LAPAROSCOPIC APPENDECTOMY
Appendix is a part of the lower right gastrointestinal tract that hangs like a 'worm' from the beginning of the large intestine (cecum). In case of acute inflammation of the appendix due to its obstruction, urgent surgical removal is needed. Appendectomy is now performed laparoscopically, ie through 3 small holes in the abdominal wall with a diameter of 0.5-1 cm, while the classical (open) appendectomy is performed by a large number of surgeons who are not acquainted to the laparoscopic approach, but also remains useful in cases where it is not possible to complete the procedure laparoscopically. Robotic appendectomy although it has been shown to be feasible, does not offer any significant advantage over laparoscopic technique and is performed when the abdomen is being investigated robotically for other possible diagnosis
During appendectomy , surgeon S.C. Hirides, after gaining access to the abdomen and insufflating gas (carbon dioxide) to create the necessary workspace ( pneumoperitoneum ), will first check the entire abdomen for any other hidden pathology. During this inspection, it is necessary to check the upper abdomen and the area around the gallbladder, as well as the pelvis, especially in women, for examination of the internal genitals. The initial part of the small intestine should also be checked to rule out an ectopic inflammatory lesion (for example a diverticulum that could cause pain in this area, called Meckel diverticulum). He will then divide thoroughly any adhesions (reactive tissue in the abdomen) around the appendix, and he will carefully open the sheath in which the appendix is often found. In case the appendix has a position behind the large intestine (posterior to the cecum), Dr. Hiridie may need to perform mobilization of the right part of the colon. He will then gently seal the blood flow to the appendix (mesentery) by means of bipolar cautery. Appendix is removed from the central incision in a special endoscopic bag . The inflamed area is rinsed with plenty of saline, which is completely aspirated before all instruments are removed. Instruments are removed under direct vision and then all remaining gas is carefully expelled from the abdomen. Incisions are sutured intradermally and the skin is reapproximated at its original position.
Appendix removal is the first operation performed by Dr. Hirides early in his career, as an intern of surgery at "Aglaia Kyriakou" Children's Hospital in 2002. From then until today, Dr Hirides has gathered years of experience concerning this procedure with both the classic open, as well as with the laparoscopic and robotic techniques.
From January 2007 to August 2017, Dr..S.Khiridis worked at the Clinic of General, Laparoscopic and Robotic Surgery of the Athens Medical Center (Director: KM Konstantinidis), and actively participated to the first Greek Robotic Surgery Program, with an accumulated experience of more than 3500 surgeries. At the same time , he specialized in Hernia, Upper and Lower GI Surgery as well as in Surgery for Obesity and Metabolic Diseases.
He completed with a scholarship the Postgraduate Program in Robotic Surgery of the Medical School of the National & Kapodistrian University of Athens for the title "Master of Science" (MSc) and later he received the title of Doctor of the University of Athens (PhD) for his research in Metabolic Science.
His first formal training in Robotic Surgery was in early 2007 at the University Hospital of Grosseto, Italy , a small town outside Siena, where the internationally renowned robotic HPB surgeon Pierro Giullanotti was then working and teaching there. Close to this great surgeon and his team (Dr. Hirides's trainer in the laboratory was the now famous Indian surgeon, Jay Deep Palep), Dr. Hirides was trained in the basic principles of robotic system setup, use of the control console, change of instruments and performed cholecystectomy on an animal model. He also had the opportunity to attend pancreas surgeries by the famous Italian team currently based at the University of Illinois, USA.
This first training was followed by a large series of advanced trainings in Advanced Laparoscopy in international referral centers abroad (Strasbourg - advanced laparoscopic surgery course (included practice in laparoscopic surgery of Nissen vaulting and single - splicectomy course), Geneva advanced course on minimally invasive upper and lower GI surgery, Vienna - advanced course on ventral and inguinal hernia surgery, Amsterdam - MIS for benign and malignant pelvic disease, Frankfurt - masterclass on hiatal hernia and GERD - Seminar on specialization in septal surgery and hernia ).
In 2009, Dr. Chiridis traveled to Houston-Texas to train in one of the first international meetings of Robotic Surgical Oncology, held at the renowned MD Anderson Oncology Reference Center (PAROS meeting 2009) .
