IVF and Reproductive Health Center

We issue reports for couples who are going to receive treatment at our clinic, meet the legal requirements and wish to benefit from SSI support. It is also possible for couples to submit reports issued at other centers for use during their treatment at our center.
On condition that the applicant meets the requirements, we issue the official report that is legally obligatory prior to treatment of female patients whose ovarian reserve has diminished or who wish to have their eggs frozen in order to sustain their chances of fertility in older ages.
The majority of individuals who visit our center experience difficulties with conception or would like to sustain their chances of reproduction in the future. Some of the relevant primary conditions can be listed as follows: 
  • Patients who are having difficulties with conception because of polycystic ovarian syndrome or ovulation problems
  • Infertility associated with sperm motility, azoospermia or low sperm count
  • Infertility associated with blocked or damaged fallopian tubes
  • Endometriosis and associated infertility
  • Congenital uterine deformities 
  • Conception difficulties due to underlying reasons like myoma, adenomyoma or polyp
  • Reduced ovarian capacity
  • Women who have concerns about reproduction in the feature owing to older age or diminished ovarian reserve
  • Patients who are at risk of compromising reproductive capacity because of treatment of cancer or other diseases 
  • Women who have experienced recurrent miscarriages
  • Couples who have a history of recurrent failed in vitro fertilization
  • Couples who would like to receive information regarding transfer of inherited diseases to children
The following staff members work at our center:
  • Gynecologists specialized in reproductive endocrinology and infertility
  • Urology specialists
  • Embryologists
  • IVF and reproductive health nurses

Allergy and Immunology

Patients often present to our department with the following complaints:
  • Respiratory system conditions: allergic rhinitis and asthma 
  • Dermal allergies: Atopic dermatitis, urticaria, angioedema, hereditary angioedema, contact dermatitis
  • Gastrointestinal system conditions: Food allergies, eosinophilic esophagitis, proctitis
  • Drug allergies
  • Food allergies
  • Anaphylaxis
  • Insect allergies
  • Eye allergies
The following diagnostic tests are performed: 
  • Skin prick test
  • Dermal and oral provocation tests for drug and food allergies
  • Spirometry, reversibility test
  • Bronchial provocation test with methacholine
  • Diffusing capacity of lung for carbon monoxide (DLCO test)
  • Pulmonary volume measurement by body plethysmography
  • Impulse oscillometry,
  • Intrathoracic pressure measurement (MIP, MEP)
  • Cardiopulmonary exercise test (CPET)
  • Exhaled nitric oxide test (FeNO)
  • 6-minute walk test
  • Arterial blood gases
  • Autologous serum test
  • Other laboratory tests (recombinant allergen-specific IgE etc.) and blood tests

Anesthesiology and Algology Clinic

Anesthesiology services for all kinds of surgeries as well as diagnostic and interventional procedures are provided to patients of all age groups. 

Procedures at the clinic are performed under ultrasound guidance, and monitors capable of close observation of the brain and heart are used. During surgical procedures, echocardiographic observation of the heart is also undertaken by experienced physicians. All types of peripheral nerve blocks, which are required for different surgeries, are established under ultrasound guidance as well. 

Additionally, all procedures relevant to chronic pain and port catheter placement are carried out at our clinic.
 
In conclusion, we combine technological facilities with current knowledge and an experienced team to provide high-level and reliable service on all occasions where anesthesia is required.
Each patient referred to our clinic is evaluated prior to their operations either at the anesthesiology polyclinic or the ward where they are hospitalized. Our physicians select the most ideal type of anesthesia and postoperative pain management (analgesia) for the patient based on their history of previous surgeries, overall health condition, known chronic diseases, regular medication, allergies, upcoming operation, patient preferences and a number of other factors. For this purpose, patients go through specific laboratory tests, investigations and consultations after an in-depth examination and evaluation. The anesthesiologist informs the patient on matters to take heed of during the entire process and answers their questions. Our objective at this point is to make sure that the patient undergoes the planned surgery uneventfully and remains healthy and comfortable all along. 

On the day of surgery, the patient is accompanied by their nurse to the preparatory section. Information like identity details, type and region of the upcoming surgery, allergies and known chronic diseases are inquired and confirmed once more. Afterwards, venous access is gained, and a sedative is administered, if deemed necessary. The operation is then performed in a fully-equipped operating room under the appropriate anesthesia. All vital systems, including the heart, lungs, brain etc., are monitored for anesthetic depth using advanced monitoring equipment during the course of the operation. Once the operation has been completed, the patient is transferred to a special recovery room. All vital functions and pain status are closely observed until the patient is ready to be transferred back to the ward. So as to detect symptoms of pain and any possible complication, observation of the patient continues by a physician and a team that we are also a part from the moment they arrive at the ward and until they are discharged.
All surgical procedures, including special interventions like congenital heart surgery and liver/kidney transplantation, are performed by specialized surgeons under the required general or regional anesthesia. The units of advanced endoscopy, interventional radiology, diagnostic radiology, radiation oncology, delivery and in vitro fertilization all have their dedicated and full-fledged postoperative recovery rooms allocated for each patient. Our preoperative evaluation, postoperative care and algology team also ensures proper execution of basic principles of patient safety.

Audiology

  • Hearing problems among infants, children and adults
  • Positional and other types of vertigo
  • Vestibular rehabilitation
  • Tinnitus (ringing ear)
The Audiology and Neuro-otology laboratory, where hearing, speech and balance problems are diagnosed and treated, covers a wide range of services from audiometry, immittance audiometry, VRA, ABD, ASSR, auto-acoustic emission (DPOAE-T-OAE), electro-nystagmography (ENG), video-nystagmography (VNG) and positional tests to VEMP tests.

Cardiology

Cardiac surgery

Coronary bypass surgeries are performed on the basis of various techniques. 
 

Surgery on the beating heart 

A surgical technique that prevents possible side effects of equipment supporting the heart and lungs, results in shorter intensive care periods and facilitates recovery.
 

Surgery utilizing arteries

This method is preferred, as it ensures prolonged patency in comparison to vessels obtained from lower extremities. 
 

No-touch aorta surgery

This technique is practiced in order to avoid complications that may result from ‘touching’ the aorta. 
 

Minimally invasive surgery

A surgical technique where the sternum is not opened completely in eligible cases. 


Conscious surgery

A technique aimed at patients who are not eligible for general anesthesia and/or would like to be hospitalized for a shorter period of time. 
 

Cardiac valve surgery

  • Complex cardiac valve repair 

  • Special surgical techniques that make it possible for high-risk patients to undergo operations

  • Surgeries where the sternum is not opened completely in eligible cases  

 

Surgeries for aortic aneurysm and aortic dissection

  • Low-risk surgeries based on special surgical techniques for complex aortic interventions

  • Minimally invasive surgeries where the sternum is not opened completely in eligible cases

 

Re-surgery

Operations performed on patients who previously underwent one or more cardiac surgeries. 
 

High-risk cardiac surgery

Special surgical techniques aimed at patients who have been evaluated as high-risk cases and deemed inoperable at other hospitals
 

Surgery in congenital heart diseases 

Relevant cases are evaluated together with the department of pediatric cardiology. Preoperative and postoperative close observation and treatment are then planned in collaboration with pediatric intensive care specialists. 
 
Robotic cardiac surgery

 

Cardiovascular Surgery

Cardiac surgery

Coronary bypass surgeries are performed on the basis of various techniques. 
 

Surgery on the beating heart 

A surgical technique that prevents possible side effects of equipment supporting the heart and lungs, results in shorter intensive care periods and facilitates recovery.
 

Surgery utilizing arteries

This method is preferred, as it ensures prolonged patency in comparison to vessels obtained from lower extremities. 
 

No-touch aorta surgery

This technique is practiced in order to avoid complications that may result from ‘touching’ the aorta. 
 

Minimally invasive surgery

A surgical technique where the sternum is not opened completely in eligible cases. 


Conscious surgery

A technique aimed at patients who are not eligible for general anesthesia and/or would like to be hospitalized for a shorter period of time. 
 

Cardiac valve surgery

  • Complex cardiac valve repair 

  • Special surgical techniques that make it possible for high-risk patients to undergo operations

  • Surgeries where the sternum is not opened completely in eligible cases  

 

Surgeries for aortic aneurysm and aortic dissection

  • Low-risk surgeries based on special surgical techniques for complex aortic interventions

  • Minimally invasive surgeries where the sternum is not opened completely in eligible cases

 

Re-surgery

Operations performed on patients who previously underwent one or more cardiac surgeries. 
 

High-risk cardiac surgery

Special surgical techniques aimed at patients who have been evaluated as high-risk cases and deemed inoperable at other hospitals
 

Surgery in congenital heart diseases 

Relevant cases are evaluated together with the department of pediatric cardiology. Preoperative and postoperative close observation and treatment are then planned in collaboration with pediatric intensive care specialists. 
 
Robotic cardiac surgery

Check-Up

The check-up department is not limited to only one specialization. Instead, we prefer to focus on a holistic evaluation of patients. Our department collaborates with the departments of cardiology, clinical laboratory, radiology and nuclear medicine for check-up programs. Support is provided by all other departments as well, primarily branches such as nutrition and dietetics, endocrinology, gastroenterology, physical medicine and general surgery.
Rather than offering treatment for specific complaints, our department provides preventive healthcare services and aims to make sure that individuals stay healthy by taking precautions in advance before a medical condition occurs.

Dermatology

Our department offers specialized diagnostic and treatment services such as dermoscopy, interventional dermatology/dermosurgery, dermato-oncology, cosmetic dermatology and laser therapy for all types of dermal diseases, including dermal allergies, atopic dermatitis, urticaria, psoriasis and autoimmune bullous diseases.
Our skin is the largest organ that surrounds the entire body. While there are numerous specific diseases affecting the skin, it may also be influenced by other internal diseases. In fact, symptoms of some diseases may initially appear on the skin. There are currently over 1500 skin diseases and associated variants. Patients most frequently present to our Dermatology polyclinic with the following conditions:

Itching, rashes, fungal infection, eczema, acne, psoriasis, rosacea, nail and scalp diseases, skin tone changes, urticaria, moles, infectious diseases of skin, contagious skin diseases, sexually transmitted dermal conditions, dermal symptoms of metabolic and systemic diseases, inflammatory skin conditions, hemangioma, vascular moles and spots, hereditary skin conditions, dermal tumors, skin lymphoma, skin cancer and melanoma. 

