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Surgery

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Professionalism. Dedication.

Are you planning on scheduling a surgery? Does your loved one need specialized treatment or a prevention surgery procedure?

Here at our surgery service, we are teamed with the best qualified intelligent surgeons and specialized consultants to offer you a high-standard surgery that fulfills your medical requirements.

Our team does not only perform daily procedures on urology, vascular, endocrine, cancer, and tumors associated surgeries but provides focused surgical care for critical and complex cases from various surgical specialties. The service plays a major role in the training of Omani surgeons by providing well-planned educational and training programs.

It provides a multidisciplinary service of networking and collaboration with all other surgery units in the country to deliver the best patient-centered care service.

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The department of Surgery is an effective element in providing all local hospitals with the highest surgical services, whether by receiving referrals or by visiting hospitals and performing complex operations in them. As well as seeking to support academic and practical cooperation with various tertiary and secondary hospitals in order to provide all the new updates in surgery and also to benefit from other experiences.

The Centre of Surgery works side by side with educational and training institutions in the Sultanate in order to prepare and train Omani surgeons at the highest level, and there are many efforts exerted to receive and educate medical students in the academic years and then train them during the year of internship.

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Duties and tasks of the Surgery Department

  • Covering the surgical service at the Royal Hospital
  • Covering surgical services at all levels in Muscat
  • Treatment of complicated surgical cases referred from within the Sultanate or from other tertiary hospitals
  • Carrying out all surgical services in the event of disasters and mass accidents
  • Continuing to train surgical residents from the Oman Medical Specialty Board, as well as teaching medical students and Interns
  • Training of specialists in various surgical specialties and then joining them to secondary hospitals in order to improve the surgical services in these hospitals without the need to transfer cases to tertiary hospitals
  • Provide the up to date in Oncosurgery and work hand in hand with the National Cancer Center

It is a tertiary surgical providing specialized care unit for the citizen of the sultanate of Oman with mission to deliver most advanced and updated specialized people-centered care along side promoting and undertaking continuous education, Training, research and innovation for its staff, surgical residents, and medical students.

Alongside the clinical part, the department implements the professional values between its staff and the others including the patients, such values as teamwork, safety first, integrity & respect and others which made the department the leading body for other surgical units.

General Surgery department consist of.

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COLORECTAL SURGERY
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BREAST SURGERY

UPPER G.I & BARIATRIC

The unit consists of highly qualified surgeons with interests in Upper GI benign and malignant conditions. The unit has sub-specialty interest in Bariatric (Obesity surgery) and Metabolic Surgery. It also provides laparoscopic procedures simple and complex and all kind of hernia repair laparoscopic and open hernia repairs.

The unit also provide Upper GI diagnostic services. There are rotating Registrars with rotating junior and senior residents who are part of the team. Our team of surgeons are committed to provide service of excellence based on the lasted evidence-based medicine and updates. The team also part of tumor board and other multidisciplinary teams related to Upper GI and obesity. The Unit also provides training for Upper GI and Bariatric surgery.

COLORECTAL SURGERY

The unit consists of highly qualified surgeons with interests in Colorectal benign and malignant conditions. The unit has sub-specialty interest in Perianal condition and pelvic flood diseases. It also provides laparoscopic procedures simple and complex for all kind of Colorectal Malignancies.

There are rotating Registrars with rotating junior and senior residents who are part of the team. Our team of surgeons are committed to provide service of excellence based on the lasted evidence-based medicine and updates. The team also part of tumor board and other multidisciplinary teams related to Colorectal diseases. The Unit also provides training for Colorectal conditions.

The units doing maximum number of colonic cancer in the latest advanced laparoscopic surge-oncological techniques. Also, They provided the latest procedures for fissures in ano and fistula in ano Management in minimal invasive techniques.

BREAST SURGERY

The breast unit is the largest center to treat breast cancer in the Sultanate. The unit has highly qualified consultant surgeons who are expert in the treatment of breast cancer.

There are also qualified specialists and rotating surgical residents and medical students who join the unit on regular basis. The unit aims to evaluate and diagnose all referred breast cases within 2 weeks from the referral time.

