General Surgery Center

Free consultation

Find out which world your operation belongs to before you book anything

The review costs nothing and carries no obligation. Send your endoscopy or colonoscopy report, the biopsy or pathology report if one exists, your CT or MRI images on disc or as files, recent blood results and your medication list, and a general surgeon will reply in writing with the operation your case calls for, the nights in hospital it involves, how long you would need to be in Turkey, and a cost estimate for that plan.

Two worlds share the name general surgery

Planned keyhole surgery on the gallbladder, a hernia, the thyroid or haemorrhoids keeps most patients in hospital for two nights at most and in Turkey for about a week, at a cost in the low thousands of euros. Major abdominal cancer surgery, meaning the Whipple procedure, liver resection, gastrectomy or a colectomy for cancer, keeps a patient in hospital for a week or more, in the country for close to a month, and carries a five-figure cost. Between those worlds sits no middle ground worth planning around.

Almost every practical question you have, about time off work, about who should travel with you, about what could go wrong and what it would mean, is answered differently depending on which column below your operation sits in.

The columns describe a planned course that goes to plan. Your own written opinion, prepared from your file before you travel, states the figures for your specific case, and the sections below explain where each number in the table comes from.

What the General Surgery Center at Biruni Hospital operates on

Four organs account for most of the centre's planned work: the gastrointestinal tract from stomach to rectum, the liver, the pancreas and the gallbladder. Around them sits the rest of the specialty. Hernias of the groin and abdominal wall, which about 27 percent of men develop at some point in life according to the Cochrane review of hernia repair, are the most frequent reason patients write. The centre also performs appendectomy, thyroidectomy for nodules and thyroid cancer, breast surgery, and colon surgery for both benign disease and cancer.

At the complex end stand the major abdominal cancer operations: the Whipple procedure, formally pancreaticoduodenectomy, for tumours of the pancreatic head; liver resection, or hepatectomy, for primary liver tumours and metastases; and subtotal or total gastrectomy for stomach cancer, with lymph node dissection and reconstruction of the digestive tract in the same operation.

A surgical team is available around the clock, which matters less for the planned operations themselves than for what surrounds them: a patient whose wound bleeds at two in the morning is seen by a surgeon at two in the morning, not by a night nurse holding a phone.

Keyhole or open surgery: a difference measured in days, not in safety

The Cochrane review comparing laparoscopic with open gallbladder removal, covering 38 randomised trials and 2,338 patients, found no difference in death or complication rates between the two approaches. What it did find is the reason keyhole surgery took over: hospital stay was around three days shorter and full convalescence around three weeks shorter after the laparoscopic operation. For a patient who has flown in from another country, those three weeks are the difference between recovering at home and recovering in a hotel.

Keyhole surgery is therefore the default at the centre for gallbladder, hernia, appendix and much colon surgery. Open surgery has not disappeared. It remains the right choice for some large tumours, for scarred abdomens after several previous operations, and for parts of most Whipple procedures.

When a keyhole operation becomes an open one

Sometimes the surgeon starts laparoscopically and finds dense scarring, unclear anatomy or unexpected bleeding, and converts to an open incision during the operation. Conversion is a safety decision, not a failure, and it is part of the consent conversation before every laparoscopic procedure here. For a travelling patient it has a consequence nobody at home will have mentioned: a trip planned around a day-case operation and a three-day recovery can become a ten-day trip with a larger wound. Build slack into your ticket, and ask the team in advance how likely conversion is in your particular case, because scarring from previous surgery and severe past inflammation raise the odds.

Mesh repair for hernia, and what the evidence says about recurrence

Hernia repair with a synthetic mesh roughly halves the risk of the hernia coming back compared with stitched repair alone: the 2018 Cochrane review of 25 trials with 6,293 participants put the recurrence risk at less than half, meaning one recurrence prevented for roughly every 46 mesh repairs, with patients returning to normal daily activity close to three days sooner. Mesh brings its own trade-offs, mainly a somewhat higher chance of seroma, which is a harmless fluid pocket, and a small risk of chronic groin discomfort, and the surgeon weighs these openly when recommending a technique.

Gallbladder, hernia and thyroid: how the short-stay week runs

A gallstone patient whose attacks have settled is the classic short-stay traveller. The week has a standard shape. You arrive and are examined on the first day, with blood tests, anaesthesia review and any missing imaging done the same afternoon. Surgery follows on the second day. A laparoscopic gallbladder removal or hernia repair means either discharge the same evening or one night on the ward; a thyroidectomy usually means one or two nights, because the team checks your voice and your blood calcium before letting you go. The remaining days belong to a wound check, the pathology conversation where tissue was removed, and the written discharge summary. Most short-stay patients fly home five to seven days after landing.

