments taken from the damaged area, PET / CT shows the areas where living cells are concentrated and guides biopsy.</p> <p>It is a guide in reaching the diagnosis in the fastest way.</p> <p>What are the features of PET / CT that make the difference?</p> <p>Evaluation of cancer prevalence: PET / CT technology is successfully used in many types of cancer for the purpose of evaluating (staging) the disease prevalence at the first stage after cancer diagnosis. It is a guide for regional treatments in patients with disease that has spread (metastasis) to the body.</p> <p>Determination of the treatment approach: On average, after this examination, the treatment approach changes in one out of three patients. Sometimes drug treatment can be performed instead of a heavy surgical application and/or operation may not be required. In some cases, PET / CT shows that there is no spread in the patient who is thought to have distant spread, allowing the decision to remove the cancerous tissue by surgery instead of the drug treatment decision.</p> <p>Early detection of the benefit of cancer drugs: Cancer drugs are drugs whose side effects should be considered. Using the appropriate medication can prevent the side effects and prevent the disease with the right medication and early intervention to the cancerous tissue. The evaluation to be made with PET / CT after the 1st or 2nd course of treatment gives information about how useful the drug can be in the early period. Thus, the drug can be changed early and a new drug treatment can be started.</p> <p>Determination of treatment response: With PET / CT, response to cancer drugs can be evaluated by measuring both structural changes and the intensity of cellular activity numerically. After the treatment is completed, the effectiveness of the treatment can be determined by investigating the presence of live cancer cells. PET / CT is the imaging system that shows the earliest response to treatment.</p> <p>Making beam treatment plan: By mapping the areas of living tumor cells to be given radiation in radiotherapy or radiation therapy with PET / CT, the chance of correct and effective treatment increases. In addition, irradiation to healthy tissues is prevented.</p> <p>Early detection of recurrent disease: After treatment cures are completed, patients are followed up with methods such as ultrasound and tomography and blood tests. In these methods, in case of doubt, whether living cancer cells reappear or not and their prevalence are determined by PET / CT method.</p> <p>HOW IS PET / CT PROCEDURE PERFORMED?</p> <p>For PET / CT procedure, the patient needs at least 6 hours of fasting. First, the patient&#39;s blood glucose is measured. If the blood sugar is within the desired limits, radioactive material is injected into the vein. Although there are various radioactive materials, the most used one is F-18 Fluorodeoxyglucose. This substance is a sugar molecule bound to a radioactive substance called Flor-18. Following the injection, the patient is kept waiting for an hour to keep the drug in the cancerous tissue in sufficient amount. It is then captured in the PET / CT device. Other materials used in PET / CT are F-18 NaF to visualize bones, Ga-68 PSMA in the investigation of the spread of prostate cancers, and Ga-68 DOTA-TATE used in the investigation of neuroendocrine tumors. Apart from these, there are many radiopharmaceuticals that are not used routinely.</p> <p>&nbsp;</p> <p>PET / CT can increase the success in the fight against cancer in many stages from the detection of cancerous tissue to the treatment plan, from the evaluation of the treatment success to the planning of the radiation therapy.</p> <p>&nbsp;</p> <p>FREQUENTLY ASKED QUESTIONS</p> <p>What does PET / CT mean?</p> <p>The most important difference of cancer cells from normal cells is their rapid and uncontrolled proliferation. The energy needs of highly active cells are also higher than normal. When substances such as sugar, protein and some special building blocks used by cancer cells in this process are radioactively labeled and displayed, the location of cancerous tissues can be determined. The PET / CT device operates on the basis of this logic.</p> <p>&nbsp;</p> <p>What is PET / CT for?</p> <p>It is the most advanced medical imaging method in the diagnosis and staging of cancer to a great extent.</p> <p>&nbsp;</p> <p>How long does a PET / CT procedure take?</p> <p>It takes an average of 20-25 minutes, although it varies according to the area to be shot.</p>