We take a multidisciplinary approach to diagnose and treat breast cancer with the cooperation from other departments in the hospital including:

  • Breast Radiology
  • Medical oncology
  • Radiation oncology
  • Pathology
  • Nuclear medicine

We have regular MDT meeting to discuss the beast treatment options for all breast cancer cases. We also treat all benign breast tumors and acute and chronic inflammatory conditions of the breast.

The unit performs various types of breast surgeries including:

  • Breast conservative surgery
  • All types of mastectomy(simple, nipple-sparing and skin-sparing) with or without immediate reconstruction with implant or autologous flaps
  • Axillary surgery (SLND and axillary dissection)
  • Excision of breast lesion by wore localization
  • Excision of benign breast lesion

We also aims to improve breast cancer treatment and awareness in Oman by encouraging breast cancer research and participating in local and international conferences.

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ENDOCRINE SURGERY
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HEPATOBILIARY & LIVER TRANSPLANT

ENDOCRINE SURGERY

The Endocrine Surgery Unit is the only unit specialized in treating endocrine diseases in the Sultanate. The unit includes a group of experienced surgeons in treating endocrine diseases (thyroid, parathyroid and adrenal glands).

The unit also includes specialists in the same field and receives trained doctors in the Department of Surgery and medical students at varying intervals.

The unit aims to receive and diagnose transferred cases within two weeks from the date of transfer, following the international recommendations, by discussing all endocrine cases periodically to reach the best appropriate treatment plan for each case.

The Endocrine Surgery Unit works with coordination to diagnose and treat these cases with some other departments in the hospital to reach an integrated service, including:

  • National Endocrine Center
  • Department of Radiology
  • Department of Oncology
  • Department of Histology
  • Department of Nuclear Medicine
  • Department of Radiation Therapy

Types of diseases that the endocrine surgery unit treats:

  • Thyroid
    - Benign and malignant tumors
    - Hyperthyroidism
    - Hypothyroidism
  • Parathyroid glands
    - Benign and malignant tumors
    - Increased activity of the parathyroid glands
  • Adrenal
    - Benign and malignant tumors

Types of operations carried out by the unit:

  • Thyroid
    - Total thyroidectomy
    - Hemithyroidectomy
    - Lymph node dissection
  • Parathyroid glands
    - Excision of benign and malignant
  • Adrenal
    - Laparoscopic resection of the adrenal gland

The unit contributes to improving the treatment of endocrine diseases and spreading awareness in the Sultanate by encouraging scientific research and participating in local and regional scientific conferences.

HEPATOBILIARY & LIVER TRANSPLANT

The HPB Unit is the nationally recognised centre of excellence for managing liver, biliary and pancreatic cancer and the largest in the Sultanate of Oman serving a population of over 4 million and providing a comprehensive patient care in General Surgery, Hepatobiliary Surgery and Liver transplantation. The quality of our care, the extensive knowledge and experience of our specialised team attract many patients for their care at Royal Hospital.

We provide a multi-disciplinary service with a team of experienced surgeons, gastroenterologists, radiologists, pathologists, anaesthetists, oncologists, intensive care physicians, clinical nurses, physiotherapists, wound care nurses and dieticians, all dedicated to providing the best possible care for individual patients.

The Royal Hospital is a designated government tertiary referral care center for patients from all over the country. It is one of the largest teaching hospitals in Oman. Along with other surgical subspecialties, our unit conducts an active undergraduate teaching in partnership with the college of medicine and health sciences at Sultan Qaboos university. In addition, we provide postgraduate surgical training in partnership with the Oman Medical Specialty Board to general surgery program and others.

