Породување - Ре Медика | Poroduvanje - Re Medika

SURGERY - РЕ-МЕДИКА

SURGERY

The Surgery Department at Re-Mediкa hospital has been operating since the first day of hospital operation. All surgical interventions are performed, from the simplest to the most complex, thanks to the experienced surgical team as well as the constant monitoring of new trends in surgery using highly sophisticated medical equipment.
Department is consisted of:


  • GENERAL SURGERY

  • ABDOMINAL SURGERY

  • CHILD SURGERY

  • NEUROSURGERY

  • ORTHOPAEDIC SURGERY

  • UROLOGY

  • OTORHINOLARYNGOLOGY

  • PLASTIC AND AESTHETIC SURGERY

  • THORACIC SURGERY

  • VASCULAR SURGERY

A lot of patients, lot of challenges, a lot of successfully realized surgical interventions confirm our care for the paitents’ health, as well as the given trust from all our patients.

Sincerelly yours, Prof. d-r Aco Dimov, Head of Surgery department

GENERAL SURGERY

Dear all,

General and abdominal surgery have been part from the surgery department from the very beginning of Re-Medika. Modern trends and development are incorporated in our department, so, today thanks to all Re-Medika team, we keep the pace with the latest professional trends of medical treatment and care for the patients.

General and abdominal surgery cover the most common diseases in population, the latest trends require that this problems should be solved with minimally invasive techniques, and the hospital treatment be shorter. The patients’ requirements are the same for painless surgical interventions, better aesthetic outcome and faster post surgical recovery.

Most of the interventons from general and abdominal surgery are laparascopy conducted, starting from cholecystectomy, hernia on the front abdominal wall to colon surgical interventions.

Hernia repair is one of the most conducted surgical interventions in the world. Our hospital offers a surgical treatment which is within the latest recommendations of the European associations for hernia, so laparscopic and open inguinal repair as well as other types of hernia are conducted.

Also, laparascopic treatment of benign gaster diseases is possible ( hiatal hernia and achalasia), as well as diagnostic laparascopy of certain conditions, verification of the level of spread of the malignant diseases at digestive system and taking samples for analysis. Part of the interventions we are able to conduct laparascopically are colon surgical interventons, both for benign and malignant diseases.

MEDICAL SERVICES IN GENERAL SURGERY

Surgical examination
Consultation
Anal examination with rectal touché
Anal examination with anoscope
Treatment of wound
Outpatient surgical procedures(big)
Outpatient surgical procedures(small)
Surgical small swathing
Surgical big swathing
Catheter change
Preparation for intervention
Gaster repair without stapler
Gaster repair
Gastroentroanastomosis
Gastrostomy/opened and laparascopy Jejunostomy
Lateral ulcus, outside particle in gaster
Laparoscopic Gallbladder removal
Classic Gallbladder removal
Bili-digestive anastomoses with calculus evacuate from choledoch
Echinoccosis treatment
Pseudocyst in Pancreas
Small intestine repair
Large intestine repair without stapler
Large and Small intestine stoma creation
Colostoma closure
Ileostoma closure
Ventral Hernia repair
Ventral Hernia repair/open and laparascopic Ventral reccurent hernia
Hernia ing.fem.inguskr.unilateral/ open and laparascopic
Inguinoskr.Hernia per magna unilateral
Incarcerated hernia
Inguinal, femoral. Hernia residue/ open and laparascopic
Inguinal hernia bilateral / open and laparascopic
Umbilical hernia/ open and laparascopic
Appendectomy (Appendix removal)
Laparascopic appendectomy
Hemorrhoids repair
P.sinus repair and Fistulaetomy/ Operative treatment of perianal fistula and fisural
Spleen removal
Exploration laparotomy without biopsy
Explor.laparoscop.without biopsy
Various small surgical repairs in the surgical room
Outpatient interventions in the surgical room with local anaesthesia
Outpatient interventions in the surgical room with anaesthesia
(HAL) Hemorrhoid Artery Ligation
HAL with PAP (hemorrhoidal artery ligation with mycopexy

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ABDOMINAL SURGERY

Dear All,

General and abdominal surgery have been part from the surgery department from the very beginning of Re-Medika. Modern trends and development are incorporated in our department, so, today thanks to all Re-Medika team, we keep the pace with the latest professional trends of medical treatment and care for the patients.

General and abdominal surgery cover the most common diseases in population, the latest trends require that this problems should be solved with minimally invasive techniques, and the hospital treatment  be shorter. The patients’ requirements are the same for painless surgical interventions, better aesthetic outcome and faster post surgical recovery.

Most of the interventons from general and abdominal surgery are laparascopically conducted, starting from cholecystectomy, hernia on the front abdominal wall to colon surgical interventions.

Hernia repair is one of the most conducted surgical interventions in the world. Our hospital offers a surgical treatment which is within the latest recommendations of the European associations for hernia, so laparscopic and open inguinal repair as well as other types of hernia are conducted.