 

Service subcategories of the Dermatology department:
 

Diagnostic services: 

  • Skin biopsy (punch, incisional, shave, excisional)
  • Urticaria provocation test (TempTest, Fric test, bicycle test, pressure test)
  • Patch skin test
  • Dermoscopy
  • Wood light examination
  • Pathergy test
  • Autologous serum skin test
  • Tzanck smear test
  • Fungal examination under light microscope


Treatment services:

  • Cryotherapy, electro-cauterization
  • Intralesional injection therapy
  • Botox injection for hyperhidrosis
  • Nail wiring, nail extraction
  • Phototherapy
  • Laser treatment in vascular lesions (pulse dye laser, Nd:YAG laser)


Follow-up:

  • Digital dermoscopic nevi follow-up, mole mapping
  • Dermatopathology meeting
  • Dermato-oncology council
  • Polyclinics for specific diseases (dermato-allergy, atopic dermatitis, urticaria, psoriasis, autoimmune bullous diseases, dermato-oncology)


Cosmetic dermatology:

  • Cosmetic botulinum toxin injections
  • Cosmetic dermal filling practices (lips, cheeks, under-eye light filling)
  • PRP (platelet-rich plasma therapy for hair loss and skin rejuvenation)
  • Hair and facial mesotherapy (rejuvenation injection, salmon DNA, hyaluronic acid combinations)
  • Micro-needling
  • Skin anti-aging with non-ablative laser rejuvenation

Diagnostic services: 

  • Skin biopsy (punch, incisional, shave, excisional)
  • Urticaria provocation test (TempTest, Fric test, bicycle test, pressure test)
  • Patch skin test
  • Dermoscopy
  • Wood light examination
  • Pathergy test
  • Autologous serum skin test
  • Tzanck smear test
  • Fungal examination under light microscope

 

Treatment services:

  • Cryotherapy, electro-cauterization
  • Intralesional injection therapy
  • Botox injection for hyperhidrosis
  • Nail wiring, nail extraction
  • Phototherapy
  • Laser treatment in vascular lesions (pulse dye laser, Nd:YAG laser)



Follow-up:

  • Digital dermoscopic nevi follow-up, mole mapping
  • Dermatopathology meeting
  • Dermato-oncology council
  • Polyclinics for specific diseases (dermato-allergy, atopic dermatitis, urticaria, psoriasis, autoimmune bullous diseases, dermato-oncology)

 

Cosmetic dermatology:

  • Cosmetic botulinum toxin injections
  • Cosmetic dermal filling practices (lips, cheeks, under-eye light filling)
  • PRP (platelet-rich plasma therapy for hair loss and skin rejuvenation)
  • Hair and facial mesotherapy (rejuvenation injection, salmon DNA, hyaluronic acid combinations)
  • Micro-needling
  • Skin anti-aging with non-ablative laser rejuvenation

Dietetics and Nutrition

  • Clinical nutrition (Enteral-parenteral)
  • Medical diet therapy for inpatients
  • Medical diet therapy for oncology patients
  • Dietary support in cases of malnutrition
  • Dietary training for pregnancy and breastfeeding
  • Children’s diet
  • Training on drug-food interaction
  • Planning patient-specific diet therapies
  • Planning medical diet therapies in line with the pressure sore protocol
  • Planning monthly menus for inpatients and staff members
Below are the complaints reported by patients that visit the Dietetics and Nutrition Department of Koç University Hospital:
  • Dietary counseling for weight management
  • Nutrition during pregnancy and breastfeeding
  • Nutrition in pediatric diseases
  • Diabetic diet therapy
  • Carbohydrate counting
  • Sportive nutrition
  • Preoperative and postoperative medical diet therapy in gastrointestinal system surgery:
    • Esophageal surgery
    • Gastric surgery
    • Pancreas surgery
    • Colorectal surgery
  • Medical diet therapy in diseases associated with the digestive system:
    • Crohn’s disease
    • Ulcerative colitis
    • Diverticular disease
  • Medical diet therapy for recently diagnosed patients included in the cancer program:
    • Nutrition during the chemotherapy process
    • Nutrition during the radiotherapy process
  • Preoperative and postoperative medical diet therapy in bariatric surgery
  • Medical diet therapy in hematologic cancer types
  • Nutrition in pediatric diseases
  • Medical diet therapy in organ transplantation patients
Medical diet therapy in neurological diseases

Emergency Service

Patient care and evaluation are undertaken by emergency medicine specialists at our emergency service, which also includes a pediatric emergency service branch where pediatricians see children. As may be necessary, consultation support is provided by other branches.

Emergency service is the unit where patients presenting with any kind of complaint are evaluated to identify conditions that might potentially result in disability or sudden death. Patients receive their preliminary treatments here accordingly. Early diagnosis of and interventions for the following conditions and problems are conducted at our emergency service: 

  • Early treatment and diagnosis of sudden-onset and potentially life-threatening conditions
  • Evaluation of multiple trauma cases within the framework of current algorithms
  • Injuries of limbs and organs
  • Lacerations and bleeding
  • Conditions posing vital risk such as heart attacks and sudden cardiac arrest
  • Medical problems like stroke

Endocrinology, Diabetes and Metabolism

Patients most often present to our department with diabetes. A condition that follows a rapid course of onset and progression, diabetes may cause a variety of complaints like consumption of excessive amounts of water, frequent urination, weight loss and malaise. On the other hand, such symptoms may not be present in type 2 diabetes. Type 2 diabetic patients may present with bulking around the hip and weight gain. 

Furthermore, weight gain and associated complications (fatty liver disease, hypertension, muscle and joint problems, nocturnal apnea etc.) may be observed among those patients who have been diagnosed with obesity.

Symptoms such as tremor, perspiration, palpitation and weight loss could signal hyperactivity of the thyroid gland, while complaints like malaise, hair loss and bloating could indicate a hypoactive thyroid gland. 

Swelling in the thyroid gland may be due to possible presence of a thyroid nodule. 

Excessive malaise, hypotension and weight loss might be suggestive of deficient adrenalin function. The opposite can be inferred from excessive weight gain, increased hair growth and hypertension.

Irregular menstruation, lactation and decreased sexual drive can be due to too much prolactin being secreted. Growth in the hands and feet and hyperhidrosis could be associated with extra growth hormone secreted by the hypophyseal gland.
A subspecialty of internal medicine, the branch of endocrinology addresses hormones and hormonal diseases

Below are the primary hormonal diseases: 
  • Diabetes mellitus
  • Thyroid diseases (goiter and other types)
  • Parathyroid diseases (diseases of calcium metabolism)
  • Osteoporosis
  • Obesity
  • Hypophyseal diseases
  • Adrenal diseases
  • Gonadal diseases (polycystic ovarian syndrome, infertility due to hormonal disorders etc.)
  • Hirsutism (increased hair growth)

ESWL (Extracorporeal Shock Wave Lithotripsy) Unit

  • Renal calculi measuring less than 2 cm
  • Ureteral calculi (primarily calculi measuring approximately 1 cm, and also those measuring up to 2 cm)
  • Bladder calculi (in cases where there is no accompanying obstruction)
  • Pregnant women
  • Patients with uncontrolled urinary tract infection
  • Patients who are actively taking blood diluents (anticoagulant-antiaggregant) or have a condition of coagulopathy 
  • Patients who have an aortic aneurysm in close proximity of the target ESWL area
  • Patients with uncontrolled hypertension
  • Features of calculi
    • Count
    • Location
    • Composition and rigidity
  • Patient-associated variables
    • Anatomic features of kidneys and the body
    • Skin-to-calculus distance
  • Properties of the device used
  • Experience of the practitioner
  • Cooperation between the physician and patient
ESWL is a procedure that is usually tolerated quite well without causing severe pain. Regardless, a single dose intramuscular analgesic is administered beforehand so as to minimize any possible pain while preventing the patient from shifting focal point of the calculus by inhaling deeply, i.e. to increase the rate of success. Depending on preferences of the physician and the patient, ESPB (erector spinae plane block) or intravenous sedation may be selected as well.
While the patient is attending the admission process at the admission office, our physician and technician calibrate the device for use. Right after receiving a dose of analgesic, the patient is brough to the ESWL unit on floor 1, where the procedure takes place, and positioned in accordance with the location of the targeted calculus. The calculus is visualized under fluoroscopy or ultrasonography and device is focused on the lithotripsy zone. At this point, the ultrasonography gel is applied on the relevant area of the body, which eliminates pockets of air between the lithotripter and the body for maximum effect. The ESWL procedure then starts with a “click” sound. The patient continues to hear this click in short intervals and mildly feels vibration. Focal point of the calculus is frequently checked and energy level is increased in a controlled manner. The amount of energy and number of waves are adjusted in accordance with the patient’s tolerance level as well as with hardness, location and fragmenting capacity of the calculus.

Once the procedure has been completed, x-ray imaging at the ESWL unit reveals the extent to which the calculus has been fragmented. The patient is duly informed and discharged to revisit 5-7 days later for a polyclinic follow-up with ultrasonography and x-ray images. 

Aside from the admission and preliminary preparation, an ESWL session lasts approximately 50-55 minutes.
  • Intrinsic features of each patient, properties of calculi and patients’ expectations are taken into account to create a ‘tailored treatment approach’.
  • Treatment is planned and carried out by physicians specialized in all aspects of treatment of calculi at Koç University Hospital. 
  • Thanks to our highly experienced team, combined therapies involving more than one surgical technique can be performed in the same session for the most successful outcome possible. 
  • The latest ESWL technology is available at our and utilized under guidance of the most recent literature in this field. 
  • Following treatment of your calculous condition, a metabolic evaluation (urine and blood tests, calculus analysis) is conducted, diet-liquid intake plans are made to prevent/delay recurrence, and specific medical treatments are administered. 
  • The ESWL procedure is performed by physicians who concentrate specifically on treatment of calculous diseases of the urinary system. 
  • Siemens Modularis Variostar electromagnetic lithotripters are utilized in this procedure. 
  • Thanks to this cutting-edge technology, ESWL is performed more comfortably and at higher success rates.

Forensic Medicine

  • Claims regarding medical malpractice
  • Forensic medical assessment of injuries
  • Falling from heights
  • Sexual abuse/assault
  • Child abuse
  • Elderly abuse
  • Disablement
  • Legal capacity - penal capacity
  • Establishing personal relationship - custody
  • Forensic traumatology
  • Poisoning incidents
  • Drawing up forensic reports
  • Review of forensic documents

Gastroenterology and Hepatology

Diagnosis and treatment of conditions and diseases involving the esophagus, stomach, small intestine, colon and pancreas by a team of specialized physicians equipped with the lasts technological facilities at the department of Gastroenterology.
In addition to diagnosis and treatment of conditions and diseases involving the liver and bile ducts, treatment and observations of liver transplantation patients are also undertaken by a team of specialized physicians who utilize the most up-to-date medical practices at the department of Hepatology.
Our Endoscopy unit adopts cutting-edge technology and offers treatment and diagnostic techniques that are not available in many medical centers around the world. Diagnostic and treatment procedures at the endoscopy unit are performed under anesthesia and supervision of the Anesthesiology and Reanimation department.

The following procedures are performed at the Endoscopy unit:
  • Esophagogastroduodenoscopy
  • Colonoscopy, flexible sigmoidoscopy, rectoscopy
  • Bogie and balloon dilatation in esophageal strictures
  • Band ligation and sclerotherapy for esophageal varices
  • Cyanoacrylate therapy in gastric varices
  • Sclerotherapy in hemorrhagic lesions
  • Polypectomy
  • Argon plasma coagulation, hemoclipping
  • Stenting in malignant strictures
  • Percutaneous endoscopy gastrostomy (PEG)
  • Percutaneous endoscopic jejunostomy (PEJ)
  • Nasojejunal intubation
  • Endoscopic hemorrhoid treatments (injection sclerotherapy/band ligation
  • Esophageal and anal manometer - motility examinations (graphical evaluation of muscular functions and motions of esophagus and colon)
  • pH measurement (24-hour evaluation of migration of gastric acid to esophagus and acid level)
  • Capsule endoscopy
  • USG-guided liver biopsy
  • Endoscopic retrograde cholangiopancreatography (ERCP)
    • Imaging of bile and pancreatic
    • Endoscopic sphincterotomy
    • Extraction of bile duct calculi
    • Balloon dilatation in bile duct strictures
    • Stenting in bile duct strictures
    • Extraction of calculi or stenting in pancreas patients
    • Nasobiliary stenting
  • Endoscopic ultrasonography (EUS)
    • Diagnostic imaging, staging and biopsy
    • Cystogastrostomy in pancreatic cysts
    • Celiac blockage in chronic pancreatitis
    • Celiac blockage in pancreas cancer
    • Bile duct drainage procedures
  • Advanced endoscopic procedures
    • Chromoendoscopy-magnifying
    • Endoscopic ultrasonography, mini-probe endoscopic ultrasonography
    • Endoscopic submucosal dissection (ESD)
    • Endoscopic mucosal resection (EMR)
    • Peroral endoscopic myotomy (POEM)
    • Submucosal endoscopic tumor resection (STER/POET)
    • Endoscopic full-thickness resection (EFTR)
    • Anti-reflux mucosectomy (ARMS-reflux, GERDx, TIF2)
    • Peroral endoscopic pyloromyotomy (G-POEM/POP-gastroparesis)
    • Endoscopic Zenker diverticuloseptomyotomy (esophageal diverticula)
    • Endoscopic sleeve gastroplasty (obesity)
    • Enteroscopy (Power Spiral-motorized enteroscopy, single-balloon enteroscopy, double-balloon enteroscopy)
    • Endoscopic-laparoscopic treatments (LECS)
    • Per-anal endoscopic myectomy (PAEM)
    • Electro-incision, argon plasma coagulation and laser
    • Endoscopic suturing practices (overstitch, hemoclips, OTSC, loop etc.)