<p><strong>What is O-Arm?</strong></p> <p>It is possible to get detailed information before the patient leaves the operating room by using the O Arm. Previously, it was performed in the operating room with a C-arm and 2-dimensional x-ray device called Scopy. O-Arm&#39;s high technology provides the opportunity to be a 3D image in the operating room environment. Since the O Arm is mobile, there is no need to move the patient for imaging.</p> <p>&nbsp;</p> <p><strong>In Which Diseases Is O Arm Used?</strong></p> <p>O-Arm is mostly used in brain, nerve and spinal cord surgery operations. In brain tumor surgeries, in addition to instant display of the risky area during surgery, it can be frequently used in spine instrumentation, ie spine screwing operations. Spine screwing operations;</p> <ul> <li>Spinal fractures</li> <li>Slipped Low Back</li> <li>Spinal Tumor</li> <li>Spinal curvatures, namely scoliosis</li> <li>Spinal collapse due to infection</li> <li>Situations where excessive bone is surgically removed due to narrow canal</li> <li>Spine screwing surgery can be applied in cases such as spinal deformities due to aging.</li> <li>O Arm advantages (distinctive features)</li> </ul> <p>Spine screwing operations are usually performed with a 3-armed X-ray device called a scopy. Images obtained with scopy are 2-dimensional, while images obtained with O Arm are 3-dimensional.</p> <p>&nbsp;</p> <ul> <li>The margin of error is minimized in screwing operations performed with the arm.</li> <li>It provides critical information to the surgeon at every stage of the surgery.</li> <li>The risk of recurrence is reduced</li> <li>Due to the short exposure time, the patient is exposed to very little radiation.</li> <li>The O-Arm imaging system provides rapid recovery to the patient with a small incision.</li> <li>This system minimizes the great risks of complex surgeries.</li> <li>It reduces the risk of infection.</li> <li>The risk of stroke due to the screw is eliminated.</li> </ul>


<p>Neuronavigation is an advanced technology application that is generally used in brain nerve and spinal cord surgery department surgeries.</p> <p><strong>What is neuronavigation?</strong></p> <p>It can be compared to the navigation systems used in automobiles and mobile phones. Neuronavigation provides guidance to the surgeon during surgery and helps to plan a sensitive surgical approach to the targeted lesion by defining the surrounding nerve and vascular structures. The neuronavigation system, which significantly increases the success of brain, nerve and spinal cord surgery, also allows surgeries to be safer.</p> <p>&nbsp;</p> <p><strong>IN WHICH DISEASES IS NEURONAVIGATION USED?</strong></p> <p>Neuronavigation system is mostly used in the operations of brain, nerve and spinal cord surgery.</p> <p>&nbsp;</p> <ul> <li>Brain tumor surgeries</li> <li>Cerebral hemorrhage</li> <li>AVM (Arteriovenous Malformation) in the surgery of cerebrovascular diseases</li> <li>In cases of Parkinson&#39;s or similar diseases with tremor, in surgeries requiring battery insertion</li> <li>Spine surgeries and determination of the direction of the screws placed in the spine</li> <li>In addition, neuronavigation system can be used in some orthopedic surgeries.</li> </ul> <p>&nbsp;</p> <p><strong>Benefits of Neuronavigation System (Features that make the difference)</strong></p> <p>It shows the surgeon the shortest and safest route to the area where the lesion is located with the help of previously taken MRI and CT images in brain and spine surgeries known as sensitive area surgeries. Since the surgeon reaches the area to be operated on with the help of neuronavigation, the targeted area is approached with almost zero error and the healthy tissue is damaged at the least level. Risky brain and spine surgeries, where even millimetric errors can lead to negative consequences, become safer with the use of neuronavigation technology.</p> <p>&nbsp;</p> <p>The advantages of using the neuronavigation system in operations can be listed as follows;</p> <ul> <li>Deep brain lesions can be defined more accurately.</li> <li>The tumor is removed more precisely.</li> <li>The surgery is performed with a smaller incision than the skin and bone.</li> <li>Less blood is used.</li> <li>Operation time is shortened</li> <li>Surgery wound heals faster</li> <li>The length of stay in the hospital is shortened and the patient can return to social life more quickly.</li> <li>Frequently Asked Questions About Neuronavigation</li> </ul> <p>&nbsp;</p> <p><strong>How Is The Patient Prepared For Neuronavigation?</strong></p> <p>There is no different preparation for patients who will use neuronavigation in their surgery, except for the preparations made in standard surgeries.</p> <p>Advanced Magnetic Resonance (MR) or Computed Tomography (CT) images of the area to be operated before surgery are taken.</p> <p>The 3-dimensional images obtained are placed on top of each other and uploaded to the &quot;Neuronavigation&quot; device used in the surgery. After the patient is taken into the operating room, the surgical area is designated at the computer in 3D with the help of a probe that is passed over the skin surface.</p> <p>In this way, the shortest and safest road map to reach the area where the surgery will be performed is prepared for the surgical team.</p> <p>The neuronavigation device, which defines the patient&#39;s 3D radiological examinations, allows the surgeon to work only in the problematic area and stay away from the surrounding normal tissues by showing various risk areas in the brain or spinal cord.</p>