Also, laparascopic treatment of benign gaster diseases is possible ( hiatal hernia and achalasia), as well as diagnostic laparascopy of certain conditions, verification of the level of spread of the malignant diseases at digestive system and taking samples for analysis. Part of the interventions we are able to conduct laparascopically are colon surgical interventons, both for benign and malignant diseases.

MEDICAL SERVICES IN ABDOMINAL SURGERY

Gastroectomy-carcinoma
Gastroectomy-benign-subtotal
Gastroentroanastomosis
Gastroma-laparoscopic / Gastroma-laparoscopic
Jejunostomy-laparoscopic/ Jejunostomy-laparoscopic
Cholecystectomy-laparoscopic
Bilious anastomosis
Cholecystectomy-laparoscopic
Echinoccosis in liver
Cyst in pancreas
Resection of small intestine
Resection of large intestine without stapler (carcinoma)
Resection of large intestine with stapler (carcinoma)
Stoma creation
Colostoma closure without stapler
Ileostoma closure / Ileostoma closure
Ventral hernia/open and laparascopic
Inguinal hernia/open and laparascopic
Residue hernia/open and laparascopic
Umbilical hernia/open and laparascopic
Appendectomy/open and laparascopic
Piles
Splenectomy-laparoscopic
Anal fissures or fistulas
Whiplle
Hepaectomy
Hiatus hernia-laparoscopic/ open and laparascopic
Achalasia-laparoscopic/ open and laparascopic

THORACIC SURGERY

BREASTS

  • Benign breats diseases ( cysts, fibroadenoma, itraductal papilloma, abscesses and other benign surgical breasts diseases)
  • Wire-guided localization in non-palpable and small suspicious breast lesions (microcalcifications)
  • Malignant breast cancer ( small and radical surgical interventions)
  • Reconstructive breast surgery

THYROID GLAND

  • Surgery treatment of benign thyroid gland diseases ( cysts, nodules, benign tumors, functional disturbances, diffuse struma and other benign conditions)
  • Thyroid gland carcinoma and their surgical treatment( partial, subtotal and total thyoidectomy with or without removal of neck lymph nodes(neck dissection)

CHEST SURGERY

  • Benign and malignant diseases of the chest wall ( chest wall resection with possible use of muscular flaps or synthetic materials)
  • Chest deformities, pectus carinatum, pectus infundibuliformis- by using the minimally invasive surgical method by Nuss or by using the classical surgery technique by Rawitch

DIAPHRAGM SURGERY

ESOPHAGUS SURGERY

LUNGS SURGERY

  • Use of VATS ( Videoassisted thoracoscopic surgery)
  • LVRS- Lung Volume Reduction Surgery ( reduction of pathologically changed lung tissue), method that is used in the treatment of lung emphysema
  • Surgical treatment of echinococcus disases ( dog tapeworm), with open surgical methods or by use of VATS- Videoassisted thoracoscopic surgery
  • Surgical treatment of lungs benign conditions(cysts, bulla, abscesses, benign tumors) by use of VATS or open thoracotomy
  • Lungs carcinoma
  • Radical lung resections with lymphadenectomy with use of staplers and other modern surgical apparatus and instruments
  • Lung metastatic tumors
  • Use of VATS- Videoassisted thoracoscopic surgery or use of open resections with use of laser technologies in the treatment of lungs metastatic changes
  • Minimally invasive lungs or pleural biopsy
  • Mediastinoscopy( biopsies from mediastinum)
  • VATS talk of recurrent pleural effusions
  • Placing pleural catheters while existence of pleural effusions
  • Contemporary surgical treatment of all types of pneumothoraces by use of Videoassisted thoracoscopic surgery- VATS

VARICOSE VEINS SURGERY

  • Surgical treatment of varicose veins with the use of:
  • Radiofrequency ablation (VNUS)
  • Laser treatment
  • Treatment with open surgical methods
  • Sclerotherapy

MEDICAL SERVICES IN THORACIC SURGERY

Prof. d-r Andreja Arsovski,thoracic surgeon
Subcutaneous breast change unilateral
Breast tumour ablation – unilateral
Breast tumour ablation – bilateral
Mastectomy – bilateral
Subtotal thyroidectomy
Thyroidectomy (benign)
Total thyroidectomy with lymphodenectomy (malignant)
Varicose veins in one leg
Varicose veins in two legs
Simplex Mastectomy
Radical Mastectomy
Pectus – Ravitch
Small Resection of a thoracic wall
Big Resection of a thoracic wall
Thoracic sympathectomy
Early decortication
Late decortication
Extra anatom.resection of lung
Lobectomy
Pneumoectomy
Plastics of diaphragma
Echinococcosis of a lung removal
Echinococcosis of a lung and liver during the same surgical intervention
Thoracic drainage
Placing pleurx
Shurry Pleurodeza / Shurry Pleurodesis
Diagnostic thoracoscopy
Diagnostic thoracoscopy
Thoracoscopic taklc pleurodesis
Thoracoscopy with biopsy and talc pleurodesis
Thoracic VATS sympathectomy
Extra anatomic resection of lung with stapler
Thoracoscopic decortication
Explorative Thoracotomy
Laser treatment of veins (local t. Anaesthesia + extended flebectomy)
Laser treatment of veins in one leg with general anesthesia
Additional intervention of veins with laser
Plastica thoracis sec.nuss
Thoracentesis
Mediastinoscopy
Pectus bar removal
Removal of osteosynthetic material after pectus surgery
Ablation of mediastinal tumor