In the same year he presented 6 pioneering works of Robotic Surgery at the 19th International Congress of IASGO in Beijing , China (19th World Congress of the International Association of Surgeons, Gastroenterologists, and Oncologists (IASGO), Beijing, China).
That same year in Chicago (ACS Clinical Congress) , he had the opportunity to test the new dual training console as well as the (experimental at the time) Single Site Robotic Platform at the invitation of the manufacturer.
In December 2009 he was elected General Secretary of the Hellenic Scientific Society of Robotic Surgery and remains in this position until today .
In October 2010, the Board of Directors of the International Community of Robotic Surgery MIRA appointed him to co-chair with the internationally renowned robotic surgeon Ivo Broeders, in the Scientific Program of the 2011 MIRA World Conference on Robotic Surgery.
In the same year he successfully completed the Course and Laboratory Session in Robotic Colorectal Surgery (Hands-on) of UC University San Diego . There he had the opportunity to be trained in Robotic Colon Surgery with an emphasis on the robotic technique of Total Mesorectal Excision (robotic TME) and practical training in the laboratory, in cadaver donors.
In January 2011, together with the Medical team, they were the first in the world to be trained in Robotic Single Site Cholecystectomy in France and applied it as soon as they returned, simultaneously with a center in Italy and one in Switzerland.
In September 2012, Savvas Chiridis won the silver medal among 75 participants from all countries, in the annual Robotic Surgical Simulation Olympics in the context of the international conference SLS-MIRA-SRS 2012, in Boston, USA. At the same meeting, doctor received two awards for best video presentation that he had edited and sent himself, representing the team of the Athens Medical Center .
He then trained in Advanced Upper and Lower GI Robotic Surgery in Bucharest (Professor Irinel Popescu) and Robotic Thyroidectomy with Neurophysiological Monitoring in Cluj-Napoca (Professor Constantea).
In July 2012 he participated as an instructor in the first hands-on robotics course in Greece which took place in the laboratories of the pharmaceutical company ELPEN.
In January 2013 he attended the work of the clinic and the operations of the internationally renowned robotic surgeon and good friend Fabrizio Luca at the IEO / European Institute of Oncology in Milan, Italy. This clinic is considered a center of reference in Robotic Colon Surgery and its then director is also in America today. Dr. There, Hirides optimized his knowledge of very low anterior colectomy and robotic TME in rectal cancer. In October 2013 he successfully completed the skills course Laparoscopic and Robotic Colon Surgery in Washington DC, USA.
In November 2014 , Dr. Ηιrides received the Best Video Award from the organizing committee of the 29th National Greek Surgical Congress in Athens, for the presentation that he prepared and presented himself, entitled "Robotic Single-Site Colectomy", representing the team of Athens Medical Center.
In 2015, in the context of the launch of the first robotic program in Cyprus, Dr. Hirides was trained in the new da Vinci Xi robotic system in American Medical Center, Nicosia.
Together with the Robotic Surgery team of the Athens Medical Center, Dr. Hirides also contributed to the launch of the first Robotic Surgery Program in Thessaloniki (Inter-Balkan Medical, Professor Dr. Basdanis), in Cyprus (American Medical Center Hospital) and Sofia-Bulgaria (Dovere Hospital).
He has published extensively in Greek and foreign journals, has co-authored numerous medical books (including the chapter on Robotic Hiatal hernia at Surgical Robotics/IntechOpen-2018) and has been a guest speaker at numerous international surgical conferences in Europe. , Prague, Geneva, Turin, Brussels, Vienna, Limassol, Paris, Sofia, Bucharest, Amsterdam), America (Quebec, Chicago, Boston, San Diego, San Francisco) and Asia (Beijing).
He has presented his personal experience with robotic hiatal hernia repairs in Greece (Athens, Thessaloniki, Ioannina), as well as abroad (Paris, Frankfurt, Milan, Boston).
He is a member of the Hellenic Society of Surgery, the European Society of Laparoscopic Surgery (EAES), the International Society of Robotic Surgery (SRS), and the American College of Surgeons (FACS) .
Today he performs robotic surgical procedures from the whole spectrum of General Surgery (abdominal wall hernias, hiatal hernias and reflux, stomach, gallbladder, small & large intestine, anus and perianal diseases and morbid obesity in Greece, Cyprus and Malta). His patients are completely satisfied with both the choice of robotics and the choice of robotic surgeon Dr. Savvas C. Hiridis.