All Technology Content

Treatment Methods

Radioactive Iodine Therapy (Atom Therapy)

<p>Thyroid cancer is one of the most common endocrine, or hormonal system cancers in the society and its treatment is planned individually by surgical method. Radioactive iodine therapy&nbsp;is used to destroy invisible cancer cells that may be left behind after surgery. Radioactive iodine therapy in thyroid cancer is applied to patients who have been diagnosed with thyroid cancer and have undergone surgery to support treatment. Prof. Dr. Akın Yıldız and Dr. Mehmet Bozkurt from the Department of Nuclear Medicine at Memorial Bah&ccedil;elievler Hospital gave information about Radioactive Iodine Therapy. Dr. Mehmet Bozkurt gave information about Radioactive Iodine Treatment.</p> <h2><strong>What is Radioactive Iodine Therapy (Atom Therapy)?</strong></h2> <p>Radioactive iodine therapy, popularly known as &quot;Atom Therapy&quot;, is a treatment method used to destroy possible cancer cells that remain in the neck area after thyroid surgery or that are not visible to the eye. RAI is administered by taking a radioactive Iodine (I-131) molecule by mouth (medicated liquid or capsule). The treatment consists of introducing radioactive iodine into the body in case there are live thyroid cells, directing it towards the cells, taking the cells inside and destroying them by irradiation (beta ray). This stops the growth and proliferation of cancerous thyroid cells. Radioactive iodine can be used not only in the treatment of thyroid cancer, but also in the treatment of thyrotoxicosis - hyperthyroidism (colloquially called toxic <a href="https://www.memorial.com.tr/hastaliklar/guatr-nedir-belirti-ve-tedavi-yontemleri-nelerdir" target="_blank">goiter</a>), a condition characterized by excessive hormone production by the thyroid gland.</p> <h2><strong>Stages of Radioactive Iodine Treatment</strong></h2> <p>The radioactive iodine treatment process usually involves the following steps:</p> <p>Preparation: Before starting treatment, doctors assess the patient&#39;s storyand perform the necessary tests. During this process, the patient&#39;s blood tests are ordered and any necessary imaging, such as ultrasonography, is examined.</p> <p>Medication discontinuation: In some cases, the thyroid medication the patient is taking may be temporarily stopped before treatment. This helps iodine to accumulate more effectively in the thyroid tissue.</p> <p>Administration of radioactive iodine: The patient takes I-131 in capsules or liquid orally. This is usually performed in a hospital and the dose of treatment is determined by the physician according to the patient&#39;s condition.</p> <p>Isolation period: After receiving radioactive iodine, the patient needs to be isolated for a short time. This is because the patient can emit radiation into the environment until the body eliminates the radioactive waste. The duration of isolation varies depending on the treatment dose and the patient&#39;s condition.</p> <p>Follow-up and evaluation: After treatment, doctors monitor the patient&#39;s recovery and may perform additional tests or treatments as needed. At this stage, thyroid hormone levels, radioactive iodine scans and other necessary tests may be performed.</p> <p>Long-term follow-up: After radioactive iodine treatment, patients are regularly checked and followed up. This process may continue for many years, although it may vary depending on the condition of each patient and the success of the treatment.</p> <h2><strong>What are the Side Effects of Radioactive Iodine Treatment?</strong></h2> <p>Radioactive iodine therapy (RAI), It is a treatment for <a href="https://www.memorial.com.tr/hastaliklar/tiroid-kanseri-belirtileri-ve-tedavi-yontemleri-nelerdir">thyroid cancer</a> and some <a href="https://www.memorial.com.tr/hastaliklar/tiroid-nedir">thyroid</a> diseases. Like any treatment, RAI has some side effects. These include:</p> <ul> <li>Temporary thyroid hormone imbalance: Low or high thyroid hormone levels may occur after treatment.</li> <li>Radiation side effects: Mild symptoms such as nausea, vomiting and changes in the sense of taste.</li> <li>Swelling and pain in the salivary glands: RAI can affect the salivary glands and cause swelling.</li> <li>Dry mouth and eyes: There may be a decrease in saliva and tear production.</li> <li>Fatigue and weakness: Temporary fatigue and weakness may occur after treatment.</li> <li>Headache: Headache may occur after RAI treatment.</li> <li>Effects on fertility and pregnancy: RAI treatment may have an effect on fertility and pregnancy. RAI treatment should not be administered during pregnancy.