CHILD SURGERY


  • All types of hernia

  • Undescended testicle

  • Phimosis

  • Hypospadiasy

  • Appendectomy

  • Echinococcus disease

  • Gastrointestinal tract diseases

  • Urinary tract diseases

  • Other diseases in child age

MEDICAL SERVICES IN CHILD SURGERY

Prof. d-r Aco Dimov, child surgeon
Examination by specialist
Consultation without presence of patient
Control after discharging for bandage and remove sutures
Examination one month after operation
Resection of lingual frenulum
Elevation of twisted nail
Adhesiolysis of preputii
Circumcision – same day
Inguinal hernia -1 day
Hernia inguinalis bill
Incarcerated ing. Hernia
Inguinal hernia residue
Umbilical hernia – 1 day
Cryptorchism
Cryptorchism residue
Hypospadia anterior- Glanduar
Hypospadia anterior- on sulcus coronarius
Hypospadia medialis- upper medial
Hypospadia medialis- lower medial
Hypospadia posterior
Varices testis
M. Hirschsprung-Aganglionosis colonis with stapler
Curvatura penis
Appendectomy
Perforated appendix with diffuse peritonitis
Laparascopic appendectomy
Echinococcosis treatment
Large and small intestine stoma creation
Colostoma/ileostoma closure
Rectal biopsy
Small intervention in the surgical room with anesthesia
Middle intervention in the surgical room with anesthesia

OTORHINOLARYNGOLOGY

DIAGNOSTICS

  • Diagnostics of acute and chronical diseases of Ear, Nose and Throat
  • Child ENT
  • Video- endoscopic examination of upper respiratory tract
  • Alergy testing and treatment
  • Hearing and balance diseases
  • Voice and speech disorders (hoarseness, speech aid prosthesis)
  • Taste and smell disorder
  • Diagnostics and treatment of sleep apnea
  • Diagnostics of tumor skin changes of head and neck
  • Inhalations, aspirations, air therapy

SURGICAL INTERVENTIONS

  • Third tonsil and tonsils
  • Deviated nasal septum
  • Plastic operation of nasal pyramid
  • Thicked and bullosic changed nostrils
  • Polyp in nose and sinuses
  • FESS
  • Sinoscopes
  • Microlaryngoscopy( polyp and papilloma on vocal cords)
  • Biopsy of tumorous changes in throat
  • Parcial resections of larynx ( cordectomy), laringectomy

LASER ENT SURGERY

  • Laser treatment of polypose and papilomatose changes in throat and vocal cords (ML- scopy, abrasion ,ablation)
  • Laser treatment of tumorous changes in throat(larynx)
  • Laser treatment of ( concha bullosa and concha hypertrophy)
  • Laser treatment of nose polyp ( polypectomy nasal)
  • Ablation of lymph nodes in neck
  • Laser treatment of moles and other pigmented tu skin changes on head and neck – Laser treatment of Sleep apnea (laser interventions)
  • Surgical corections and aesthetic interventions of head nad neck changes
  • Ear shells

NOSE, FACE, LIPS

  • Removal of scar changes and tattoos
  • Correction of facial and neck wrinkles (Restylane)

MEDICAL SERVICES IN ENT

ENT Examinations and Outpatient Interventions
Specialist ENTexamination Prof. Orovchanec
ENT Examinations ( D-r Petreska, D-r Peceva)
Polysomnographic testing for Sleep Apnea
Small outpatient manipulations
Medial outpatient manipualtion
Big outpatient manipulations
Removal of outside particle in ear, nose or throat
Biopsy of TU changes from ear, nose or throat
Rhinomanometry
Tympanometry
Jet anesthesia upon indication

 

Prof. d-r Gjogji Orovchanec and D-r Vesna Petreska Dukovska
Calssiacal surgery interventions ( ear, nose and throat)
Tonsillectomy
Adenectomy
Operative treatment of bilateral maxillary sinuses
Operative treatment of a maxillary sinus
Nasal polyp removal
Biopsy of polyps of plica vocalic
Septoplastics
Septoplastics + mucotomy
Septorhinoplastics
Total laryngectomy (8 days); Hemilaryngectomy; Frontolateral; Subtotal laryngectomy
Total laryngectomy + unilateral neck dissection
Total laryngectomy with bilateral neck dissection
Total laryngectomy+glossectomy + bilateral neck dissection
Glossectomy + unilateral neck dissection
Glossectomy + bilateral neck dissection
Neck tumorectomy
Partial laryngeal resection (7 days)
Tracheotomy
Epipharyngx biopsy
Block disectio colli
Cysta colli mediana
Cysta colli brachiogenes
Ca basocellulare cutis
Ca basocellulare cutis + kutana plastic
Rhinotomia
Rhinotomy+ dissection
Frontal tamponade
Rear tamponade
Oesophagoscopy
Oesophagoscopy+bougie
Oesophagoscopy without anesthesia
Oesophagoscopy in three acts
Bronchoskopy
Revision septoplasty
Tracheostomy Suture
Adenectomy + miringotomy
Tonsil tumor
Benign tumors in parotid regia
Malignant tumors in parotid regia
Extirpation of parotid gland benign
Extirpation of parotid gland malignant
Extripatio papilom