General Intensive Care Unit

  • Postoperative observation and treatment
  • Sever infections (sepsis, septic shock etc.) 
  • Respiratory and/or circulatory support
  • Severe neurological damage
  • Polytrauma 
  • Severe bleeding
  • Poisoning
  • Treatment and observation of critical cases of organ failure
Operations of the unit cover the fields of anesthesiology and reanimation as well as intensive care and algology, whereas we offer intensive care services in all fields of specialization.
 

General Surgery

The department of general surgery successfully responds to, diagnoses, treats and follows all diseases conditions associated with this respective field. It should be noted that our department addresses numerous complaints that may initially be presented to various other branches. Some of these complaints may be listed as follows: 
  • Dysphagia
  • Gastroesophageal reflux
  • Abdominal pain
  • Vomiting
  • Intraabdominal mass
  • Intestinal and gastric bleeding (occult or explicit)
  • Esophageal, gastric and intestinal cancers
  • Digestive difficulties, indigestion, abdominal distention
  • Constipation, defecation problems, difficulty controlling defecation
  • Hemorrhoids, anal fistula, anal fissure
  • Icterus/jaundice
  • Obesity
  • Breast mass
  • Nipple discharge
  • Bodily trauma
  • Cervical mass in the neck
  • Inguinal and hiatal hernia or herniation through formal abdominal incisions

Genetic

The Medical Genetics polyclinic and laboratory of Koç University Hospital is empowered by the latest technology and a highly experienced team, and provides holistic service regarding diagnosis, investigation, follow-up and consultation of rare genetic diseases. The services we provide can be broken down into the following categories: 

Genetic consultation during the pre-conceptional and pregnancy periods:
 

Risk groups

  • Couples with a history of consanguineous marriage
  • Couples from ethnic groups with well-defined genetic risks (e.g.: Ashkenazi). 

Adverse obstetric history
  • Recurrent miscarriages (history of 2 or more miscarriages or stillborn fetuses)
  • History of newborn or infant death due to unknown causes
  • Congenital anomalies, history of infant death due to neurological or metabolic findings

Known family history of genetic diseases
  • Diagnosed or suspected genetic disease in expecting parents or their relatives
  • Known mutation carriage for genetic diseases (e.g.: beta-thalassemia, SMA) among expecting parents
  • Chromosomal anomaly or translocation carriage among expecting parents or in family history
  • Congenital anomaly (cleft lip, polydactyly, congenital cardiac anomaly), deafness, vision loss, mental deficiency etc. among expecting parents or relatives
  • Hereditary cancer syndromes, metabolic disease, muscle disease or adult neurological diseases in family history
  • Couples who do not have a risk factor, but would like to receive information on pre-conceptional or pregnancy-related genetic risks and investigations

Risk factors detected during the course of ongoing pregnancy
  • Advanced age for the mother (35 or older) and father (45 or older)
  • Pregnancies presenting increased risk in screening tests (1st trimester combined screening test, free fetal DNA screening test etc.)
  • More than one minor indicator detected in ultrasound (hyperechogenic bowel, echogenic intracardiac focus etc.)
  • Detection of fetal anomaly in ultrasound view of the womb (increased nuchal translucence, cardiac septal defects, cleft lips, polydactyly, anomalies of upper and lower extremities etc.)

Genetic screening tests and consultancy
  • Molecular screening for pediatric autosomal and X-related recessive genetic diseases 

 

Pediatric genetic diseases:

  • Congenital anomalies

(cataract, cleft palate and/or lip, congenital cardiac diseases, diaphragmatic hernia, reproductive organ anomalies, skull deformations, contractures, anomalies including missing or extra digits or limbs, spina bifida, scoliosis etc.)
  • Developmental problems (autism; learning difficulty; delayed acquisition of skills like head holding, sitting and walking; delayed speech; loss of developmental skills; muscular dystonia; seizures; mental deficiency etc.)
  • Sensory deficits (high-grade refractive errors, hearing loss, retinal diseases, compromised vision etc.) 
  • Chronic diseases (metabolic diseases, bleeding disorders, low birth weight, delayed growth-development, diabetes, acromegaly, premature aging, cystic fibrosis etc.)
  • Suspicion of a genetic syndrome (Down syndrome, Williams syndrome, Noonan syndrome, fragile-X syndrome, DiGeorge syndrome, Angelman syndrome, Prader-Willi syndrome etc.)
  • Skeletal dysplasia (achondroplasia, osteogenesis imperfecta etc.)
  • Pediatric cancers (retinoblastoma, Wilms’ tumor etc.) and rare dysmorphic syndromes where the risk of cancer is increased
  • Hematologic diseases (Mediterranean anemia, sickle-cell anemia, Fanconi anemia, Diamond-Blackfan anemia, immunodeficiency/diseases of immune system, bleeding disorders like hemophilia, hereditary thrombocyte disorders)
  • Diseases with dermal symptoms (multiple light brown spots, light-colored spots, lack or sporadic presence of eyelashes, hair and eyebrows, inability to perspire, epidermolysis bullosa, hypersensitivity to sunlight, nail and teeth anomalies)

 

Adult genetic diseases:

The majority of conditions identified among adult patients include connective tissue diseases such as type 1 neurofibromatosis, tuberous sclerosis, Marfan syndrome or Ehlers-Danlos syndrome as well as skeletal dysplasia, dysmorphic syndromes and impacts of chromosomal anomalies. 

 

Cancer genetics:

Cancer genetics services are offered to individuals who may have been or have family members diagnosed with specific types of cancer. The most common types are breast, ovarian, colonic, pancreatic, uterine, gastric and some prostate and thyroid cancers. 

 

Reproductive genetics:

Amenorrhea, premature menopause, idiopathic male and female infertility (infertility or low/no sperm count), recurrent miscarriages/stillborn deliveries, unexplained infant deaths, unsuccessful IVF treatment, pre-IVF evaluation, recurrent hydatid moles, sexual developmental deficits (androgen insensitivity syndrome, congenital adrenal hyperplasia etc.)

 

Neurogenetics:

Cerebral malformations (lissencephaly, polymicrogyria, microcephaly etc.), leukodystrophy (hereditary white matter diseases), epilepsy (seizures), early epileptic encephalopathy, spinal muscular atrophy, hereditary neuropathy (Charcot-Marie-Tooth disease), hereditary subgroups of cognitive disorders (like Alzheimer’s disease) mental deficiency, delayed speech and gait, autism spectrum disorders, movement disorders (hereditary ataxias, spastic paraplegia, Huntington’s disease)

 

Muscle disease genetics:

Duchenne/Becker muscle dystrophy, myotonic dystrophy, congenital muscle dystrophies and other congenital muscle diseases, congenital myopathies and congenital myasthenic syndromes

 

Cardiovascular genetics:

Familial hypercholesterolemia, hereditary arrythmias (long QT syndrome, Brugada, CPVT etc.), hypertrophic cardiomyopathy, idiopathic dilated cardiomyopathy, congenital valvular anomalies, rare genetic syndromes with cardiac anomalies (22q11.2 microdeletion syndrome, Noonan syndrome, Williams syndrome, Costello syndrome, Turner syndrome, CHARGE syndrome, Cantu syndrome, Naxos syndrome etc.), hereditary aortic and other large vessel diseases (Marfan syndrome, Loeys-Dietz syndrome, familial aortic aneurysm etc.), family history of sudden death.

Primary Services of Medical Genetics


Pediatric genetic diseases
  • Syndromology: Diagnosis and follow-up of rare genetic diseases with congenital malformations
  • Dysmorphology: Diagnosis, follow-up and genetic consultation for genetic diseases with facial anomalies
  • Genetic diagnosis of extremity anomalies (hands, feet and limbs) 
  • Genetic evaluation, diagnosis and follow-up of short stature and growth-developmental delays
  • Genetic diagnosis and consultation for neurologic diseases with cognitive deficiency, autism and epilepsy
  • Genetic consultation and diagnosis of hereditary cardiac diseases (arrythmia, cardiomyopathy etc.)
  • Diagnosis of adult and pediatric genetic diseases with dermal symptoms
 
Genetic diagnosis and consultation during pre-conceptional and pregnancy periods
  • Genetic consultation and screening in consanguineous marriages
  • Genetic consultation and diagnosis in cases of infertility and recurrent miscarriages
  • Genetic consultation and follow-up in pregnancies that are considered high-risk for genetic diseases
  • Prenatal genetic diagnosis, pregnancies with structural anomalies, perinatology councils
  • Fetal and neonatal postmortem physical examination and genetic diagnosis

Genetic diagnosis and consultancy services for special diagnostic groups
  • Cancer genetics (genetic consultation and investigations in hereditary cancers)
  • Neurological diseases of adult age
  • Pediatric and adult muscle diseases

 

Laboratory services available at the Genetic Diseases Diagnostic Center


Cytogenetic and molecular cytogenetic diagnostic methods (karyotyping/chromosome analysis and FISH) can be performed on the following types of specimen:
  • Blood, abortus material, tissues and tissue cultures like skin
  • Cordocentesis, amniocentesis and chorionic villus biopsy (CVS) for prenatal diagnoses
  • Bone marrow tissue and culture (cancer cytogenetics)

Molecular genetic diagnostic methods
  • SNP array analysis (300K)
  • Classical molecular diagnosis: Deletion/duplication analysis with Sanger sequencing, MLPA and q-PCR
  • Methylation analyses, triplet repeat fragmentation analyses
  • Next-gen sequencing panels, clinical exome analysis
  • Whole-exome (WES) and whole-genome (WGS) analysis (in international collaboration)

 

Functional studies within the scope of research

  • At RNA and protein level

  • At model organism level

Clinical genetics

Clinical patient services are provided by three specialized physicians at the examination room located within the pediatric polyclinic and the genetic consultation room in the obstetrics polyclinic. Our team is highly experienced in diagnosis, prenatal diagnosis and follow-up of rare genetic syndromes with cognitive deficiency and congenital deformations. Patients and/or their family members are informed in detail about benefits of individual and family-specific genetic tests in cases of cancer and risky pregnancy. Results are duly conveyed to patients and family members so as to raise awareness about existing genetic risks, if any. 

 

Genetics laboratory

Comprehensive genetic tests are performed at our laboratory for the purpose of diagnosis prenatal and postnatal genetic diseases. The diagnostic laboratory of Genetic Diseases Diagnostic Center has been accredited for compliance to testing quality standards, and is equipped with all necessary technological facilities. The laboratory has its own divisions for conventional cytogenetics, molecular cytogenetics and molecular genetics. Each unit is led by a clinical laboratory supervisor with over 10 years of experience in their own fields. The result reporting interval is the same as large-scale university reference centers around Europe. 