Our HPB unit provide focused care for people with liver, pancreatic, biliary and gall bladder diseases such as:

  • Primary liver cancer: hepatobiliary carcinoma (HCC)
  • Benign liver tumors: Focal nodular hyperplasia (FNH), Adenoma and Hemangioma
  • Biliary disease: Gallstone and PSC
  • Biliary cystadenoma and cystadenocarcinoma
  • Primary biliary cancers: Cholangiocarcinoma and Gallbladder cancer
  • Pancreatic disease: complicated pancreatitis, pancreatic cancer, pancreatic cystic lesions, chronic pancreatitis and complicated acute pancreatitis
  • Solitary liver tumors from colorectal, breast or other primary
  • Complex benign hepatobiliary and pancreatic conditions
  • Liver, biliary and pancreatic diseases
  • Liver cirrhosis and portal hypertension
  • Pathological spleens
  • Adrenal pathologies
  • Retroperitoneal lesions

Treatments provided directly by our surgical team include:

  • Laparoscopic and open liver, pancreatic and biliary resection
  • Laparoscopic surgery for complicated gallbladder disease
  • Laparoscopic and open fenestration/resection of simple and liver hydatid cysts
  • Laparoscopic and open fenestration of liver cysts
  • Laparoscopic and open CBD exploration
  • Laparoscopic and open drainage of complicated liver abscesses
  • Laparoscopic and open enoculation of pancreatic lesions
  • Laparoscopic and open management of acute liver bleeds
  • Laparoscopic and open splenectomy
  • Laparoscopic and open adrenalectomy
  • Biliary reconstruction for bile duct injuries
  • Intraoperative radio-frequency ablation of primary and secondary liver tumours
  • Laparoscopic and open inguinal and incisional hernias
  • Management of acute general surgical conditions

Treatments provided with the help of other services include:

  • Angioembolization of bleeding liver lesions (Interventional Radiologist)
  • Percutaneous radio-frequency ablation of primary and secondary liver tumours (IR)
  • Percutaneous chemo-embolisation for primary liver tumours (IR)
  • Selective Internal Radiation Therapy (SIRT) for primary or secondary liver tumours (Radonc)
  • Sorafenib for primary liver cancer – hepatocellular carcinoma (HCC) (Medonc)
  • Endoscopic Retrograde CholangioPancreaticography (ERCP) and biliary stenting. (Interventional Gastroenterologist)
  • Percutaneuous transhepatic cholangiography with biliary dilatation and stenting (IR)
  • Percutaneuous transhepatic gallbladder drainage (IR)

Fast-track Surgery

Patients who present with obstructive jaundice and suspected to have pancreatic head tumour or cholangiocarcinoma can be referred for consideration of Fast-track surgery by their referring hospital. They are assessed and reviewed by our consultant and they undergo extensive workup to assess resectability. The aim of this is to provide earlier diagnosis and proceed straight to surgery (within 1 week) thus avoiding preoperative biliary drainage (if bilirubin <350) helping to improve patient experience.

The enhanced recovery programme

At Royal Hospital, we use an enhanced recovery programme to help patients recover from the operation and return to normal activities faster with less chance of developing complications like blood clots in the legs and lungs or chest infections. It also means that you will be able to get home earlier. On average patients undergoing open liver resection are discharged six days after surgery. The majority of patients who have had complex surgery such as operations for liver or pancreatic cancer will spend their first few post-operative days in a high dependency or critical care unit. Patient will have his own dedicated nurse who will monitor him/her round the clock and will monitor the temperature, pulse, blood pressure and fluid balance. Also, will ensure the pain control is effective.

The physiotherapist will be doing regular breathing exercises, sitting the patient out of bed and walking to reduce rates of chest infections, blood clots in the legs and lungs and help patients get home quicker. After the patient wake up from the operation, he/she should start breathing exercises. Support their abdomen with their arms. A physiotherapist will do these exercises every day. The patient will be advised to perform specific leg exercises, wearing compression stockings and having daily injections of a drug that thins the blood to reduce the risk of developing a blood clot in the legs.

The day after the operation the staff will help the patient out of bed. The patient will spend several hours out of bed each day and will be encouraged to walk around (with the help of the staff initially) 3-4 times per day. At first this will feel like hard work but being out of bed and mobilising early improves lung function and reduces the risk of blood clots. The patient will be seen every day by our surgical team who will review the patient progress and decide when it is safe for the patient to go home.