 

D-r Gjorgji Orovchanec and D-r Vesna Petreska Dukovska
Laser CO2 treatment with general anesthesia
Lingual tonsils (1 day)
Polyps on larynx and other benign tumours
Displeases on larynx (daily hospital)
Papilloma of larinx (1 day)
Papilloma of larinx + mitomicin
Adhesive processes on larynx (1 day)
Aritenoidectomies (3 days)
Cordopexy
Aritenoidectomy + cordopexy
Haemilaryngectomy
Hordectomy (1 day)
Expanded Chordectomy
Optimal Chordectomy
Supraglottic laryngectomy
Expanded supraglottic laryngectomy
Supraglottic laryngectomy+ dissection unilateral
Supraglottic laryngectomy+ dissection bilateral
Reduction of postirradiation edema of gtottis
Recanalisation of trachea by laser
Adhesolysis
Laryngocele

 

D-r Gjorgji Orovchanec and D-r Vesna Petreska Dukovska
Laser- Dioden interventions
Tonsillectomy
Sleeping apnea (septum; uvula+ soft palate)
Sleep apnea (septoplastic + mucotomy + uvulopalatoplastic)
Sleep apnea (tonsillectomy+ uvulopalatoplastic)
Sleep apnea (tonsillectomy+pharyngectomy+ uvulopalatoplastic)
Sleeping apnea ( uvula+ soft palate)
Epistaxis laser coagulation (1-3 séance)
Nasal polyps with par nasal sinuses
Fess
Expanded Fess
Fess + sfenoid
Mucotomy
Miringotomy
Resectio uvulae cum laser
Soft palate lfting with fotona laser

UROLOGY

The interventions in this area are conducted by d-r Zlatko Pendovski and D-r Aleksandar Mickovski, who have many years of urology experience, together with the complete surgical team in Re-Medika and at the same time precedures are done,if necessary, by distinguished external associates from our country and abroad( D-r Zoran Krstanoski,Slovenia).

UROLOGICAL PROCEDURES THAT ARE APPLIED, AS A PART OF THE SURGERY DEPARTMENT, ARE OUTPATIENT- DIAGNOSTIC AND OPERATIONAL

  • Consultation diagnostic procedures
  • Complete infection screening (urinoculture, sperm culture, urethral swab, Chlamydia testing, HPV)
  • Screening of prostate cancer- tumor marker PSA investigation and Transrectal prostate ultrasound, with prostate biopsy (TRUS – biopsy);
  • Uroflowmetry
  • Treatment and diagnosis of erectile dysfunction
  • In cooperation with the in vitro fertilization department- diagnosis of sterility in men
  • Diagnosis of urinary calculus
  • Cystoscopy
  • Placing urethera and J-J probes and bougienage, conservative prostate carcinoma ( antiandrogen therapy) and bladder tumors ( intravesical installation of BCG and Mytomycin)
  • Treatment and diagnostic of erectile dysfunction

SURGICAL PROCEDURES COVER

  • Treatment of kidney calculus
    Minimally invasive treatment of kidney calculus with a breaking kidney stone apparatus (ESWL), endoscopic treatment of urethreal stones ( ureterorenoscopy with lithotripsy), endoscopic treatment of bladder stones.
  • Screaning of prostate carcinoma – tumor marker PSA investigation and Transrectal prostate ultrasound, with prostate biopsy (TRUS – biopsy);