 

Cytogenetics and molecular cytogenetics:Cytogenetics and molecular cytogenetics divisions are configured as separate spaces allocated to cell culture, cytogenetic analysis and in situ fluorescence procedures. Cytogenetic and molecular cytogenetic analyses can be performed on blood and various tissues/tissue cultures. They can also be carried out on cordocentesis, amniocentesis and chorionic villus biopsy (CVS) specimens for prenatal diagnosis. Up-to-date testing processes are conducted at the laboratory for cancer genetics. 
 

Molecular genetics:The molecular genetics division of the laboratory has DNA isolation, PCR and post-PCR rooms. In addition to essential basic infrastructure and equipment, the division includes NGS-based (next-gen sequencing) multi-output and micro-sequencing analysis platforms (Illumina MiSeq next-gen sequencing and Illumina Iscan micro-sequencing devices). The molecular genetics laboratory routinely conducts classical diagnostic test methods like Sanger sequencing, MLPA and q-PCR for deletion/duplication analyses as well as methylation analyses, triplet repeat fragmentation analysis for evaluation of dynamic mutation diseases and next-gen sequencing panels aimed at evaluating cancer predisposition, hereditary cardiac diseases and Mendelian hereditary diseases. 

 
Our department stands out as the only center in Turkey where molecular diagnosis of facioscapulohumeral dystrophy can be made. Used for this purpose, the Molecular Combing System was integrated to our laboratory in 2019.  


Bio-informatics

Bio-informatic stages of high-output sequencing and micro-sequencing analyses are carried out at our department. Variants are reviewed together with a bio-informatics expert and clinical genetics specialist, if necessary, which boosts diagnostic accuracy. Studies undertaken within this framework involve compilation of folders from raw data, arrangement and preparation for analysis. Genetic data obtained in this manner is thus utilized for diagnosis of recessive and X-specific inherited disease carriage and research of new genes associated with the disease.

Nursing Directorate

  • Nursing management
  • Clinical supervisor
  • Administrative supervisor
  • Chief nurse
  • Nursing team leader
  • Internal medicine ward nurse
  • Surgical ward nurse
  • Hematology and oncology nurse
  • Organ transplantation nurse
  • Bone marrow transplantation nurse
  • Intensive care nurse
  • Operating room nurse
  • Neonatal and pediatrics nurse
  • Obstetrics nurse
  • Interventional nurse
  • Training and special branch nurse
  • Training development nurse
  • Infection control nurse
  • Diabetes nurse
  • Stoma and wound care nurse
  • Transfusion nurse
  • Nutrition nurse
  • Workplace nurse
  • Dialysis nurse
  • Associate specialist department nurses
All staff members of nursing services go through a basic orientation training, which covers theoretical and practical matters that they might encounter in a clinical setting. Basic life support training is also offered and updated annually. In addition to mandatory training courses specific to each department, nursing staff members attend inhouse as well as external training as needed. 

The Nursing Directorate of Koç University Hospital, as part of the Vehbi Koç Foundation Healthcare Institutions, collaborates with Koç University School of Nursing, SANERC (Semahat Arsel Nursing Education and Research Center) and RMK AIMES (Rahmi Koç Advanced Interventional Medical Education and Simulation Center) in various fields. 

Each year, we jointly organize a Nursing Week seminar, a much-anticipated annual event that contributes to the profession of nursing and invites prominent names from national and international circles.
The “İstanbul Intensive Care Nursing Days” is another notable event that takes place biannually.
Nursing in a modern sense started in Turkey in the wake of the World War I. Admiral Bristol Nursing School, a significant pillar of nursing education, became the first school in Turkey to train nurses. The sustained success and constant improvement in the field of nursing education and healthcare that spurted after foundation of Admiral Bristol Nursing School on May 20th, 1920, and then Admiral Bristol Hospital on August 20th, 1920, was channeled by Vehbi Koç Foundation Healthcare Institutions into the foundations of Koç University School of Medicine and Koç University School of Nursing.  

At the time Admiral Bristol Nursing School was founded (1920-1999), the total term of education was 2 years and 6 months. The term was extended to 3 years in 1929 and then to 4 years in 1957. Nursing education at Koç University started off with a Vocational School of Healthcare Services in 1998. The Nursing College was established in 2005, followed with the Nursing School in 2016. As the first nursing school of Turkey, the institution raised leading nurses and set an example for other nursing schools to be founded over time. Esteemed Esma Deniz, one of the first 5 graduates of Admiral Bristol Nursing School in the year 1923, went on to found the Turkish Nurses Association in 1943, where she served as the Chair for 19 years and had the association acknowledged as an active member of the International Council of Nurses in 1949. Following in these footsteps, the Turkish Intensive Care Nurses Association was founded in 1992. Nurses of Vehbi Koç Foundation Healthcare Institutions have always been proud of Esma Deniz, forever an exemplary nurse and unyielding defender of women’s rights. 

Contributions of Vehbi Koç Foundation to the profession of nursing started after launch of the Nursing Fund in 1974. The Nursing fund has constantly contributed to education of nurses by means of conferences and seminars as well as publications and course books. So far, over 2000 nurses have been granted scholarships through the fund. Recognizing the essential value added by robust nursing education to a hospital’s quality of service, Vehbi Koç Foundation has supported efforts in the field of nursing at all times. Under the umbrella of the foundation, SANERC (Semahat Arsel Nursing Education and Research Center) delivered the first Intensive Care Nursing Course approved by the Ministry of Health. SANERC has been supporting nurses with national and international training courses, education events, symposiums and conventions since 1992 as well. 
 
After completion of preparations, Koç University Hospital started admitting patients in September 2014. Our Nursing Services Director, a member of the Admiral Bristol school, and the highly experienced leaders at American Hospital have been marching forward on our journey since the foundation. With an ever expanding staff of nurses and training and administration teams, the Directorate of Nursing Services has been promoting superior patient care in line with the mission and vision of Koç University Research and Education Hospital, and attained a privileged position in the field by training valuable students and leading research activities. 

Honorable Mrs. Semahat Arsel, Chair of the Vehbi Koç Foundation Board of Directors, has always contributed and continues to contribute to the development and empowerment of the nursing profession. As nurses of Koç University, we are infinitely grateful to the Koç Family and Mrs. Semahat Arsel.
  • Nursing
  • Midwifery
  • Emergency medicine
  • Anesthesiology
  • Medical technician
  • Number of medication errors
  • Medication administering errors
  • Rate of falling patients
  • Rate of adherence to the falling prevention protocol
  • Rate of complete blue code incident forms
  • Rate of correctly labeled medications drawn into injectors
  • Rate of compliance to patient identity policy
  • SBAR compliance ratio
  • Final check ratio
  • Process control compliance ratio
  • Compliance to hand hygiene
  • Pressure sore occurrence ratio
  • Pressure sore occurrence ratio under intensive care
  • Compliance to the hypoglycemia protocol
  • Compliance to isolation measures
  • Patient satisfaction ratios
Every medical unit expands their scope of knowledge each day, while the manner in which healthcare services are offered rapidly evolve. In this regard, it is essential for nursing services to catch up with this dynamism by arranging training and development courses and enabling employees to constantly update their own knowledge.
 
Training needs of our staff members are determined on the basis of interviews with unit managers, requirements to use new devices and equipment, reports from the risk management system, updates, recurrent training requirements and staff feedback. Our professional training nurses accordingly plan training activities.

Below are some of our routine training programs:
  • Basic nursing orientation certification program
  • CPR (basic life support) and recertification 
  • ACLS (advanced life support) and recertification
  • Basic ECG
  • Intensive care nursing certification program
  • NRP (neonatal resuscitation) training (Ministry of Health)
  • Basic pediatrics training
  • Departmental surgical training
  • Departmental intensive care training
  • Operating room training
  • Anesthesiology training
  • Internal medicine training
  • Stem cell transplantation unit training
  • Nursing team leader training
  • ECG and lethal arrythmias training
  • Compassion fatigue training
  • Baby-friendly hospital practices

Basic Nursing Orientation Program
The theoretical and practical orientation training of new nursing staff members includes the topics of corporate mission and vision, nursing practices, basic life support, infection and isolation measures, device usage, patient safety and communication. Nursing skill drills and scenario roleplays take place at the OSCE laboratory, where models are used for this purpose.

A test is conducted prior to and after the training program.
 
Department-specific Orientation Programs
  • Emergency nursing
  • Intensive care nursing    
  • Pediatrics nursing    
  • Operating room nursing practices
  • Anesthesiology technician training program

In-service Training for Employees
  • Patient safety
  • Personal protective equipment and spill kit usage
  • Environmental health
  • Hand washing
  • Drug safety
  • Supporting gender equality for my country
  • Emergencies
 
Training for New Nursing Staff Members
  • Basic nursing orientation program
  • Basic life support
  • Skill development training
  • Scenario applications
  • Intensive care orientation 
  • Operating room orientation
  • Pediatrics orientation
  • Departmental regular training sessions
  • Basic life support recertification
  • Basic pediatrics training
  • Departmental surgical training
  • Intensive care training
  • Operating room training
  • Anesthesiology training
  • Internal medicine training
  • Stem cell transplantation unit training
  • Nursing team leader training
  • ECG and lethal arrythmias 
  • Compassion fatigue
  • Baby-friendly hospital practices
 
Trainings for Patients/Patients’ Relatives
  • Patient safety
  • Blood transfusion process
  • Enteral nutrition process
  • Pressure sore prevention and care
  • Pediatric/adult diabetes training
  • Stoma training
As the Nursing Directorate of Koç University Hospital, we collaborate with the Human Resources department and take into consideration the following points with regard to recruitment and performance evaluation:
  • Adoption of modern nursing philosophy and concepts
  • Embracing the institution’s and nursing directorate’s mission, vision, values, policies and guidelines; and instilling these into team members under one’s responsibility
  • Striving to improve the institution’s and the nursing profession’s image at all times, setting an example as a role model to colleagues and team members under one’s responsibility by means of verbal and nonverbal communication
  • Being enthusiastic to ensure quality tailored and compassionate nursing care, assuming complete responsibility in care, being able to develop projects, keeping track of the professional literature for this purpose
  • Promoting and sustaining sound open communication with other healthcare team members and colleagues 
  • Promoting teamwork and leadership qualities, acting as a representative of the senior hospital management, being able to solve problems and issues of the staff members under one’s responsibility within the confines of one’s own unit, appropriately reporting unresolved problems along with recommendations
  • Making sensible and objective decisions, striving to constantly improve oneself and colleagues
  • Applications to our vacant positions and performance ratings are taken into consideration when promoting employees and transferring them among different departments. 
Net 45 hours weekly. Working schedules vary depending on the operations of each department. Two 4 x 12-hour shifts (day/night) are applied for the emergency service, intensive care units and inpatient wards.
You may visit the Human Resources page of our website for detailed information.  