</li> <li>Risk of radiation exposure: There is a risk of radiation exposure to people in your immediate environment during and after treatment. Therefore, they need to restrict contact with other people for a certain period of time.</li> </ul> <p>Side effects may be different for each patient and in some cases more serious side effects may also occur. Therefore, the process should be followed together with the doctor before and after treatment.</p> <h2><strong>What Should Be The Post-Treatment Follow-Up and Care?</strong></h2> <p>Follow-up and care after radioactive iodine treatment should be as follows:</p> <ul> <li>Doctor&#39;s advice: During and after treatment, follow the doctor&#39;s advice and instructions.</li> <li>Isolation After radioactive iodine treatment, you should stay away from others for a short time to prevent the spread of radiation. Your doctor will determine the appropriate duration for you.</li> <li>Hygiene: Urinate frequently and drink plenty of water to accelerate the excretion of radioactive iodine. Hands should be washed frequently and personal items cleaned regularly.</li> <li>Diet: If recommended by the doctor, a low iodine diet can be followed.</li> <li>Medications: The medications prescribed by the doctor should be used regularly and in case of any side effects, the doctor should be consulted again.</li> <li>Regular controls: After radioactive iodine treatment, your doctor may order regular thyroid function tests, blood tests and imaging studies.</li> <li>Monitor symptoms: Any abnormal signs or symptoms should be reported to a health care provider.</li> <li>Lifestyle changes: Reducing stress, maintaining sleep patterns and adopting a healthy lifestyle can contribute to the healing process.</li> </ul> <p>Since each patient&#39;s condition is different, the post-treatment care and follow-up process may also vary from person to person. Therefore, attention should be paid to the doctor&#39;s recommendations and treatment protocols to be applied individually.</p> <h2><strong>What Are The Advantages of Radioactive Lodine Therapy?</strong></h2> <p>Radioactive iodine therapy is used to treat thyroid diseases such as thyroid cancer and hyperthyroidism. With this treatment, it is aimed to effectively destroy possible invisible cancer cells that may remain in the neck area after thyroid cancer surgery. Therefore, treatment success is high and it is a direct targeted treatment. It has fewer side effects than other treatment methods. RAI is among the prioritized treatments according to many studies in the US and Europe.</p> <h2><strong>Comparison of Radioactive Iodine Therapy and Other Treatment Methods</strong></h2> <p>In addition to radioactive iodine treatment to be applied after surgery for thyroid cancer, there are also medication, surgery and external radiation therapy.</p> <p>Here is a comparison of these methods:</p> <p><strong>Radioactive iodine therapy:</strong></p> <p>- Advantages: It is not an invasive procedure and may cause less damage to surrounding tissues.</p> <p>- Disadvantages: Temporary side effects. Isolation is required due to radiation emission. It is not suitable for every patient. It should not be preferred during pregnancy or breastfeeding.</p> <p><strong>Drug therapy (antithyroid drugs):</strong></p> <p>- Advantages: It is not an invasive method. Fast and effective. It also provides efficacy control with dose adjustment.</p> <p>- Disadvantages: Side effects may occur with long-term use. The duration of treatment may be long and in some cases may not provide a permanent solution.</p> <p><strong>Surgery (Thyroid lobectomy, Total thyroidectomy):</strong></p> <p>- Advantages: Permanent solution. Quick recovery is achieved by completely removing the cancerous tissue.</p> <p>- Disadvantages: It is a surgical procedure. A scar may remain in the form of a thin line in the neck area. Anesthesia risk and surgical complications of the operation may occur.</p> <p><strong>External radiation therapy (Radiotherapy):</strong></p> <p>- Advantages: It is not an interventional treatment. It destroys cancerous cells and targets them locally.</p> <p>- Disadvantages: Long-term treatment may be required, side effects may occur. It can damage healthy tissues and may not help to completely destroy cancerous cells.</p> <p>The choice of treatment method is based on the patient&#39;s age, general health status, type and stage of thyroid disease and potential risks. Treatment options and risks should be discussed in detail with the doctor and the most appropriate treatment method should be decided together.</p> <h2><strong>Frequently Asked Questions About Radioactive Iodine Therapy</strong></h2> <p>Frequently asked questions and answers about radioactive iodine therapy (RAI)</p> <h3><strong>What is radioactive iodine therapy and what is it used for?</strong></h3> <p>Radioactive iodine therapy can be used to control overactive thyroid (hyperthyroidism) or as a targeted radiation therapy to treat thyroid cancer.