  • Laparascopic procedures
    Laparascopic urology is used completely in all urologic interventions- Radical prostatectomy, radical nephrectomy, correction of stenotic UP segment, excision of kidney cyst. The interventions are conducted with participation of D-r Zoran Krstanoski, urologist form R. Slovenia, who has many years experience in laparascopic urology.
  • Microsurgical procedures
    Novelty in the IVF program at Re – Medika are the microsurgical procedures in the treatment of male sterility – especially micro tese and microsurgical procedure after the varicocele treatment.
  • Transurethral surgery
    Transurethral resection of bladder tumor and transurethral resection of prostate and resolving the urethra structure – urethromy intera.
  • Complete diagnostic of urinary calculus
  • Cystoscopy
  • Classical ( opened surgery procedures- nephrectomy simplex; radical nephrectomy; radical prostatectomy, correction of stenosis on uretheropielic neck; uretherocystoneostomy).
  • What is laser prostate surgery
    The photo selective vaporsation of prostate with “Green-light laser” is a relatively new technology in the treatment of BPH. According clinical results, it has proved as an equivalent method of TUR-P. In the 7-years- clinical experience, over 370000 patients have been treated, presented in over 100 clinical articles and 150 published abstracts, which confirm safety and efficiency of the method: -risk absence for TUR- syndrome, liquids absorption or blood transfusion and less than 1% reported cases of erectile dysfunction. The mechanism of action is, interference of laser beam with oxyhemoglobin from the prostatic tissue, in watery area, enabled by specific wave length -532nm, with the power to 120W and energy of 275KJ that enables penetration into the tissue to 4mm, during work temperature from 55 and 85 degrees.
  • Procedure
    When the patient is under anesthesia and lithotomic (gynecologic) position, the intervention begins, first, with an examination of the urethra, bladder and prostate under eye control, with optic instrument- cystoscopy, and then a fiber optic is used that emits laser beam with the previously mentioned wave length. The high temperature and the mentioned wave length from the laser beam with the use of watery area, and the constant wash out with physiology solution, causes vaporization- prostate melting, so the extra tissue is being eliminated and a urine channel with a larger lumen is done. Following the intervention, a urinary catheter is placed. Postopearation- there are no additional treatments with wash outs or blood transfusion or blood products, which is usual for all other prostate surgeries. The postsurgical laboratory analyses do not differ in great way from the ones done before surgery, and that applies for the hemoglobin values and hematocrit values, as referents of blood loose.

    It is a minimally invasive procedure, bleeding and damaging the areal tissue is minimal, so usually patients are discharged from hospital the same day or the following day. The urinary catheter is displaced after 24 hours. The patient returns to his activities the next day after the procedure and the physical activity must be avoided in the period of two weeks.

  • Advantages of the Green-light treatment
    It is suitable for the operation risky patients- cardiovascular risk ( heart diseases), sick people with anticoagulant therapy. The time of the interevantion is relatively short- 40-60minutes. There is a good visibility and no blood loose. The period of catetherisation is short- 1 day. Short period of hospitalization. No need of blood therapy and blood derivates. Fast recovery.
  • What are the adventages of the laparascopic prostatectomy and where it is done in Macedonia
    This procedure in Macedonia is conducted exclusively in our hospital. The advantage is in the short period of patient’s hospitalization, minimal blood loose, minimal distress, fast and easy recovery, taking out of the catether the 7th day after surgery.
  • What is micro tese -biopsy of testicles
    Only in Re-Medika the microsurgical procedures are conducted in the area of in vitro fertilization, when there is sterility in men. These types of interventions allow precise sperm extraction from testicles under microscopic control. The results are obvious and far better than the conventional testical biopsy.
  • What is the most accurate biopsy for proving the prostate cancer
    Using endorectal probe, the most sophisticated one by TOSHIBA manufacturer, through the rectum an image for the size, form, structure, limitations, the weight of the pathological prostate blood supply are gained, as well as the possible pathological changes of tissue that may be with malignant characteristics. Only in this way may the required information be gained for the prostate condition, while the prostate echo examination through abdomen (transabdominal ultrasound of prostate) has got many weaknesses, i.t., only the size and the weight of the prostate may be determined. As a written rule- EAU guidelines, is the principle of abstracting pieces of prostate tissue, after the so- called Vienna protocol for prostate biopsy, usually 6+6 cylinders prostate tissue, of 15-20mm length.

MEDICAL SERVICES IN THE UROLOGY DEPARTMENT

Urological examinations and interventions D-r Zlatko Pendovski
Sextan biopsy + analysis costs
Urological examination
Placement or change of catheter
Rectal touché
Uroflowmetry
Examination with novocainisation
Prostate Trans-rectal ultrasound
Ultrasound of urinary tract
Rest urine
Cystoscopy without anaesthesia
Cystoscopy with anaesthesia
Biopsy of Urinary bladder
Unilateral placement of urethral (J-J) probe
Bilateral placement of urethral (J-J) pro
Placement of cystostome minima
Change of cystostome
Drugs instillation in the urinary bladder (without prices of drugs)
Bougienage
ESWL – Extracorporeal lithotripsy – two treatments of calculosis on the same side in the duration of three weeks + two echo examination of treated kidney
ESWL – Extracorporeal lithotripsy – the third treatment of previous treated calculosis + echo examination of treated kidney
Testical biopsy – TESSE
Outpatient prostate biopsy
Circumcision
Frenulotomy
Trans-Urethral Resection (TUR)
Trans-Urethral Resection of urinary bladder
Trans-Urethral Resection of urinary bladder
Nephrectomy – Simplex
Nephrectomy – Radicalis
Uretherorenoscopy
Uretherorenoscopy and lithotripsy
Lithotripsy of urinary bladder
TUR of pro.with lith.of urinary bladder
Internal Urethrotomy
TUR of neck of urinary bladder
Hydrocele of testis
Orchiphunculectomy
Pyelolytotomy
Uretheropyelic Plastics
Uretheronephrectomy
Uretercystoneostomy
Package hormons for TESSE (testosteron, prolaktin, FSH, LH
Varicocella surgery
Retention surgery of testical
Cyst surgery of epididym
Epididymectomy- incision of epididym
Orchiectomy- bill.
Classical prostatectomy
Vasectomy
Open lithotripsy of bladder stone
Laser vaporization of prostate
Meatottomy
Caruncle surgery
Laparascopic surgery of Varicocella
Retrograde pielography
Retrograde pielography with J-J probe placement