Follow-up clinic

Patients are provided with follow up appointment two to four weeks after their discharge home. This allows us to check their progress, recovery from the operation before undergoing any further treatment and plan their future imaging when required. If necessary, arrangements will be made to see the medical oncologist (a doctor who specialises in chemotherapy treatment).

General Surgery Department Achievements

2019

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- Upper Gastro-Intestinal Surgery unit - Introduction of Revision Bariatric Surgery

2018

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- Hepatobiliary Surgery Unit - Live Donor Liver Transplant

- Upper Gastro-Intestinal Surgery unit - Introduction of Laparoscopic Gastric Bypass Surgery

2017

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- Upper Gastro-Intestinal Surgery unit - Introduction of ERAS in Bariatric and Upper GI surgery

- Breast Surgery Unit - Wireless Gamma probe for Sentinal Lymph Node excision

- Endocrine Surgery Unit - Endoscopic Thyroidectomy

2016

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- General Achievements - Introduction of Out-reach laparoscopic surgery to peripheral hospitals

- Colorectal Surgery Unit -Total Pelvic Exenteration with Ileal Conduit and HIPEC

- Breast Surgery Unit - Reconstruction Breast Surgery service - Implant-based and Local Flaps

The department looks after patients with arterial, venous or lymphatic diseases as well as vascular access issues for dialysis in renal failure patients. Apart from patients with varicose veins, vascular malformations and vascular trauma who are mostly young and healthy, majority of the department's patients are elderlies with co morbidities like diabetes, ischemic heart disease and renal diseases.

The latter group of patients is increasing in prevalence in tandem with increasing life expectancy and the change in life style in Oman.

Services

  • Every Sunday vascular clinics
  • Every Wednesday vascular access clinic
  • Every Monday multidisciplinary diabetic foot clinic at National Endocrine and Diabetic Centre
  • Round the clock In-patient services
  • On call 24/7 for vascular emergencies and surgeries
  • Daily morning and evening ward rounds for in-patient care
  • Operating every Tuesday and Thursday for elective and urgent vascular and endovascular procedures
  • Every Wednesday endovascular procedures in Cath-lab

The Urology section provides care for various pathologies such as Urinary stones:

- Extra-corporeal ShockWave Lithotripsy (ESWL).

- Endourological procedures: Cystoscopy, Rigid Ureteroscopy, retrograde intrarenal surgery (RIRS) using a flexible ureteroscope and laser therapy, percutaneous nephrolithotomy (PCNL), open pyelo-nephrolithotomy.

Lower urinary tract symptoms: Prostate surgery (TURP, Open prostatic adenomectomy), Prostatic Artery Embolization (PAE) in cooperation with the Interventional Radiologists (IR), treatment of urethral structure either through endoluminal procedure (Internal urethrotomy) or through open repair by BMG (Buccal mucosa grafting) urethroplasty.

Urological cancers: Management of renal cancers, upper tract urothelial carcinoma, bladder malignancies, prostatic and testicular cancers.

Treatment of urinary tract infections.

Management of functional disorders: neuropathic bladder, erectile dysfunction.

ESRD: Renal transplantation in cooperation with the Nephrology Department. The Urology Department is an active part of the National Transplantation Program.

Congenital genito-urinary abnormalities.

Genito-urinary trauma.

The division of Paediatric Urology at Royal Hospital offers Diagnosis and specialty care for a wide range of developmental problems affecting the kidneys, bladder, urethra or genital tract.

For example, commonly seen conditions include:

  • Bladder extrophy (congenital abnormality that occurs when the skin over the lower abdominal wall does not form properly. The bladder is open and exposed on the outside of the abdomen).
  • Cloacal anomalies (abnormal congenital confluence of the rectum, vagina, and urethra into a single common channel)
  • Hernias
  • Hydronephrosis (kidney dilation, detected prenatally or in childhood)
  • Hypospadias (urine passage ending short of the end of the penis)
  • Intersex (incomplete or otherwise abnormal development of the genital organs)
  • Kidney stones
  • Neurogenic bladder from spinal cord lesions, such as myelomeningocele
  • Re-do urology surgery
  • Testicular tumors
  • Undescended testicles
  • Pelviureteric junction obstruction (blockage of urine flow from the kidneys)
  • Vesicoureteral reflux (backup of urine from the bladder toward the kidneys)
  • Wilm’s tumor and other kidney tumors in children