</p> <h3><strong>How is radioactive iodine treatment administered?</strong></h3> <p>Radioactive iodine is given as an oral capsule or liquid. Iodine is transported directly to the thyroid gland and destroys overactive or cancerous cells.</p> <h3><strong>What are the side effects of radioactive iodine treatment?</strong></h3> <p>Side effects include temporary salivary gland inflammation, nausea, taste disturbance, dry mouth and fatigue. In the long term, the risk of hypothyroidism (underactive thyroid) may increase.</p> <h3><strong>What precautions should be taken after radioactive iodine treatment?</strong></h3> <p>Measures such as short-term isolation, attention to hygiene rules, drinking plenty of water, a low-iodine diet and using medications recommended by the doctor should be taken.</p> <h3><strong>How long does radioactive iodine treatment work?</strong></h3> <p>The effect of the treatment may vary depending on the individual. In hyperthyroidism, recovery can take several weeks to several months. Treatment for thyroid cancer can take effect within a few months and is evaluated with follow-up tests.</p> <h3><strong>Is radioactive iodine treatment suitable for every thyroid patient?</strong></h3> <p>RAI is not suitable for every thyroid patient. For example, RAI is not recommended for patients who are pregnant or breastfeeding and for some types of thyroid cancer. The doctor will determine the most suitable treatment method for you.</p> <h3><strong>How safe is radioactive iodine treatment?</strong></h3> <p>RAI is generally a safe and effective treatment. But like any treatment, it can involve some risks and side effects. These risks can be minimized by taking precautions before and after treatment.</p> <p>These answers are intended to provide general information and may vary according to each patient&#39;s situation.</p>


<p>Prostate cancer is among the most common cancers in men in the world and in our country. As in other types of cancer, early diagnosis has an important place in the treatment of this disease. In recent years, HIFU, which is a non-surgical treatment method, has been used frequently in prostate cancer cases. High Intensity Focused Ultrasound- High Intensity Focused Ultrasound Waves, ie HIFU technology, is described as non-surgical, point-targeted treatment in prostate cancer. The latest version of the HIFU technology applied in the Memorial Bah&ccedil;elievler Hospital can ensure that only the diseased area of the prostate is treated and the surrounding tissues are not damaged. With HIFU, risks such as urinary incontinence or sexual dysfunction are also eliminated. The duration of the HIFU process is directly proportional to the size of the area to be burned. The process, which takes an average of 1-2 hours, may take longer if the area to be burned is large.</p> <p><strong>What is the HIFU method?</strong></p> <p>Treatments such as surgery and radiotherapy are used in prostate cancer. These treatment methods may have many side effects. As a result, the High Intensity Focused Ultrasound, in short, HIFU method has been developed. However, in the first HIFU applications, the entire prostate was burned and this caused various side effects. The current version of the HIFU technology applied in the Memorial Bah&ccedil;elievler Hospital, known as focal, in other words, point shot therapy, can also eliminate risks such as urinary incontinence or sexual dysfunction by ensuring that only the diseased area of the prostate is treated and the surrounding tissues are not damaged. This new device is applied only in Memorial Bah&ccedil;elievler Hospital in Istanbul.</p> <p>Our expert staff serving in our center:</p> <p>&nbsp;</p> <p><strong>Urology</strong></p> <p>Op. Dr. İlker &Ccedil;&ouml;mez</p> <p>&nbsp;</p> <p><strong>Radiology</strong></p> <p>Prof. Dr. Barış Bakır</p> <p>Assist. Prof. Dr. Selim Bakan</p> <p>&nbsp;</p> <p><strong>NUCLEAR MEDICINE</strong></p> <p>Prof. Dr. Akın Yıldız</p> <p>Dr. Aria Forouz</p> <p>&nbsp;</p> <p><strong>For which patients is the HIFU method suitable?</strong></p> <p>The HIFU method is mostly applied in the initial stages of prostate cancer, in small and non-spread patients. Patients for whom the HIFU method is recommended;</p> <p>&nbsp;</p> <p>The HIFU method is a more suitable treatment option, as it provides an advantage in mostly young patients who do not want to have urinary problems and whose sexual life is active.</p> <p>Patients with prostate cancer in early stage T1 or T2 stage,</p> <p>Cancer in the initial stage,</p> <p>Patients whose age or general condition is not suitable for prostate cancer surgery</p> <p>Patients seeking minimally invasive treatment preferences against radical surgical treatment methods</p> <p>Patients who have had previous abdominal surgeries&nbsp;&nbsp;</p> <p><strong>HOW IS HIFU APPLIED?