 

Urological examinations and interventions D-r Zoran Krstanoski
Urological examination
Biopsy of Urinary bladder
Laparoscopic radical prostatectomy
Laparoscopic radical prostatectomy with limphaden.
Laparoscopic radical nephrectomy
Laparoscopic pyeloplastics
Перкутана литолапаксија на камен во бубрег
Varicocella laparascopic surgery

ORTHOPAEDIC SURGERY

The orthopaedic surgery is a constitual part of the Surgery Department in Re- Medika. Towards the end of 2007, we started conducted the most difficult surgical interventions in the area of orthopaedics ,starting from endoprothetic change of the hip and knee joint, through knee arthroscopy, ancle joint and shoulder, as well as surgical stability of fractures and reconstruction of torn tendons.

Surgical interventions in the area of orthopaedics are conducted by our orthopaedic surgeons D-r Ivanka Stefanovska ( orthopaedic surgeon with great experience from the hand surgery area) and D-r Dimitar Spoa.

MEDICAL SERVICES IN THE ORTHOPAEDIC SURGERY DEPARTMENT

Orthopedic examinations
Orthopedic examinations of a child
Echo orthopaedic examination
Puncture on bursa + amp.kenalog
Plaster cast or removal
Intra-articular application
Autologus Conditioned Plasma
Collagen application
Elbow arthroscopy
Arthroscopy of a knee with synovectomy
Arthroscopy of a knee with meniscectomy
Arthroscopy of a knee with Baker’s cyst
Arthroscopy of a ankle joint with synovectomy
Arthroscopy of a ankle joint with procedure on talus
Reposition of a fracture under anesthesia
Plaster change under anesthesia
Elongation of the Achilles Tendon
Complete correction of a club’s foot in child
Correction of Hallux valgus
Correction of deformity of the foot
Resection of the head of metatarsal bone on 4 fingers
Excision of the ganglion of the foot
Excision of the ganglion of the foot
Synovectomy on the foot joint
Ablation of the exostosis of the over-knee
Removal of the soft tissue changes on the under-knee
Removal of the soft tissue changes on the upper region of the knee
Synovectomy of the knee
Tenotomy of the hip
Tenotomy of the hip- two sided
Tenotomy of the hip aductors
Operative treatment of tumor changes of the upper extremity without the hand
Puncture of the cyste of the thigh bone
Removal of the exostosis of the upper extremity
Removal of the exostosis
Transposition of n. ulnaris in the elbow area
Decompression of a nerve in the area of the elbow – local anesthesia

 

Orthopaedic Interventions
Discision of the tendon sheet thumb in child
Excision of palmar fascia – Dupuytran
Synovectomy of the wrist
Synovectomy of the hand thumb
Synovectomy of other hand joints
Arthrodesis of small hand joints
Tenodesis of the tendon
Synovectomy of extensors / flexors
Transposition of the hand tendon
Removal of tumor changes of the hand
Skin Plastic of the hand – Z
Treatment of syndactilia – 2 fingers
Treatment of syndactilia – Multiple fingers
Transplantant with Suture
Tenotomyof the sternokleidomastoideus muscle
Release of the tendon of m.EPB and m.APL
Subcutaneous Tenotomy of Achilles Tendon
Coxal Joint Cap correction
Coxal Joint Cap correction with trochleoplasty
Endoprothetic joint hip change
Endoprothetic joint knee change
Endoprothetic shoulder change with bipolar prosthesis
Endoprothetic shoulder change with anatomic prosthesis
Endoprothetic shoulder change with reverse prosthesis
Endoprothetic shoulder change with glenoid
Amputatio dig. Accesorii
ACL Reconstruction (Anterior Cruciate Ligament)
Arthroscopic reconstruction of the posterior cruciate ligament
Reconstruction of anterior and posterior cruciate ligament in same act
Reconstruction of posterior cruciate ligament with posterolateral knee corner
Revision of Reconstructed ACL
Achilles Tendon suture
Achilles Tendon suture with graft os semitendinosus
Aponeurotomy of under knee
Aponeurotomy of under knee- two sided
Osteotomy of upper knee (LFOW) with spongioplasty
Osteotomy of under knee (LFOW) with spongioplasty
Lavage of knee
Rearthoscopy of knee because of arthrofibrosis
Surgical intervention with anesthesia
Stability of shoulder instability after LATARJET
Diagnostic arthroscopy of shoulder
Diagnostic arthroscopy of shoulder with bursectomy and subacromial decompression
Diagnostic arthroscopy of shoulder with anterior an posterior instability
Diagnostic arthroscopy of shoulder with reconstruction of rotator cuff
Diagnostic arthroscopy of shoulder with biceps tenodesis

VASCULAR SURGERY

Vascular surgery department in Re-Medika is contemporary concepted department which provides up-to-date diagnostic and treatment of PAB and treatment of superficial and deep veinous system diseases.
In our institution we conduct the most sophisticated deseases diagnostic on the artherial blood vessels by non invasive dopler ultrasonography.