Hematology

  • Malaise, fatigue, exhaustion, palpitation, dyspnea, chest pain, anemia (anemia)
  • Nasal bleeding, gingival bleeding, small-sized red skin rashes, bruising, prolonged menstrual bleeding (thrombocytopenia and factor deficiencies)
  • Fever, frequently recurring infections (low leukocyte level)
  • Enlargement of lymph nodes, fever, weight loss, nocturnal perspiration (lymphoma)
  • Fever, bleeding, enlargement of lymph nodes (acute leukemia)
  • Incidentally detected elevation in leukocytes, splenomegaly, enlargement of lymph nodes (chronic leukemia) 
  • Idiopathic extensive bone and lower back pain (multiple myeloma)
The diseases/conditions below lie within the scope of our field of specialization:
  • Erythrocyte (red blood cell) diseases
    • Iron deficiency anemia and other hypoproliferative anemias
    • Thalassemia 
    • Hemoglobinopathy
    • Megaloblastic and other macrocytic anemias
    • Aplastic anemia
    • Hemolytic anemia
  • Leukocyte (white blood cell) diseases
    • Quantitative and qualitative neutrophil disorders
    • Acute myeloid leukemia
    • Chronic myeloid leukemia
    • Polycythemia vera
    • Myelofibrosis
    • Essential thrombocytosis
    • Lymphopenia and immune deficiency
    • Acute lymphoblastic leukemia
    • Chronic lymphocytic leukemia
    • Hodgkin’s lymphoma
    • Non-Hodgkin’s lymphoma
    • Myelodysplastic syndrome
    • Multiple myeloma and other plasma-cell diseases
  • Thrombocyte and coagulation (clotting) disorders
    • Thrombocytopenia
    • Thrombocyte function disorders
    • Hemophilia and other coagulation factor deficiencies
    • Von Willebrand disease
    • Consumptive coagulopathies
  • Thrombotic disorders
The following procedures are available at our 14-bed stem cell transplantation unit.
1-   Determination and application of stem cell mobilization protocols
2-   Peripheral stem cell apheresis
3-   Stem cell collection from bone marrow (at operating theater)
4-   Stem cell cryopreservation 
5-   Autologous stem cell transplantation
6-   Allogenic stem cell transplantation 
      a.    Stem cell transplantation from fully-matching and 9/10-matching sibling
      b.    Stem cell transplantation from fully-matching and 9/10-matching unrelated donor
      c.    Haploidentical stem cell transplantation

Infectious Diseases

  • High fever
  • Elevate body temperature during cancer and its treatment
  • Urinary tract complaints (urination frequency, burning sensation)
  • Coughing, dyspnea and chest pain accompanied with high fever
  • Diarrhea
  • Headache, clouded consciousness and nape stiffness accompanied with high fever
  • Hemorrhagic fevers
  • Icterus/jaundice
The course of an infectious diseases is usually characterized with fever. Therefore, patients exhibiting high fever as well as prolonged episodes of fever of unknown etiology are treated at the department of infectious diseases. 
  • Febrile diseases of unknown etiology
  • Infections in oncology patients
  • Sexually transmitted diseases
  • New infections
  • Diseases accompanied with diarrhea
  • Urinary tract infections
  • Infections involving the central nervous system
  • Infections spread through respiration
  • Acute and chronic viral hepatitis (Jaundice)
  • Infections associated with medical care
  • Diabetic foot and wound infections
  • Infection control
  • Adult immunization
  • Diagnosis and treatment of HIV / AIDS patients
  • COVID-19 management

Interventional Neuroradiology

Cerebral aneurysms

An aneurysm is ballooning that occurs in a weak spot of the brain’s arteries. Cerebral aneurysms might potentially burst at a fragile point, resulting in a type of intracranial hemorrhage known as subarachnoid hemorrhage, which is a severe and life-threatening medical condition. Approximately 35% of patients experiencing subarachnoid hemorrhage lose their lives. On the other hand, we are able to diagnose and endovascularly treat the majority of cerebral aneurysms before they burst and cause intracranial hemorrhage. It is essential to close the aneurysm in patients who have experienced an intracranial hemorrhage. Along with novel techniques devised within the past 20 years, endovascular treatment methods have become the primary option in treatment of aneurysms. 


Carotid stenosis

Carotid arteries are two of the 4 essential vessels supplying blood to the brain. The disease of atherosclerosis often impairs carotid arteries with stenosis and occlusions, which in turn prevent adequate blood from being supplied to the brain and might consequently cause palsy/stroke. Stenoses building up in carotid arteries lead to temporary ischemic attacks, which last less than 24 hours and subside on their own. Temporary ischemic attacks trigger symptoms like formication, numbing and weakness in legs and arms; speech disorder; difficulty making out words; lisping; sudden loss of vision in one eye; shifting in one half of the face and lips; and dizziness. These attacks are precursors of an impending permanent palsy attack. Medical treatment proves to be insufficient if the level of stenosis in a carotid artery is over 70 percent, in which case additional interventional treatment is required. Stenting and balloon angioplasty are reliable and effective methods in treatment of carotid stenosis. 


Arteriovenous malformations (AVM)

Arteriovenous malformation is a cerebrovascular condition where multiple vessels of abnormal morphology get tangled up. AVM causes high blood flow velocity inside that gradually causes vessel walls in the tangle to weaken. Over time, one of the vessels constituting the tangle might burst and result in intracranial hemorrhage. Overall, AVM is not accompanied with any complaint in 25% of cases and is incidentally diagnosed in imaging studies like MRI, which may originally be performed for other reasons. The other 75% of the patients will experience headache, epilepsy (seizures), numbing in arms and legs, weakness and speech difficulty. Endovascular treatment (embolization), open surgery and radiosurgery are the primary treatment methods for arteriovenous malformation. AVM treatment should be carried out by taking into account numerous factors and handled by a team of neurosurgery, interventional neuroradiology and radiosurgery specialists. Some patients may require combined therapies where two or even three different techniques are practiced consecutively. 


Arteriovenous fistula (AVF)

Arteriovenous fistula is a condition characterized with a direct connection that forms between an artery and vein. As a result, the high-pressure blood in an artery passes through a vein and leads to elevated venous pressure in the brain or spinal cord. The high pressure in the vein eventually tears the vein and could cause intracranial hemorrhage. In other cases where there is no intracranial hemorrhage, the high venous pressure prevents the brain and spinal cord from receiving sufficient blood, leading to complaints like weakness, speech disorder, inability to urinate and stroke. Arteriovenous fistulas of the brain and spinal cord are treated by means of endovascular methods. Some patients may require open surgery as well.

 

  • Brain bubbles (aneurysm)
  • Endovascular treatment of aneurysms (closed surgery)
  • Cerebrovascular tangles (arteriovenous malformations / AVM)
  • Endovascular treatment of cerebral AVM
  • Spinal vascular tangles (spinal AVM)
  • Dural arteriovenous fistulas (dural AVF)
  • Arteriovenous fistulas of the spinal cord (spinal AV)
  • Carotid-cavernous fistula (CCF)
  • Carotid stenosis/occlusion 
  • Cerebrovascular stenosis
  • Endovascular stroke treatment (thrombectomy)
  • Tumor embolization
  • Intra-arterial chemotherapy in retinoblastomas

Interventional Radiology

Interventional radiology procedures are not surgeries. All procedures are performed by gaining access through a tiny needle hole and either in a radiology room or angiography room. They come with substantial advantages over surgical operations: 
 
  • General anesthesia is not required.
  • All treatments are performed through a thin needle.
  • No surgical scar remains on the body.
  • Patients are often able to receive their treatment and return home on the same day. 
  • Risks are far lower than those of surgery. 
  • Patients return to their daily routines far sooner. 


General anesthesia may still be required in interventional radiology procedures aimed at major conditions like cerebral aneurysm. Otherwise all procedures can be carried out under local anesthesia. In some cases, the patient may be given sedatives through the intravenous route. Sedation relieves patients who may grow concerned, excited or afraid even in some simple procedures like a needle biopsy. Patients are often kept under observation for 2-6 hours after each treatment and then allowed to return home afterwards. They can usually return to their normal routines within the same day or the next day. 

Neonatal Intensive Care

  • Neonatology
  • General pediatrics

Prematurity (early delivery)

Babies delivered before the expected term may be unable to sustain vital functions such as respiration, feeding and preservation of body temperature, which means they need to be supported by simulating circumstances similar to the womb. The necessary support is provided at our unit with the help of modern technological facilities like incubator, patient monitors, respirators, parenteral nutrition systems etc. 


Diseases specific to the neonatal period

Some diseases that are life-threatening or might result in permanent damage like jaundice, necrotizing enterocolitis, retinopathy of prematurity, patent ductus arteriosus, respiratory distress syndrome, intracranial hemorrhage etc. might be encountered during the neonatal period. Our unit adopts painstaking observation measures for prevention and early diagnosis and treatment of such conditions. Newborns’ examinations and investigations, including hearing and ophthalmological examinations, cranial USG, EEG, echocardiogram etc., are conducted in accordance with their screening programs.  


Congenital malformations, syndromes, metabolic/endocrine/genetic diseases etc.

Some structural disorders or diseases may be detectable right away, whereas others may manifest symptoms during the first days of life. If such disorders or diseases are identified or suspected, patients are evaluated in collaboration with medical genetics or other relevant departments in order to diagnose their conditions with special tests and screening procedures. 


Surgical diseases

Neonates who underwent pediatric, cardiovascular, plastic or otorhinolaryngological surgery are observed at our unit during the preoperative and postoperative periods. 


Infectious diseases

Infections are among the most prominent problems experienced at intensive care units, and unfortunately, rate of infection can never be reduced to zero. However, the risk may be mitigated substantially by employing strict measures. If necessary, this group of infants can be observed in rooms specifically designated to this purpose. 


Perinatal asphyxia

This is an incident where the baby might be deprived of oxygen due to various reasons and sustain damage to some organs, primarily the brain. To mitigate this damage as much as possible, whole-body therapeutic hypothermia is practiced at our unit. Long term monitoring under aEEG, a special format of regular EEG, and MRI imaging (under supervision of an anesthesiologist, if necessary) are conducted to determine the impact on the brain.   

Service Subcategories of the Neonatal Intensive Care Unit
 

Level 1 Intensive Care:

  • Neonates unable to preserve body temperature
  • Late premature infants, neonates experiencing difficulty with breastfeeding
  • Hypoglycemia that will not improve with enteral nutrition
  • Neonates who require or will most likely require phototherapy  
  • Neonates receiving up to 24 hours of free-flow oxygen support and need to be observed under monitoring or pulse oximetry


Level 2 Intensive Care:

  • Neonates who weigh 1500-2500 gr, cannot preserve body temperature, are hypoglycemic, and cannot be fed orally
  • Neonates who weigh >2500 gr and remain hypoglycemic for over 24 hours or receive O2 support
  • Neonates who weigh >1500 gr and have to receive oxygen support for over 24 hours or require nasal respiratory support
  • Neonates who weigh >2500 gr, have a central venous catheter or have undergone minor surgical intervention  
  • Neonates who weigh >1500 gr and had a blood transfusion or received IVIg therapy
  • Neonates who are treated for arrythmia
  • ​Infants with infections -on condition that it is not highly severe-, congenital anomalies and systemic diseases 


Leve 3 Intensive Care:

  • All neonates weighing <1500 gr 
  • Neonates with dysfunction in two or more organs, requiring circulation support
  • Neonates requiring invasive mechanical ventilation support
  • Neonates who weigh 1500-2500 gr, have a central venous catheter or have undergone minor surgical intervention
  • Neonates who went through peritoneal dialysis or hemofiltration
  • Therapeutic hypothermia
  • Treatment and examination for retinopathy
  • Neonates requiring thoracic intubation
  • Echocardiography 

 

Isolation chambers

In cases of risky infection, neonates are observed in special negative-pressure chambers. 


Co-sleeping rooms

To evaluate harmony between the mother and a neonate due for discharge, they stay in a special room for several nights. 


Neonatology polyclinic

Neonates who were treated at our unit and discharged, have their initial follow-ups at our unit. Regular follow-ups are held for high-risk babies.