</strong></p> <p>Prostate cancer treatment with HIFU is performed by giving the person a light dose of anesthesia. High power ultrasound waves are sent to the cancerous area of the prostate by entering through the anus with a probe. With the absorption of these, a temperature increase of 85-100 degrees occurs and only cancerous cells are destroyed. In this way, targeted treatment is achieved by preserving the healthy prostate tissue around it.</p> <p>&nbsp;</p> <p><strong>What are the characteristics of HIFU method? WHAT ARE THE ADVANTAGES?</strong></p> <p>It prevents sexual dysfunction and protects urine control.</p> <p>In open surgeries, the patient stays in the hospital for 3-4 days. Since radiotherapy treatment takes 30 days, the patient has to come to the hospital almost every day. HIFU operation is a one-session application. Patients who undergo HIFU can return to their homes after staying in the hospital for 1 night. If the procedure is applied in the morning, patients can be discharged in the evening of the same day.</p> <p>The risk of complications is low.</p> <p>It can be easily applied in cases of recurrence after open surgery, closed surgery, radiotherapy or HIFU.</p> <p>It provides the chance to intervene in cancer tissue without damaging the surrounding organs and tissues.</p> <p>It is not exposed to the harmful effects of radiation.</p> <p>Patients who are not suitable for surgery can benefit from HIFU.</p> <p>Although the pain threshold varies according to each individual, the HIFU procedure is defined as a painless application.</p> <p>It can be applied in elderly patients who cannot receive anesthesia.</p> <p>&nbsp;</p> <p><strong>FREQUENTLY ASKED QUESTIONS</strong></p> <p><strong>Can HIFU be used in benign prostate enlargement?</strong></p> <p>HIFU is a treatment method used only in prostate cancer.</p> <p>&nbsp;</p> <p><strong>Can it be applied at later ages?</strong></p> <p>HIFU can be applied to men of all ages with prostate cancer, depending on the patient&#39;s suitability for treatment.</p> <p>&nbsp;</p> <p><strong>Is the entire prostate destroyed by ultrasonic waves?</strong></p> <p>In the HIFU procedure, only the cancerous tissues of the prostate are targeted and the heat increase is provided only with ultrasonic waves specific to that point. In this way, the surrounding tissues are not damaged and the prostate is provided to fulfill all its functions.</p>

Robotic Kidney Transplantation

<h2><strong>ROBOTIC KIDNEY TRANSPLANT</strong></h2> <p>Kidney transplantation is the most effective treatment of chronic kidney failure which is the result of permanent loss of kidney function. The patients with chronic kidney failure can return to their lives as healthy individuals in a short time upon a successful transplant and post-operation follow-up process. The &quot;Da Vinci Robotic Surgery&quot; method applied in Memorial Bah&ccedil;elievler Kidney Transplant Center offers opportunities to reduce many risks during surgery as well as to improve the quality of life of the patient after surgery.</p> <p>[doctor-box]1221[/doctor-box]&nbsp;</p> <h2><strong>KIDNEY IS TRANSPLANTED WITH ROBOTIC METHOD</strong></h2> <p>Kidney transplant is a versatile process that requires proper pre-operation preparations, an experienced team using advanced technology during transplant process, a professional team to manage the post-transplant care and treatments.&nbsp; Good and proper management of this process is important for the patient&#39;s future quality of life and reducing the risk of possible complications. The &quot;Da Vinci Robotic Surgery&quot; method applied in Memorial Bah&ccedil;elievler Kidney Transplant Center provides important privileges to the physician as well as the patient during and after the kidney transplant process. Thanks to the image zooming system that increases the vision quality of the surgeon 15 times during the surgery, even the thinnest veins can be seen in all details. In addition, it does not cause tiredness and loss of concentration since the surgeon can sit for the long period of surgery. In case of possible hand tremor of the surgeon, the risk of developing complications is also minimized by the anti-tremor system in the device. In addition, in these operations in which the kidney is completely attached to the recipient by the robotic method, the risk of developing post-operative infections is much lower compared to the open method by providing a quick healing of the scar thanks to the only 4 cm incision opened in the patient. In addition, immunosuppressive drugs that suppress the immune system administrated to the patient after open surgery can delay the healing of the large scar area in open surgery. The small incision in the robotic surgery method greatly reduces this risk.