Doppler ultrasonography – is a noninvasive procedure by which with the help of the ultrasound wave that travels together with the blood stream, the blood vessels narrowing is registered. The ultrasound waves reflect from the narrowing and are registered on the ultrasound apparatus. Moreover, the blood speed may be registered by which indirectly the existence or absence of the blood vessel narrowing is estimated. The normal signal is three phase.
Determening of the AB index- is the relation of the blood pressure of ancle joint in contrast to blood pressure of the upper hand. Its physiological value is 1.

CT- angiography- is a method that helps in diagnostic of PAB, the exact localization of lesion is determined, its length as well as the condition of the vascular bed of the segment up and under the occluded segment. It is conducted within a few seconds and for visualization a contrast is used.

We conduct the most up-to –date treatment of artheria and vein blood vessels in our institution:

Medicaments- application of the newest vasodilator therapy with prostaglandins, application of the newest fibrinolisis therapy in embolia of arterial blood vessels and deep vein trombose.

Surgical treatment


  • Surgical treatment of suprarenal and infrarenial aneurisms of abdominal aorta ( aneurysmectomy)

  • Surgical treatment of iliac, femoral and poplitheal artherie aneurysms

  • Surgical treatment of occlusions of iliac aorta segment (aortobifemoral by pass, aortofemoral by pass, iliac femoral by pass and cross-over by pass)

  • Surgical treatment of occlusions of artherias in infrainguinal segment ( femoral- poplitheal by pass- under knee and upper knee, with vein or with dacron prosthesis)

  • Surgical treatment of varicose veins with endovenous laser procedure, radiofrequency ablation and surgical stripping and ligation

  • Surgical treatment of deep vein thrombosis and postphlebitic syndrome ( Linton operation)

Postsurgical treatment for the patients is continued at the intensive care unit within 24 hours period with top monitoring and professional medical care. The unit is fully authomatically climatised and provides clear air through hepa filters and uses sterile technique.

MEDICAL SERVICES IN THE VASCULAR SURGERY DEPARTMENT

Vascular examinations/treatments Vlatko Cvetanovski M.D.
Vascular consultative examination
Arteria and veins Doppler
Prostaglandin therapy without incalculated ampulla therapy
The package includes:
Prostaglandin therapy without incalculated ampulla therapy
Ultrasonographic heart examination
Prostaglandin therapy with incalculated ampulla therapy
The package includes:
Prostaglandin therapy with incalculated ampulla therapy
Ultrasonographic heart examination
Prostaglandin therapy with incalculated ampulla therapy-one dosage
Treatment of arterial ischemia with stem cells – 4 vials
Treatment of arterial ischemia with stem cells – 8 vials
Treatment of arterial ischemia with stem cells – 12 vials
Perforator ligation
Transposition of USM (cross over)
Weekly treatment of diabetic angio-neuropathy with alpha- lipoic acid
Day therapy with Amp.Angioflex
Thrombolytic therapy application
Conservative treatment of deep vein thrombosis
Femoro-popliteal by раѕѕ with vena saphena above knee
Fem-pop by раѕѕ with svg-segmenten
Fem-pop by раѕѕ with svg-multi segmenten
Femoro-popliteal by раѕѕ with dacron graft above knee
Femoro-crural by раѕѕ with vena saphena
Femoro-crural by раѕѕ with cone prosthesis
Thrombendarectomy of А. Iliaca
Iliac- Femoral by раѕѕ with dacron graft
Aorto-Bi Femoral by раѕѕ with Y Dacron gaft
Aorto-Bi Femoral by раѕѕ with Y Dacron gaft(silver)
Aneurismectomy of iliac artery аneurysm
Aneurismektomy of iliac artery aneurysm (segmental)
Aneurismektomy ofiliac artery aneurysm (with iliako-fem by раѕѕ/еxclusion)
Aneurismectomy of abdominal aorta aneurysm (tubulаг prosthesis)
Aneurismectomy of abdominal aorta aneurysm (y-graft)
Carotid thrombendarterectomy (ТЕА) (without sant)
Carotid thrombendarterectomy (ТЕА) (with sant)
Glomus tumor (with resection and sant)
Glomus tumor (without resection and sant)
Aneurismectomy of peripheral artery aneurysm (end-end)
Aneurismectomy of peripheral artery aneurysm(prostehsis)
Precardial fenestration in peritoneal cavity
Precardial fenestration in pleural cavity
Artefitial A-V fistula for dyalisis uninfected
Artefitial A-V fistula for dyalisis infected
Embolectomy with Fogarty catheter
Cross over by раѕѕ fem-fem
Extra anatomical bypass
DVT-Throbecthomy (without A-V fistula)
DVT-Throbecthomy (with A-V fistula)
Subfascial perforator ligation(without ulcus)
Subfascial perforator ligation(with ulcus)
Subfascial perforator ligation(with ulcus)+ stem cells
Cros over by раѕѕ fem-fem(venous)
Artefitial venous valve for DVT
Cor matrix implantation
Wedge-shaped amputation (finger)
Metatarsal amputation
Transmetatarsal amputation- Chopard
Under-knee amputation
Above-knee amputation
Alpication of 50IE Botulinum toxin type A
Alpication of 100IE Botulinum toxin type A
Alpication of 150IE Botulinum toxin type A