 

Nephrology

  • Acute kidney damage (failure)
  • Chronic kidney disease (failure) 
  • Glomerular diseases: Evaluation, diagnosis and treatment of pathologic urinary findings like nephrotic syndrome, nephritic syndrome, hematuria and proteinuria 
  • Liquid and electrolyte disorders (problems related to water and salt balance (fluid overload or edema, hypertension etc.) 
  • Acid-base balance disorders
  • Diagnosis and treatment of edema
  • Tubulointerstitial diseases
  • Hypertension
  • Gout disease associated with elevated uric acid levels
  • Familial Mediterranean fever
  • Treatment and diagnosis of kidney disease associated with diabetes
  • Treatment and diagnosis of recurrent urinary system infection
  • Treatment and diagnosis of recurrent nephrolithiasis
  • Kidney damage occurring as a result of systemic diseases (lupus nephropathy, amyloidosis etc.)
  • Pathologies of the urinary system (infection etc.)
  • Congenital or acquired cystic renal diseases (polycystic kidney diseases, medullary cystic disease etc.)
  • Hemodialysis therapy (starting patients on hemodialysis, follow-up, management and emergency hemodialysis applications)
  • Peritoneal dialysis
  • Kidney transplantation
  • Elevated blood pressure (hypertension)
  • Low blood sodium level (hyponatremia)
  • Edema (fluid accumulation in the body, weight gain)
  • Increased or decreased urinary output
  • Foaming urine, changes in urine color
  • Frequent urination at night (nocturia)
  • Electrolyte disorders (elevated or low levels of electrolytes such as sodium, potassium, calcium, phosphorus etc.)
  • Kidney inflammation (nephritis, pyelonephritis etc.)
  • Infections of the urinary tract
  • Chronic glomerulonephritis 
  • Kidney stones
  • Complaints associated with uremia (nausea, vomiting, itching, dyspnea etc.)
  • Disrupted renal functions (elevated urea or creatinine)

Neurology

  • Headache
  • Dizziness
  • Numbing in hands and feet
  • Forgetfulness 
  • Imbalance
  • Diplopia 
  • Seizure
  • Weakness in legs and arms
  • Tremor
  • Slow movement
  • Involuntary movement in legs and arms, neck and face
  • Drooping eyelids
  • Sleeplessness, oversleeping, limb movements in sleep, sleep talking, restlessness in legs
  • Sudden jerks in legs and arms, syncope accompanied with loss of consciousness and loosened or convulsed arms and legs
  • Gait disorder, frequent falling

Neurosurgery

Brain Tumors
  • Headache
  • Nausea
  • Vomiting
  • Speech disorders
  • Syncope
  • Epilepsy (seizure)
  • Paralysis
  • Weakness in limbs
  • Loss of vision
  • Gait imbalance

Cerebrovascular Diseases
  • Headache
  • Nausea
  • Vomiting
  • Syncope
  • Epilepsy (seizure)
  • Paralysis
  • Weakness in limbs
  • Loss of vision
  • Gait imbalance

Degenerative Spinal Diseases
  • Pain in the neck, back and lower back
  • Pain, numbing, burning/stinging sensation, weakness or paralysis in arms, hands, legs and feet
  • Gait difficulty
  • Stiffness and movement problems in the lower back and neck

Spinal Deformities
  • Crooked posture, kyphosis, forward or backward slanting

Peripheral Nerve Surgery
  • Pain, numbing, burning/stinging sensation, weakness or paralysis in arms, hands, legs and feet

Range of Motion Disorder Surgery
  • Tremors and slowed motion in the hands and feet, gait disorders
  • Rigidity, difficulty moving and spasticity in arms, hands, legs and feet
  • Parkinson’s disease, dystonia and essential tremor

Epilepsy Surgery
  • Epilepsy (seizures) that is refractory to medical treatment
  • Neuro-oncological surgery (surgery on all cerebrospinal tumors)
  • Neurovascular surgery (surgery on all cerebrospinal vascular diseases)
  • Complex spinal surgery
  • Spinal deformity surgery
  • Scoliosis surgery
  • Minimally invasive spinal surgery
  • Pediatric neurosurgery
  • Gamma knife radiosurgery
  • Parkinson’s disease and dystonia surgery
  • Epilepsy surgery

Nuclear Medicine and Molecular Imaging

The department of Nuclear Medicine and Molecular Imaging assists in detection of causes underlying a specific medical condition on the basis of functional knowledge relevant to organs and bones. Accordingly, complaints referred to the department are often related to the following: 
  • Benign and malign tumors
  • Cancers
  • Bones
  • Brain
  • Endocrine diseases
  • Gallbladder
  • Cardiovascular diseases
  • Lungs
  • Lymphoma
  • Neuroblastoma
  • Neuroendocrine tumors
  • Pediatric diseases
  • Prostate cancer
  • Kidneys
  • Thyroid diseases (thyroid cancer, Graves’ disease)

Obstetrics and Gynecology

Reproductive Endocrinology and Infertility Unit

It is a priority for use to make sure that patients achieve conception in the shortest time and easiest manner and at the lowest cost possible. On top of routine processes like fertility consultancy, ovulation induction, intrauterine insemination and in vitro fertilization/intracytoplasmic sperm injection, we offer other services like preimplantation genetic diagnosis and fertility protection through cryopreservation of oocytes and ovarian tissue. Under guidance of evidence-based medicine, our clinic is capable of obtaining, practicing and even developing any novel technology that we believe will contribute to our patients’ care. 

 

Perinatology Unit

Our perinatology unit concentrates on genetic consultancy for conditions associated with the fetus or parents, recurrent miscarriage, fetal developmental deficit, preeclampsia, preterm delivery, multiple pregnancies and evaluation of women experiencing various high-risk pregnancy complications.  
Top-level healthcare services and up-to-date diagnostic and treatment methods are provided by the perinatology team to ensure a healthy mother and fetus. For this purpose, the team is in collaboration with neonatology, medical genetics, pediatric surgery and pediatric cardiology. Fetal anomaly screening under advance ultrasonography during the first and second trimesters and fetal echocardiography examination are services provided at the unit as well. Our perinatology specialists are specialized also in techniques/practices like fetal blood transfusion, radiofrequency ablation, laser application and fetal shunt placement in addition to diagnostic procedures like amniocentesis, chorionic villus sampling and cordocentesis. 


Gyneco-oncological Surgery

Our foremost objective is to deliver optimal diagnostic and treatment services to gynecological cancer patients as a team equipped with current knowledge and the highest-standard technology currently available in the field of gynecological oncology. Laparoscopic, robotic and ultra-radical surgical operations are successfully performed at our clinic in this regard. Furthermore, cases are evaluated in a multidisciplinary manner and as may be necessary, treatment decisions are made together with other disciplines like urology, general surgery, thoracic surgery, radiation oncology and medical oncology. Cases requiring genetic consultancy are evaluated at our Genetic Diagnostic Center.


Gynecology

The Gynecology unit of the Obstetrics and Gynecology Department of Koç University Hospital serve women throughout their lives, including adolescence, reproductive period and post-menopausal term. Our team offers a wide range of professional healthcare services from annual screening programs to complex medical and surgical care. Among others, the most common medical conditions that are referred to the unit include: 
 
  • Sexually transmitted diseases
  • Vaginitis
  • Pelvic infections
  • Abnormal menstruation
  • Acute or chronic pelvic pain
  • Uterine myomas
  • Uterine pathologies
  • Pelvic floor disorders
  • Urinary incontinence
  • Benign ovarian cysts and adnexal cysts 
  • Endometriosis
 
Endometriosis and DIE (deep infiltrative endometriosis) cases are routinely treated laparoscopically in collaboration with urology and colorectal surgery, if necessary, at our clinic. Pelvic floor anomalies and urinary function disorders like urinary incontinence are diagnosed and improved by means of medical and surgical techniques. Routine surgical interventions practiced by our specialists include:
 
  • Laparoscopic myomectomy and contained morcellation for prevention of spread of myoma/uterine tissue
  • Hysterectomy
  • Ovarian cystectomy
  • Laparoscopic excision of endometriosis and deep infiltrative endometriotic nodules
  • Laparoscopic sacral colpopexy
  • Lateral suspensions, urinary sling and vaginal suspension procedures
  • Hysteroscopic myomectomy and polypectomy
  • Vaginal hysterectomy and oophorectomy

Aiming for excellence and leadership in patient care, research and education, our team delivers the most recent and up-to-date surgical and medical gynecological care services to patients.

 

  • Pregnancy follow-up and delivery
  • High-risk pregnancies
  • Multiple pregnancies
  • Recurrent miscarriages
  • Recurrent failed implantations 
  • Fetal anomaly screening under advanced ultrasonography during the 1st and 2nd trimesters
  • Fetal echocardiography
  • Perinatology council (in collaboration with neonatology, medical genetics, pediatric surgery and pediatric cardiology)
  • Delivery and post-partum services
  • Assisted reproductive techniques and infertility treatment
  • Services regarding adolescence and associated problems
  • Menstrual irregularity and abnormal menstruation
  • Groin pain, acute and chronic pelvic pain (menstrual pain, pain in sexual intercourse, pain radiating to anus and others)
  • Polycystic ovarian syndrome
  • Hair problems and excessive hair growth on the face, chin and other parts of the body
  • Benign and malignant ovarian cysts
  • Endometriosis and chocolate cysts
  • Uterine neoplasms and myomas
  • Uterine pathologies
  • Vaginal discharge, burning sensation and itching
  • Sexually transmitted diseases
  • Sexual dysfunction
  • Pelvic infections, acute and chronic pelvic pain
  • Pelvic floor disorders
  • Urinary incontinence, prolapsed bladder or uterus
  • Cosmetic gynecological surgeries and treatments 
  • Menopausal and premenopausal problems
  • General and preventive gynecology
  • Warts
  • Evaluation of abnormal or suspicious PAP smear results, advanced investigation and treatment
  • Laparoscopy, hysteroscopy and robotic surgery in female reproductive system
  • Diagnosis and treatment of cancers of the female reproductive system
  • Diagnosis of cancers of the female reproductive system
  • Treatment and laparoscopic/robotic/open surgery of gynecological cancers
  • Oncology council, radiotherapy, chemotherapy, immunotherapy
  • Organ-sparing treatment approaches in gynecological cancers

Ophthalmology

Refractive Surgery (Elimination of Dependency on Spectacles)

Refractive disorders occur depending on refractive capacity of the cornea and structure/anteroposterior length of the lens. There are 3 primary types of refractive disorders: Myopia, hypermetropia and astigmatism, which are also known as refraction errors. Refraction errors are mitigated with the help of optic products like spectacles and contact lenses, and can be corrected through refractive surgery, which includes laser applications and intraocular lens implantation. Based on examination and investigation findings, patients with refractive errors undergo the most suitable refractive surgery procedure. Refractive laser surgeries are performed at our department to eliminate dependency on spectacles. These include the flap-free wavefront-backed PRK and LASIK operation, which involves a flap. In cases where the use of a laser is not practical for correction of myopia, hypermetropia or astigmatism, intraocular lens (phakic) implantation is successfully performed as well. 