Pain after these operations is real but manageable, usually shoulder-tip and incision pain for two or three days after laparoscopy, controlled with ordinary tablets. You will be walking the same day. Desk work is realistic within a week of a gallbladder operation, and heavy lifting waits four to six weeks after a hernia repair regardless of how good you feel, because the repair needs that long to bear load.

Whipple, liver resection and gastrectomy: when surgery is the cancer treatment

A Whipple procedure removes the head of the pancreas together with the duodenum, the gallbladder and part of the bile duct, then reconnects the remaining pancreas, bile duct and stomach to the small intestine. It is the standard curative operation for cancer of the pancreatic head, and one of the most demanding procedures in abdominal surgery. Liver resection removes the part of the liver carrying a tumour and relies on the organ's ability to regrow functional tissue over the following weeks. Gastrectomy for stomach cancer removes part or all of the stomach along with the surrounding lymph nodes, then rebuilds the food passage from the oesophagus or the gastric remnant to the small intestine.

These operations are staged, planned and reviewed with the oncology side of the hospital, because for most of these cancers surgery is one chapter of the treatment, with chemotherapy before or after it. Where a tumour involves major blood vessels, the hospital's hybrid operating theatre with fixed Artis angiography allows a vascular imaging or endovascular step in the same session as the resection, instead of two separate procedures on two separate days.

The volume question every pancreatic surgery patient should ask

How often a hospital performs the Whipple procedure changes how safe it is there, and the effect is unusually large. The landmark New England Journal of Medicine analysis of 2.5 million operations by Birkmeyer and colleagues found that death after pancreatic resection fell from 16.3 percent at the lowest-volume hospitals to 3.8 percent at the highest-volume ones, the widest gap of any of the fourteen operations studied. A 2016 meta-analysis in Annals of Surgery, pooling 58,023 patients from eleven countries, confirmed it: the odds of dying after pancreaticoduodenectomy were more than twice as high outside high-volume centres, and the advantage grew with the annual caseload.

So ask any hospital you are considering, this one included, a plain question: how many Whipple procedures did you perform last year, and who manages the complications at night. A centre doing this surgery seriously will answer with a number.

Why you will be walking the day after major abdominal surgery

Enhanced recovery after surgery, usually shortened to ERAS, is a protocol that replaced the old regime of long fasting and long bed rest: patients drink clear fluids until shortly before anaesthesia, eat and stand within a day of the operation, have drains and catheters removed early, and receive pain relief designed to keep them mobile. A meta-analysis of sixteen randomised trials in colorectal surgery, covering 2,376 patients, found that ERAS cut overall complications by about 40 percent and shortened hospital stay by roughly two and a quarter days, without any rise in readmissions.

For an international patient the protocol has a second value: it makes the length of the stay predictable, and predictability is what a return ticket is bought on. When the surgical team quotes seven to ten nights for a colectomy, that quote rests on a recovery pathway with defined daily targets, not on a guess.

Appendicitis is not a reason to book a flight

Pain that began in the last day or two and is getting worse belongs in the nearest hospital, not on an aircraft. Acute appendicitis and acute cholecystitis, the inflamed gallbladder, are emergencies in which hours matter, an appendix can perforate, and a pressurised cabin three time zones from an operating theatre is the worst place to be while it happens. No honest surgical centre abroad will tell you otherwise, and this one will not: if it is happening now, be treated where you are.

Medical travel is for planned surgery. The realistic sequence after an acute gallbladder attack is that doctors at home settle the inflammation with antibiotics, and the gallbladder is then removed weeks later as a planned laparoscopic operation. That planned operation travels well, and it is exactly the case the short-stay pathway above describes. The same logic covers a hernia that has been present for months but suddenly becomes hard, irreducible and very painful: that is a strangulation risk and an emergency at home, not a booking enquiry.

Complications that belong in the conversation before you travel

Every operation on this page carries risks, and the consent discussion at the centre goes through the ones relevant to your procedure with their approximate likelihood in your case. The ones a travelling patient most needs to understand in advance are these, because each can change the length of the trip.

Flying home after abdominal surgery, and what happens once you land

Recent surgery is one of the recognised risk factors that raise the chance of a blood clot on a long flight. A systematic review of 25 studies of travel-related venous thromboembolism found that symptomatic clots after flying are rare overall, that flights longer than six hours carry most of the risk, and that travellers with risk factors benefit from graduated compression stockings, while everyone should stay hydrated and move their legs regularly. The centre applies that guidance concretely: short-stay patients are usually cleared to fly within a week once the wound check is clean, while major abdominal surgery patients wait until eating, wound healing and blood results have settled, generally two to four weeks after discharge, and fly with stockings, an aisle seat and, where indicated, a course of injected blood thinner.