PLASTIC SURGERY


  • Nose surgical interventions

  • Dermatolipopexy

  • Liposuction

  • Breast implant and correction

  • Auricular-plastic

MEDICAL SERVICES IN THE PLASTIC SURGERY DEPARTMENT

Ognen Daskalov M.D.
Examination
Breast repair-augmentation, 2 breasts (1 day, general anesthesia)
Breast repair-augmentation, 1breast (1 day, general anesthesia)
Breast repair-suspension, 2 breasts (1 day, general anesthesia)
Breast repair-suspension, 1 breast (1 day, general anesthesia)
Breast repair-mutual reduction
Breast repair-unilateral reduction
Dermolipectomy, with abdominal muscles reconstrucion(2 days, general anesthesia)
Dermolipectomy-abdomen, (2 days, general anesthesia)
Liposuction by region, up to 500 ml, 1 day, local anesthesia
Liposuction by region, up to 1500 ml, 1 day, general anesthesia
Liposuction by region, from 1500 ml to 3000 ml, 1 day, general anesthesia
Blepharoplastics (eyelids repair)
Blepharoplastics (eyelids repair)
Sinus pylonidalis with reconstruction
Rhinoseptoplastics without osteotomy
Rhinoseptoplastics
Excision by local anesthesia
Excision with reconstruction (general anesthesia)
Face lifting (forehead, cheeks, neck)
Face lifting – forehead, cheeks, partial
Lips filling (basic price-without the price for the material )
Wrinkles –filling ( basic price-without the price for the material)
Auricleplastics (auricles repair), 1 day, local anesthesia
Auricleplastics (auricles repair), 1 day, general anesthesia
Otoplastics – congenital and acquired deformities of the auricle
Small reconstructive surgical interventions (general anesthesia)
Big reconstructive surgical interventions (general anesthesia)
Middle reconstructive surgical interventions up to 1,5 hour (general anesthesia)

DAY HOSPITAL SERVICES


  • IV Parenteral intravenous infusion

  • ECG 12 lead

  • IM Intramuscular injection

  • IV Intravenous injection

  • IV Intraarticular injection

  • Pain treatment IV or IM

  • Day hospital stay up till 6 hours

TRANSFUSION SERVICES


  • Blood group, Rh factor

  • COOMBS

  • Direct COOMBS

  • Indirect COOMBS

  • Direct COOMBS in IGG

  • Indirect COOMBS in IGG

  • Enzyme test (papain, bromeline)

  • Titer of ERC antibody with COOMBS

  • Titer of ERC antibody-Pap…

  • Titer of direct COOMBS

  • HIV confirmation test

  • Full blood application

  • Eryth.conc.application in SAG-M

  • Eryth.conc.application washed

  • Eryth.conc.application filtered

  • Fresh frozen plasma application isogroup

  • Fresh frozen plasma application universal

  • Cryoprecipitate application (1 dose)

  • Thromb.conc.application (1 dose)

  • Aplication of Leuc.conc.from 1 cell separator donor

  • Per.moth.cells application

  • Endobulin application (immunog.)

  • G.Globulin application

  • Immunogl. Application for Hep.B

  • Blood interaction

  • Thrombus test

  • Factor II

  • Factor V

  • Factor VII

  • Factor X

  • Factor VIII

  • Factor IX

  • Factor XI

  • Factor XII

  • Fibrillation – Activators

  • Fibrillation – Inhibitors

  • D-Dimmer

  • Factors for hemostasis

PATHOHISTOLOGICAL AND CYTOLOGICAL ANALYSES


  • Additional charge for histopathological analyzes of ambulatory done biopsies

  • Additional charge for histopathological analyzes of operative materials

  • Cytodiagnostic from fine–needle biopsy

  • Pathohistological analysis from fine–needle biopsy

  • Cytodiagnostic of body liquids

  • Aditional charge for biopsy of operative materials with the technique Wertheim-Meigs

  • Additional charge for Histopathological analysis of biop.with cyr.

  • Additional charge for Histopathological analysis of Conus, LEETZ

  • EX TEMPORE

  • Additional charge for pathohistological diagnosis- fetus, placenta

DOCTORS