Cataract and Intraocular Lens Surgery

Currently the most recognized technique for cataract surgery around the world, suture-free phacoemulsification under drip anesthesia is performed at our department. In this procedure, the eye is anesthetized with drops instead of an injection. Cataract surgery is performed through a tiny incision measuring approximately 2 millimeters on the transparent layer, and an appropriate lens is performed in the ocular zone. The patient does not need to be hospitalized afterwards, and is bound to regain their former pre-cataract visual acuity. Ordinary and complex (high-risk) cataract surgeries are routinely performed at our clinic. Once the cataractous lens has been cleaned, a monofocal (far focus), multifocal (known commonly as ‘smart lens’; near, intermediate and far focus) toric (astigmatism correction) or next-gen monofocal (ring/glare reduction, far to intermediate focus) can be selected and implanted to the eye in accordance with the patient’s preferences and indications. Other procedures aimed at complex cases (such as pupilloplasty, iris repair, intraocular lens fixation to iris/sclera etc.) are successfully performed at our clinic too. 
 

Cornea and Ocular Surface Unit

Cornea is a transparent, dome-like anatomic structure positioned in front of the ocular globe. Cornea and the structures in its periphery are called the ocular surface. There is a lacrimal layer on it, which keeps the ocular surface smooth and damp and protects it from external factors. Diseases of cornea, conjunctiva and eyelids are addressed separately, and also collectively as ocular surface diseases. Ocular surface diseases like infections of eyelids and eyelash roots (blepharitis), ocular membrane (conjunctivitis) and corneal infections associated with bacteria, viruses, fungi and parasites (keratitis) as well as congenital and acquired structural disorders of cornea (e.g.: keratoconus, corneal edema, neurotrophic keratopathy etc.) are among the conditions in which our clinic is specialized.  

In addition to diagnostic procedures like biomicroscopic examination for diagnosis of corneal and ocular surface diseases, confocal microscopy, meibography, tear osmolarity test (TearLab) and clinical microbiology tests, medical and surgical treatment methods are successfully practiced. These treatments include medical therapy and punctum plug implantation for dry eyes; amniotic membrane cover and tarsorraphy for advanced ocular surface disorders; corneal collagen cross-linking, intrastromal corneal ring segment implantation (ICRS) and special contact lens applications for keratoconus; and cornea transplantation procedures (phototherapeutic, penetrating, deep frontal lamellar, Descemet’s membrane endothelial keratoplasty).

Our department also carries out numerous leading scientific studies in diagnosis and treatment of corneal and ocular surface diseases. 


Retina

Our retina unit is equipped with the facilities required for color fundus photography, fundus autofluorescence imaging, multicolor imaging, optic coherence tomography, fundus fluorescein angiography and indocyanine green angiography, which are all investigations aimed at diagnosis of all retinal diseases. Intraocular drug injections for age-related macular degeneration, which is also known as ‘yellow spot’ disease and currently the most prominent reason underlying loss of vision around the world, is successfully performed at our clinic. Differential diagnosis of various other conditions that are often mistaken for age-related yellow spot disease is also conducted without error thanks to our specialized physicians and advanced diagnostic technology. For treatment of diabetic retinopathy -a condition that develops secondary to diabetes- and retinal venous occlusion, we utilize argon laser photocoagulation and intraocular drug injection methods. Hereditary retinal conditions like night blindness (retinitis pigmentosa), cone dystrophy and Stargardt disease are routinely treated by means of PRP administration into the membrane.  

Furthermore, ‘vitrectomy’ and other surgical techniques are carried out to successfully treat other conditions requiring surgical intervention, including diabetic retinopathy, intraocular bleeding (vitreus hemorrhage), retinal detachment, macular hole and epiretinal membrane. 

We are also developing novel treatment options with a focus on various retinal diseases as part of the leading regenerative medicine studies conducted in collaboration with Koç University Laboratories.  


Ocular Immunology and Uveitis 

Uveitis is described as inflammation of the uveal tissue of eyes. It is condition that results from infections like herpes virus, toxoplasmosis, tuberculosis or syphilis or due to inflammation of the eyes secondary to other autoimmune conditions like rheumatoid arthritis, Behcet’s disease, ankylosing spondylitis and sarcoidosis. Sometimes, uveitis is not necessarily accompanied by another disease. Such cases are categorized as idiopathic. Uveitis cases are evaluated by specialized physicians, who carry out necessary diagnostic studies and draft a suitable treatment and follow-up plan at our unit. In addition to medical treatment of uveitis, ocular complications associated with uveitis are taken under control and essential surgical interventions are performed afterwards.


Ocular Hypertension (Glaucoma)

Glaucoma, i.e. ocular hypertension disease, is a chronic disease that is accompanied with optic nerve damage, often runs a subtle course of progression, and threatens public health. Patients presenting to our clinic with early or late-stage glaucoma go through diagnostic tests and receive medical or surgical treatment under the light of current medical literature. 
Applanation tonometer, Tono-Pen, non-contact tonometer or iCare tonometer are utilized to measure intraocular pressure. A computerized visual field test with different color adjustments is performed at our unit in order to identify visual field defects. Retinal nerve fiber layer is evaluated under optic coherence tomography (OCT) for the purpose of detecting optic nerve damage. Additionally, ultrasound Biomicroscopy is utilized in diagnosis of some specific subtypes of glaucoma. Thanks to all of these tests, glaucoma, a chronic disease, is diagnosed, treated and followed in a robust manner. 

Treatment options include drops for reducing intraocular pressure and a range of surgical procedures from laser iridotomy to trabeculoplasty, combine cataract and trabeculoplasty surgery, seton operations and Ahmed valve tube implantation. 

We are also conducting leading studies on diagnosis and treatment of glaucoma in collaboration with Koç University Laboratories.


Neuro-ophthalmology Unit

As can be inferred from the name, the neuro-ophthalmology unit is a subbranch concentrating on ophthalmologic conditions associated with the brain, which looks into ocular or visual field disorders, synchronization disorder of eye movements and abnormalities of the pupil that may accompany optic nerve or cerebral diseases. Ophthalmologists specialized in this field most often treat optic neuritis resulting from involvement of the optic nerve by multiple sclerosis, ischemic optic neuropathies or papilledema, which might be caused by increased intraocular pressure. Disorders associated with cranial tumors, myasthenia gravis, ocular muscle paresis, pupillary abnormalities and cancer (paraneoplastic syndromes) are included in the field of interest for this subbranch. 

To diagnose this group of diseases, color vision examination, pupillary examination, pharmacologic tests, computerized visual field test, color fundus photography, ocular ultrasound and optic nerve tomography are employed at the clinic. Eligible cases are also referred to the department of neurology for visual evoked potentials test (VEP). 

Interdisciplinary work is essential in treatment of neuro-ophthalmologic diseases. Therefore, treatment plans are drafted in collaboration with the departments of neurology, neurosurgery, internal medicine and radiology. 


Pediatric Ophthalmology and Strabismus Unit

Treated and followed in only a few medical centers in our country, retinopathy of prematurity (ROP) is a prevalent condition among premature infants. The specialized physicians at our polyclinic treat infants diagnosed with this condition, including those who are staying in incubators at the neonatal intensive care unit or present on outpatient basis. Treatment options for ROP include intravitreal drug injection and laser photocoagulation. Backed up modern surgical equipment, our experienced team practices medical and surgical treatment for pediatric cases of congenital cataract, strabismus and amblyopia (lazy eye) in addition to conducting routine eye checks for healthy children. Non-contact automatic refractometer measurements are carried among the pediatric population below 3 years of age. The Krimsky test -which employs prismatic glasses- and Worth 4-dot test are conducted in examinations for strabismus and amblyopia. The Titmus test for stereopsis is also available at our clinic. 


Oculoplastic Surgery (Ocular Cosmetic Surgery) and Orbital Surgery

Our oculoplastic and orbital surgery unit performs interventions and operations aimed at treatment of eyelid diseases, lacrimal canal disorders, orbital implant problems, thyroid orbitopathy, eyelid and orbital tumors as well as all cosmetic procedures around the eye. Among the polyclinic services provided by the oculoplastic surgery unit are biomicroscopic examination, Hertel exophthalmometer, Humphrey visual field test and Ishihara color vision test. Punctum plug and perforated punctum plug applications are carried out to treat dry eyes and epiphora as well. Treatment of congenital or acquired ptosis, trichiasis, entropion and ectropion pathologies of eyelids are treated with modern surgical techniques. Endonasal or external dacryocystorhinostomy are surgical procedures aimed at lacrimal system disorders. Thyroid orbitopathy cases are diagnosed and followed in coordination with the department of Endocrinology. We provide medical treatment, orbital decompression surgery and radioactive iodine therapy options in accordance with patient preferences and clinical indications. On the cosmetic side, upper and lower blepharoplasty operations, reposition of fat pads and Botox injections can be performed to improve the cosmetic appearance of the areas around the eyes.  


Ocular Oncology Unit

Ocular Oncology is the branch that focuses on tumors afflicting the eyes or their periphery. Differential diagnosis of all types of ocular oncology cases is rendered by use of advanced radiologic, medical and ophthalmic instruments. Our unit is well capable of treating all tumors that may be found in or around the eyes, including some severe cases like malignant melanoma and retinoblastoma. Treatment of ocular tumors at our clinic includes radiotherapy, plaque radiotherapy, cyber knife, chemotherapy and surgical excision. 


Contact Lens Unit

Contact lenses are widely used in correction of refractory disorders. Manufacturing technologies in this field have followed in the footsteps of advancements in biotechnology. Currently, soft contact lenses provide an alternative to spectacles in numerous conditions. Contact lens trial sets by a number of different contact lens manufacturers, all approved by the Ministry of Health, are available at our contact lens unit. These allow each patient to try on different options for a precise prescription. It is possible for new users with no prior history of contact lens use to find out whether or not their eyes are suitable, whereas anterior and posterior surfaces of long-time contact lens users can be evaluated through corneal topography at our unit. Schirmer test and non-invasive tear film breakup time tests are other investigations specifically designed to determine tear quantity and functions. 

Aside from contact lenses suitable for myopia (minus refractive error) and hypermetropia (positive refractive error), toric (astigmatic) contact lenses can be tried on at our polyclinics, where satisfactory results are attained for refractive error margins up to -3.0 diopters. As an alternative to multifocal glasses and intraocular lenses designed for both near and far vision, we offer multifocal contact lenses that enable clear vision in close, intermediate and far distances.  

On top of the various usage cases described above, contact lenses can be utilized almost like a ‘band-aid’ for therapeutic purposes in corneal diseases or following refractive surgeries. If the corneal hue has changed because of underlying ocular conditions, special colored contact lenses are also a prosthetic option for matching the color of the intact eye for a satisfactory cosmetic appearance.


Low Vision Rehabilitation Unit

Patients who experience advanced loss of vision due to conditions such as retinitis pigmentosa (night blindness), cone dystrophy, Stargardt disease, age-related macular degeneration (yellow spot disease), diabetic retinopathy, glaucoma and retinopathy of prematurity are assisted at this unit to restore adequate vision by use of special spectacles, devices and methods of rehabilitation.
The diseases/conditions below are within the scope of our department’s specialization:
  • General eye conditions
  • Refractive surgery (elimination of dependency on spectacles)
  • Cataract and intraocular lens surgery
  • Cornea and ocular surface
  • Retina
  • Ocular immunology and uveitis
  • Glaucoma (intraocular hypertension)
  • Neuro-ophthalmology
  • Pediatric ophthalmology and strabismus
  • Oculoplastic and orbital surgery
  • Ocular oncology
  • Contact lens
  • Low vision rehabilitation

Organ Transplant Center

  • Kidney, liver and pancreas transplantation
  • Laparoscopic or robotic nephrectomy on live donors
  • Laparoscopic hepatectomy on live donors
  • Pediatric kidney and liver transplantation (simultaneous or consecutive)
  • Crossmatched kidney transplantation
  • Crossmatched liver transplantation
  • Domino liver transplantation

For the purpose of achieving the highest success rate, our organ transplantation surgeons have combined their collective specializations in laparoscopic and robotic techniques in the field of kidney transplantation. 