</p> <p>&nbsp;</p> <h3>There are 3 parts in the Da Vinci System in which the surgeon moves the arms of the robot as his/her hands with 3D image:</h3> <p>&nbsp;</p> <p><strong>Surgical console section</strong> where the surgeon sits during operation,</p> <p><strong>Patient console section</strong> next to the patient and including robotic arms prepared under sterile conditions,</p> <p><strong>Camera system unit providing advanced imaging system</strong>.</p> <p>In the Da Vinci Robotic System, the camera and the accompanying three robotic arms are proceeded into the abdomen through tunnels with a diameter of 0.8 cm or 1 cm placed on the wall of the abdomen from certain points. Thanks to the thin and gentle surgical robotic arms, the joining (anostomosis) of the veins of the kidney which is placed into the abdomen through a small incision, is performed. In order to increase safety, the incision in the lower part of the abdomen from where the kidney will be removed, is performed at the beginning of the surgery. Since the surgeon&#39;s hand can enter through this incision during the surgery, there is the advantage of feeling and the chance to intervene in an emergency.</p> <p>&nbsp;</p> <h2><strong>THINGS TO KNOW ABOUT &quot;DA VINCI ROBOTIC SURGERY&quot; METHOD</strong></h2> <p>Robotic kidney transplant surgery requires high surgical experience and advanced technology. Surgery for the kidney donor is now performed as standard with the laparoscopic method. Robotic surgery provides additional benefits in terms of kidney recipient&#39;s quality of life and reduction of complications.</p> <p>&nbsp;</p> <p>Robotic kidney transplant surgery has important advantages for both surgeon and patient. One of the most important of these concerns the surgeon&#39;s quality of vision during the operation. Laparoscopic kidney transplantation methods with standard camera provide only two-dimensional images. In the Da Vinci Robotic Surgery system, 3D images can be obtained thanks to high resolution cameras that transmit seperate images to each eye. In addition, since these cameras can zoom in 15 times, surgery can be performed with an ideal view.</p> <p>&nbsp;</p> <p>The ends of the surgical instruments at the tip of the robot&#39;s arms rotate around their axes at total of 540 degrees in all planes. This technology enables the surgery to be performed even in the deepest parts of the body, beyond the mobility capacity of the human wrist.</p> <p>The &quot;tremor scaling&quot; feature in the Da Vinci Robotic Surgery system prevents the surgeon from transmitting possible hand tremors to the devices during the surgery.</p> <p>&nbsp;</p> <p>In classical surgeries, surgeons perform the surgeries by standing up and this may cause difficulties due to tiredness in prolonged surgical interventions. In robotic surgery, since the surgeon works by sitting, his/her concentration is higher and the risk of stress due to tiredness decreases.</p> <p>&nbsp;</p> <p>The operation continues meticulously, as the robot moves according to the surgeon&#39;s wrist movements. Especially in suturing and suturing tissues, a much greater advantage is provided compared to the laparoscopic system.</p> <p>&nbsp;</p> <p>After the operations performed with robotic surgery, the patient can recover in a much shorter time and the length of hospital stay is also shortened.</p> <p>&nbsp;</p> <p>&nbsp;</p>


<h2>What is Botox?</h2> <p>Botox (Botulinum toxin) is a toxin obtained from bacteria called Clostridium botulinum. It acts by preventing the release of substances that provide conduction at the nerve endings and stopping the transmission between the nerves and the organs reached by the nerves. Stopping nerve conduction causes the functions of the organ that the nerve reaches to decrease or disappear completely. It can be used for aesthetic and cosmetic purposes, to reduce the wrinkles on the face, to prevent its formation and to reduce sweating in the areas of excessive sweating and in the treatment of chronic migraine.</p> <h2>For what areas is botox used?</h2> <p><strong>Wrinkle treatment</strong></p> <p>The working of the mimic muscles over the years makes the folds on the skin that cover them prominent, resulting in dynamic streaks on the face. The most common dynamic lines appear on the forehead, between the eyebrows, around the eyes and around the lips. The lines on the forehead and eye edges give the person an older look, while the lines between the eyebrows give the person a frowned and angry look. By applying Botox to the mimic muscles, the movements of these muscles can be weakened, and the decrease in muscle movements also reduces the folding of the skin on it with muscle movements and streaking due to folding. In this way, a significant improvement is gained in the facial expression that appears old and angry.</p> <p><strong>Face contouring</strong></p> <p>With Botox injection, it can be provided to lift the eyebrows from the tail part and to decrease the height in the middle part of the eyebrow which makes a confused facial appearance.</p> <p>Be seen clearly of upper gum while smiling causes an non aesthetic appearance while laughing. With Botox injection this can be easily corrected.