Neurosurgical Clinic at the University Hospital “St. Georgi – Base 2”

Plovdiv
https://mu-plovdiv.bg/fakulteti/medicinski/katedri/nevrohirurgiya/

Info

The Department of Neurosurgery in Plovdiv was opened within the framework of the Department of Neuropsychiatry established in 1946. The department has 6 beds and is headed by Assoc. Prof. Dr. Yanko Namichev since its establishment until 1965. In 1965, a Clinic of Neurosurgery was established with 45 beds within the Department of Neurology and Neurosurgery and headed by Prof. Dr. D. Kitov. Currently, the Clinic of Neurosurgery is an independent clinic at the University Hospital "St. Georgi EAD and an independent department at MU - Plovdiv. The first room is furnished and designed for routine and micro-neurosurgery with a lamp, anesthesiology apparatus, bipolar coagulator, as well as an operating table adapted for all neurosurgical operations with the necessary attachments; an intraoperative ultrasound control apparatus allowing intraoperative imaging and targeting of tumors and other brain diseases; a high-speed motor bone-cutting system with craniotomies for fast and sparing performance of all craniotomies, as well as tips for sparingly and efficiently working on bone structures, both on the head and spine; ultrasonic aspirator for dusting and aspirating tumors in areas where echartation and other surgical operations (pulling, pulling) are particularly dangerous. The room is equipped with state-of-the-art LEICA neurosurgical microscope equipment that enables all mini-invasive and microsurgical access to the brain and spinal cord. At the same time, the microscope provides the opportunity to use the FUNCTIONAL MAGNETIC RESONANCE TOMOGRAPHY of the Medical University, as the magnetic resonance images are "injected" into the eyepiece of the microscope, which allows for maximum functional storage effect during the operative interventions. The second operating room is equipped for routine neurosurgical surgery and adapted for spinal surgery - operating table with all necessary attachments, mobile X-ray - operating microscope.

The surgery unit is equipped with a complete set of tools for routine neurosurgical interventions, a spinal surgery toolkit, and a microneedle microsurgery kit including automatic brain echarteria. Available in the operating room of neurosurgery is a modern instrumentation for stabilization of the spine in traumas, tumors and degenerative diseases.

At the clinic's disposal is the newly established Integral Center, which has the most modern equipment for neurosurgery: • Neuronavigation - a navigation system that enables extremely gentle, safe and accurate access to surgery for small, deep and hard to reach brain lesions. • O-arm - computer tomography x-ray system giving a three-dimensional image of bone structures. Thanks to this system and in conjunction with neuronavigation, access to and work on the spine, especially with stabilization with spinal implants, is much more secure and accurate. • Neuroendoscope - for interventions in the brain ventricles and for the treatment of hydrocephalus.

This integrated center with the possibilities for simultaneous use of O-arm, neuronavigation and neuroendoscope is the only one in Bulgaria.

The clinic has the capabilities for state-of-the-art imaging diagnostics - a new generation of computed tomographs operating in emergency mode and state-of-the-art magnetic resonance imaging at the Imaging Center.

1. The Neurosurgery Clinic operates on all neurosurgical paths in accordance with Level III of the Neurosurgery Standard. CP No. 204 Severe head injury - surgical treatment; CP № 205 Serious head injury - conservative behavior; CP No. 206 Craniotomies not injured by injury, using modern technologies - neuronavigation, neuroendoscopy, intraoperative ultrasound; CP No. 207 Craniotomies, not indicated by trauma, in the classical manner; CP No. 208 Conservative behavior in mild and moderate traumatic brain injuries. CP No. 209 Surgical treatment for head trauma; CP No. 210 Peripheral and cranial nerves / extracranial part / - operative treatment; KP №211 Spinal and cerebrospinal surgery interventions - average volume; CP №211 Spinal and cerebrospinal surgery interventions - large and very large volume;

2. The Neurosurgery Clinic is the only neurosurgical clinic in the city of Plovdiv, Plovdiv, Pazardzhik, Smolyan, Haskovo and Kardzhali. Scheduled examinations are performed in patients in the outpatient clinic from 8 am to 1 pm every working day, and for the rest of the time by the doctor on duty at the clinic in emergency and urgent conditions. Patients referred to all treatment units in the above mentioned districts and Plovdiv city are examined. For the clinics of St. George Hospital EAD there is a separate consultant, and the consultations in the clinics outside the St. George Hospital. Georgi EAD and in the cities of all the serviced areas - by a consultant on the line of the Center.

3. The following surgical interventions are performed at the Neurosurgery Clinic: • Interventions on the brain: In trauma: Impression fractures, evacuation of the epidural

Activity

Since its inception, the Department of Neurosurgery has been a recognized training center for master's students in medicine. The teaching activities of the Department of Neurosurgery include: - training of Bulgarian and foreign students in Medicine from IV and V courses, respectively in Bulgarian and in English within the special surgery course (10 lectures in 2 academic hours and 10 exercises in 2 academic hours). - a neurosurgery training cycle for trainee physicians within 7 days, including seminars on topics selected by trainees in the field of neurosurgery.

The lecture course is taught by Prof. Dr. Borislav Kitov, MD, and by Dr. Hristo Zhelyazkov, MD. The main purpose of the teaching activity that the Department aims at is to know the basic neurosurgical diseases, their clinical picture, methods for their diagnosis and principles of their treatment. Emphasis is placed on emergency situations in neurosurgery.

The department is a center for specialization of physicians in neurosurgery, neurology and surgery. A considerable number of students, PhD students and post-graduate students have received their training or advanced professional qualifications in the department. During the internship in the 6th year, the trainee doctors are introduced to the algorithms of behavior in different neurosurgical diseases, the possibilities of modern imaging studies and basic neurosurgical interventions. In the period 2010 - 2015, neurosurgery training was significantly upgraded with the construction of seminar rooms with multimedia presentation of imaging and clinical cases. During this period the staff of the Department and the Clinic published two textbooks in Bulgarian and English, enabling medical students and young doctors to get acquainted with the basics of neurosurgical pathology, which allows them to think about it, to know the modern imaging and ways of treatment.

Representatives of the Department participate as lecturers in the Lecture Course in Clinical Neuroanatomy, where they introduce students to the anatomical substrate of neurosurgical pathology. Currently, the Department trains one specialist and courses for neurology, pediatric neurology, orthopedics and surgery are offered.