Clearance is written down, not assumed. You leave with a discharge summary in English covering the operation, the pathology result, your medications and the follow-up plan, addressed to the doctor who will see you at home. Stitches or clips that need removal can be handled by any clinic; the timing is in the summary.

Once you are back home, remote follow-up runs over WhatsApp with the same coordinator you dealt with before travelling: wound photographs, blood results from a local laboratory, and for cancer patients the surveillance scans your home team performs, reviewed here at agreed intervals. Fever above 38 degrees, spreading wound redness, persistent vomiting, or a swollen painful leg are the four findings that should send you to a local doctor the same day rather than to a chat message.

What general surgery costs in Turkey, and why the two worlds sit so far apart

Public medical tourism aggregators publish indicative figures for Turkey of roughly 2,100 to 2,800 euros for hernia repair, 1,700 to 2,400 euros for gallbladder removal and 2,300 to 3,000 euros for thyroidectomy, rising to around 11,600 euros for gastrectomy or liver resection and 13,200 to 16,500 euros for pancreatic cancer surgery, and they advertise savings of up to 80 percent against private prices in the United Kingdom. All of those are aggregator figures, not this hospital's prices.

The gap between a 2,000 euro operation and a 15,000 euro one is not markup. A hernia repair consumes an hour of theatre, a mesh and a ward bed until the evening. A Whipple consumes six to eight theatre hours, an intensive care bed, days of drain management, detailed pathology on the removed tissue, and one to two weeks on a ward, and its quote must carry the realistic possibility of treating a fistula or a leak. When two quotes for the same major operation differ sharply, the difference is usually in what happens if something goes wrong: ask each hospital whether the price includes intensive care days, reoperation and an extended stay, or whether those are billed on top.

A package quote for an international patient typically bundles the surgeon and anaesthesia fees, the hospital nights, standard materials such as mesh, airport transfers and an interpreter, with the companion's hotel and any extra nights after a changed plan handled separately.

What a remote review of your surgical file can settle, and what it cannot

Four documents decide most general surgery opinions: the endoscopy or colonoscopy report, the biopsy or pathology report, the CT or MRI images as original files on disc rather than printed pictures, and recent blood results including liver and kidney function. With those, a surgeon here can usually state in writing which operation your case needs, whether it can be done laparoscopically, which of the two worlds it belongs to with the stay and cost that follow, and whether you should have chemotherapy before surgery instead of surgery first. Sometimes the honest written answer is that the operation you were offered is not needed, or that travelling adds nothing to what your local hospital can do; that answer is given as plainly as any other.

Two things a file cannot settle. Whether a keyhole operation will stay keyhole is decided partly on the operating table, as described above. And for some borderline pancreatic and liver tumours, the final judgement on whether the tumour is removable is made during surgery itself, with the imaging giving a strong prediction but not a promise. The written opinion tells you when your case carries that kind of uncertainty, so you can weigh the trip with it in view.

Questions international patients ask the General Surgery Center

References

1. Birkmeyer JD, Siewers AE, Finlayson EV, Stukel TA, Lucas FL, Batista I, Welch HG, Wennberg DE. Hospital volume and surgical mortality in the United States. The New England Journal of Medicine. 2002;346(15):1128-1137.
2. Hata T, Motoi F, Ishida M, Naitoh T, Katayose Y, Egawa S, Unno M. Effect of hospital volume on surgical outcomes after pancreaticoduodenectomy: a systematic review and meta-analysis. Annals of Surgery. 2016;263(4):664-672.
3. Keus F, de Jong JA, Gooszen HG, van Laarhoven CJ. Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. Cochrane Database of Systematic Reviews. 2006;2006(4):CD006231.
4. Lockhart K, Dunn D, Teo S, Ng JY, Dhillon M, Teo E, van Driel ML. Mesh versus non-mesh for inguinal and femoral hernia repair. Cochrane Database of Systematic Reviews. 2018;9(9):CD011517.
5. Greco M, Capretti G, Beretta L, Gemma M, Pecorelli N, Braga M. Enhanced recovery program in colorectal surgery: a meta-analysis of randomized controlled trials. World Journal of Surgery. 2014;38(6):1531-1541.
6. Philbrick JT, Shumate R, Siadaty MS, Becker DM. Air travel and venous thromboembolism: a systematic review. Journal of General Internal Medicine. 2007;22(1):107-114.