</p> <p>Masetter (chewing muscle) Hypertrophy: Unlike other region applications, Botox applications to the massetter muscle are performed not for wrinkles, but especially to soften the square face appearance of the patients with prominent hypertrophy of the massetter muscle and to obtain an oval face. Thus, a thinner and feminine facial appearance is obtained.</p> <p><strong>Excessive sweating treatment</strong></p> <p>When Botox is applied to the sweat glands, the connection between the sweat glands and nerve endings can also be stopped by reducing the activity of the sweat glands.</p> <p>The most sweating areas of the body are palms and armpits. With applying botox to sweating areas of people who suffer from excessive sweating and smell, improvement in complaints is provided.</p> <p>After determining the excessive sweating zones with the pre-application tests, the effect of the procedure lasts up to 6 months.</p> <p><strong>Migraine treatment</strong></p> <p>Botox procedure is made with needle tips thinner than 31 injection points to 7 regions of head and neck. The treatment is planned individually and there are at least 2 treatment periods with an interval of 12 weeks. In some patients, the injection should be repeated for the efficiency while in others the efficiency continues for several years. With the decision of a specialist neurologist, additional doses in botox injections according to the pain location can be applied to the required areas and migraine can be taken under control by obtaining successful results.</p> <h2>How is Botox applied?</h2> <p>Botox is applied as an injection and is not a painful procedure, a slight pain may be felt at the time of injection. If a decrease in the movements of the mimic muscles is desired, injection is made into the mimic muscles and If the complaint of sweating is desired to be reduced, injection is made inside the skin.</p> <p>The effect of Botox starts 3-4 days after the injection and completed totally in the first week and the duration of efficiency is 4-6 months. When Botox loses its efficiency, the procedure can be repeated.</p> <p>Botox has no serious side effects on health. After procedure, a temporary swelling, bruising, and rarely temporarily lower eyelid can happen.</p> <p>Immediately after the procedure, daily life can be easily continued. However, it should be avoided from movements that require bending for a long time and to active the facial muscles. In addition, after Botox injection, the head should be kept high for about four hours, bending forward should be avoided and should not be lying down. About eight hours after the Botox injection, a shower can be taken with warm water and without causing any damage to the face, i.e. without sac or pressure. While washing the face, pay attention to using cold water.</p> <h2>FREQUENTLY ASKED QUESTIONS ABOUT BOTOKS</h2> <p><strong>Is Botox snake poison?</strong></p> <p>No, Botox is a natural, protein-based drug made from a special bacterium.</p> <p><strong>Who should perform Botox?</strong></p> <p>Botox procedure, which is an effective method for facial rejuvenation, should be perforemed by specialist physicians who know the facial anatomy well and in order to avoid possible complications and achieve the desired result.</p> <p><strong>Is Botox a reliable treatment method?</strong></p> <p>It is a drug with over 2000 studies approved by the Ministry of Health in our country and by more than 70 countries around the world. It has been used for 20 years and millions of people prefer these procedures safely every year.</p> <p><strong>How long does the effect of Botox last for?</strong></p> <p>Approximately 3 months after the application, the movement begins to return in strong muscles. The movement of weak muscles also begins after 4 months. The effect disappears completely after 6 months. It is recomended to repeat it between 4-6 months.</p> <p><strong>Does Botox cause any expression loss in face?</strong></p> <p>The main purpose of Botox procedure is not to neutralize the expression on the face, but to soften the facial expressions and give the face a natural aesthetic appearance. Confused and expressionless images are caused by the procedure being done by wrong hands. Botox must be done by experts.</p> <p><strong>How many times can a person get botox throughout his life?</strong></p> <p>As long as it is done in specialist and right hands, it can be done under the control of a doctor during all life.</p> <p><strong>Can pregnant women get botox?</strong></p> <p>It is not yet known exactly whether Botox has a harmful effect during pregnancy and breastfeeding. For this reason, botox procedures are not recommended during pregnancy and breastfeeding, and botox should not be applied in people with diseases of the nervous-muscular system.</p>

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