Specialties

  • Endourology
  • Uro-Oncology
  • Minimally Invasive Surgery
  • Reconstructive Urology
  • Renal Transplantation
  • Robotic Surgery and Andrology

Form its humble beginnings in a Portacabin on the premises of the Khoula hospital in October 1985, to half occupancy of the Pediatric Orthopedic ward with one Consultant and on Medical Officer to its current standing as one of the leading centers in the region has been an exciting journey.

The main mission of the Pediatric Surgery Department at Royal Hospital is to provide surgical care for children in a friendly and family-centered environment. The department consists of highly skilled experienced paediatric surgeons who are specialized in paediatric general surgery and urology for children in various stages of their lives from the womb to birth until the age of thirteen years.

Since patients are the center of our mission, the paediatric surgery team, made up of surgeons and nurses, understands that surgery can be stressful for the child and the family. Therefore, we respect the needs of each patient and work together to ensure the child's well-being.

To fulfill our mission, we promise:

  • To treat every child and family with dignity, compassion, and respect
  • To utilize the expertise of the entire team and other hospital services to provide the best care for every child
  • To discuss all alternatives related to treatment with patients and families
  • Act as an advocate for every child in the health care system. Keep patients and their families fully informed of their treatment plan and address concerns in an open and honest manner.

We also in the paediatric surgery department encourage families to share their experiences and suggestions with us at any time during or after their child's admission to the hospital.

Sections

  • Paediatric General surgery Division
  • Paediatric Urology Division
  • Neonatal Gastrointestinal surgery
  • Neonatal Thoracic surgery
  • Neonatal urological surgery
  • Paediatric Gastrointestinal surgery
  • Paediatric hepatobiliary surgery
  • Paediatric oncology surgery
  • Paediatric endocrine surgery

The Division of Paediatric General Surgery provides comprehensive care to neonates, infants and children with surgical problems. Diagnosis, consultation, management, and follow-up of inpatients and outpatients are being done by the department.

Pediatric Surgery department consist of.

Gastrointestinal surgery

The department provides multidisciplinary care for neonates, infants and children, with complex colorectal or upper gastrointestinal conditions.

Hepatobiliary surgery

The department is involved in operations involving the liver, gall bladder and pancreas whether they are due to congenital or acquired conditions.

Surgical Treatment of Childhood Cancer

The department is a major referral center for childhood cancer in the country for cases requiring surgical intervention. The department also takes care of General Surgical Complications of Cancer Therapy.

Minimally Invasive Surgery

Minimally invasive surgery is an innovative method of surgery that allows for smaller incisions, less pain, and faster healing. The department has some surgeons who are expert in minimally invasive surgery.

Trauma Care

Provide immediate evaluation, consultation, and care of children involved in trauma.

Newborn Congenital Anomalies

Newborn congenital anomalies, often referred to as birth defects, have a variety of causes ranging from pregnancy or birth complications to genetic malformations to viral infections in utero. The department is involved in the management of these newborns who have surgical conditions.

Thoracic Surgery

In general, paediatric thoracic surgery involves diseases or injuries to the area of the body between the neck and the abdomen. Our Surgeons are specialized in general paediatric thoracic surgery, whether congenital, such as a birth defect, or acquired, such as pneumonia.

Inguinal and Scrotal Disorders

Disorders involving a child’s inguinal (groin) and scrotal area are frequent and the most common condition treated by the paediatric surgeons at our hospital.

Head and Neck Disorders

Our Paediatric surgeons treat a wide variety of head and neck masses, including inflamed lymph nodes and neck lesions.

Vascular Access

Inserting a central line is one of the most common procedures performed at Royal Hospital, whether for medical purposes or for treatment. Our surgeons are also involved with vascular access.

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