Available only in few centers around the world, robotic kidney transplantation is performed by the experienced organ transplantation team of Koç University Hospital. This is an operation were the donor’s kidney is placed in the recipient’s body through a small 5 mm periumbilical incision. The rest of the procedure is performed by use of the da Vinci XI robotic surgery system. Surgeons control the robotic arm via a computer interface and conclude the kidney transplantation procedure by means of surgical instruments introduced into the abdomen through small incisions. 

Not only is robotic kidney transplantation cosmetically far superior to open surgery, but it also ensures that postoperative pain is mitigated and patients can return to their daily routines sooner.

On top of all the advantages of robotic kidney transplantation, the Organ Transplantation Center of Koç University Hospital offers the most up-to-date equipment and practices for reliable minimally invasive operations on end-stage renal failure patients.

Orthopedics and Traumatology

The department of Orthopedics and Traumatology diagnoses and treats congenital and acquired conditions of joints (shoulder, elbow, wrist, hand, hip, knee and ankle) and spinal column, such as restricted range of motion, pain, dysmorphic/short limbs, musculoskeletal tumors and infections among adults and children, and gait/posture disorders. All traumas relevant to these parts of the body and all pediatric musculoskeletal diseases are addressed at our department too. Furthermore, the department of Orthopedics and Traumatology collaborates with other branches in treatment and diagnosis of foot problems resulting from vascular occlusion, infection and chronic injury.
  • Orthopedics and Traumatology (principal branch)
  • Hand Surgery and Microsurgery (side branch)

Pathology

Cytology and surgical specimens are analyzed for pathology by a team of specialized pathologists equipped with cutting-edge laboratory infrastructure at our laboratory. Additionally, the team conducts immunohistochemical and molecular studies, which are of predictive significance for determining immunotherapy options or target-specific therapies for cancer patients.  

Our advanced immunohistochemistry laboratory is able to conduct studies using nearly 300 antibodies, while routine tests of our department include immunofluorescence and in-situ hybridization as well.

The molecular pathology laboratory, on the other hand, routinely performs real-time PCR, pyrosequencing and next-gen sequencing tests.
  • Electron Microscopy

The electron microscopy unit of our department was launched in 2020 under directorship of Prof. Dilek Ertoy Baydar, M.D., and conducts detailed investigations on liver and kidney biopsies.

 

  • Molecular Pathology
The molecular pathology laboratory keeps building up on its equipment and facilities in order to keep up-to-date with and meet needs in this field. Next-gen sequencing cancer panels aimed at detection of gene-specific mutations and determining targeted therapies for various types of cancer- pulmonary carcinomas in particular- are performed in this laboratory

Pediatric Allergy

The department treats patients with immunotherapy (allergy vaccine therapy) and serves them in differential diagnosis of allergic diseases, asthma, atopic dermatitis (eczema), urticaria (rash), angioedema, hereditary angioedema, allergic rhinitis (allergic flu), food allergies, drug allergies, anaphylaxis (allergic shock), bee allergies, mastocytosis, chronic coughing, recurrent wheezing, exercise-induced asthma, asthma presenting only with coughing, pollen-food allergy syndrome and snoring/nasal congestion.

Pediatric Cardiology

  • Congenital pediatric cardiac diseases
  • Congenital adolescent cardiac diseases
  • Acquired cardiac diseases (rheumatic heart disease, Kawasaki syndrome, infective endocarditis etc.)
  • Cardiac rhythm and conduction disorders
  • Fetal cardiac diseases
  • Interventional cardiology
Patients often present to our polyclinic with or referred by other departments for consultation due to complaints such as murmur, chest pain, cyanosis, palpitation, dizziness, syncope and high blood pressure.

Pediatric Endocrinology and Diabetes

Aside from diagnosis and treatment, our team offers consultancy to children and parents in the following matters to facilitate life with diabetes:
  • Inpatient treatment and training of children recently diagnosed with diabetes
  • Treatment of urgent conditions such as diabetic ketoacidosis
  • Placement of insulin pumps and follow-up
  • Placement of next-gen blood glucose measurement systems (which do not require fingertip puncture) and follow-up
  • Structured diabetes training and provision of training material
  • Training on carbohydrate count/management
  • Mental health observation and resilience training
  • Emergency support and consultancy
  • Experience sharing meetings with diabetic peers and experienced patients/cultural trips
  • Participation in the ‘My Friend Diabetes’ camp set up in İznik each year
  • Participation in the ‘My Friend Diabetes’ parents’ camp set up in Uludağ each year
  • Diabetes at School Program
  • Support for diabetic children and parents in need/mentor parent program

Comprehensive Pediatric Diabetes Program 

Although diabetes is primarily known as an adult disease, it is also encountered among children, starting from early ages. Type 1 diabetes among children occurs due to permanent deficiency of the insulin hormone, which regulates blood glucose levels. Therefore, once diagnosed, diabetic children are required to measure blood glucose levels at least 4-6 times a day and receive insulin hormone externally by means of injection or an insulin pump accordingly. 

Diabetic training is as important as insulin intake and treatment in terms of long-term follow-up and leading a healthy life. Diabetes has recently become not so much of a burden for children and parents after the advent of “Flexible Diabetes Therapy”, which is essentially based on carbohydrate counting. Training also plays an important role in alleviating level of concern for diabetic children and their parents. While diagnosed children are provided with basic information after being admitted to a hospital, diabetic children camps also offer quite an effective means of training by enabling children to meet physicians, nurses, dietitians and other experienced diabetic peers. 

All of these efforts should also be reinforced with support in the school setting, resilience building to cope with diabetes, early diagnosis of possible mental problems, a diabetic-friendly life and guidance on the route to adult life.


The Comprehensive Pediatric Diabetes Program includes the following:
  • Physician consultation for 45 minutes at minimum for type 1 diabetes patients presenting for the first time, who are then given a written report on the physician’s recommendations/glycemic targets. 
  • Basic training updates and advanced training (consultations once with a nurse, 3 times with a dietitian and once with a psychologist - training on carbohydrate, protein and fat count as well as exercise management).
  • Constant communication with the diabetes team.
  • Dietitian consultation during at least one of every two visits. 
  • Use of Continuous Glucose Monitoring Systems (sensors) for cases where it is possible. 
  • Use of insulin pump for cases where it is possible. 
  • “First Visit Package” and “Insulin Pump Therapy Package” aimed at facilitating access to our programs and payment. 

 

Insulin Pump Therapy and Advanced Technologies Program 

Treatment of type 1 diabetes has recently use of insulin pumps as well as introduction of some significant technologic advancements. Insulin therapy with “smart insulin pumps” renders treatment more physiological, whereas continuous blood glucose measurement systems are about to replace the conventional fingertip puncture. Not so long ago, these advancements have also enabled routine use of systems such as “artificial pancreas” and “bionic pancreas”, which allow automatic administration of insulin and blood glucose measurements. Insulin pump therapy and sensor products that are available in our country are utilized at our department. Currently, 20% of the children followed at Koç University Hospital with the diagnosis type 1 diabetes use insulin pumps, and 46% use continuous glucose monitoring systems. 

As the Pediatric Diabetes team of Koç University, we do realize that insulin pump alone will not make a substantial contribution to treatment. That is why we concentrate on comprehensive diabetes training, primarily carbohydrate counting. Upon reaching a mutual agreement with diagnosed children/adolescents, parents and team members, we decide on fitting patients with pumps and make sure that they are trained in and follow training on carbohydrate counting/management. Insulin pump therapy consists of a 3-day process and consequent follow-ups. 

Insulin Pump Therapy

Day 1
  • Consultation with dietitian and psychologist, determination of insulin/carbohydrate ratio and insulin sensitivity factor in the morning;
  • Pump training, demo pump fitting with distilled water and treatment continued at home in the afternoon.

Day 2
  • Downloading GCMS data, if available, and glucometer; 
  • Training on pump functions;
  • Training on hypoglycemia and hyperglycemia management; 
  • Team session, basal rate adjustments; 
  • Switch to insulin in the demo pump;
  • Report compilation. 

Day 3
  • Answering questions; 
  • Review; 
  • Change of set; 
  • Training on exercise management;
  • Management of disease conditions. 

2 weeks later
  • Pump and sensor download report; 
  • Review of settings; 
  • Introduction of models; 
  • Detailed sensor training, introduction of alarms. 

1 month later
  • Pump and sensor download report
  • Review of settings. 
 

Diabetic Children’s Parents Solidarity and Guidance (Mentorship) Program

The diagnosis process of type 1 diabetic children, management of the consequent process, parents’ approach and perception of their children’s condition and social support are of utmost importance. Availability of people healthcare personnel as well as other parents who can provide support and share their own experiences can positively influence the mood of parents and increase their level of resilience. 

The Diabetic Children’s Parents Solidarity and Guidance (Mentorship) Program aims to facilitate access to correct knowledge, train experienced parents practicing good management as mentors, and closely support other type 1 diabetic patients and their parents. Below are the objectives of this program: 
  • Creating an environment where type 1 diabetic children and their parents can share their experiences, questions and knowledge alongside experts sharing their scientific data with the help of the website www.arkadasimdiyabet.com
  • Training volunteering parents who can act as mentors; 
  • Allocating a certain number of parents to mentors (by taking into account specific features such as having diagnosed children of the same age group and residing in close proximity to each other), who will then assist these parents in matters such as management of diabetes and social support (immediately as needed); 
  • Visiting recently diagnosed type 1 diabetic children and their parents at the hospital and supporting them; 
  • Organizing activities where parents and children gather together and promoting sharing among them; 
  • Providing voluntary aid to those families whose may be in need of financial support. 

 

My Friend Diabetes İznik Camp

“My Friend Diabetes” camps have been set up in İznik since 1997 and Diyarbakır since 2011 (and commonly in İznik since 2016) in order to provide a setting that can help improve training and restore health among diabetic children. While basic topics are covered in the form of class lessons, groupwork and experience sharing activities are held at the camp. Children are grouped in accordance with age groups, where they are trained and share their experiences in topics like “general approach to diabetes treatment”, “being at peace and coping with diabetes”, “type 1 diabetes and exercise”, “insulin pump therapy and new technologies”, “carbohydrate, protein and fat counting”, “adjusting insulin dosage” and “hyperglycemia and ketonemia management at home”. Various sports -primarily swimming-, entertainment and art activities are also made available outside the training hours. A team of pediatric endocrinologists, pediatric health and mental health specialists, dietitians, diabetes nurses, psychologists, activity leaders and students from departments of medicine, dietetics and nursing works on the camp grounds 24 hours a day under leadership of at least 2 faculty members. Experienced older brothers and sisters also share every moment of the day with children as “role models”.  
You can find out more on the My Friend Diabetes İznik Camp page.
 

My Friend Diabetes Parents’ Camp

Parents sending their children to these camps have often mentioned that they would also like to attend such a camp, where they get to meet other parents or diabetic children and interact with them. To answer this call and complete the “value creation chain” as part of our “Comprehensive Pediatric Diabetes Program”, we have been organizing the “My Friend Diabetes” parents’ camp since 2018. This is a camp for diabetic children as well as parents and non-diabetic siblings.  
You can find out more on the My Friend Diabetes Parents’ Camp page.
 

Diabetes at School Program

Diabetic children spend the majority of an ordinary day (8-10 hours a day) under supervision of school staff. The lack of glycemic control within this period of time has a negative impact on management of diabetes. Unless they receive proper training, school staff -mainly teachers- may experience difficulty in terms of responding to requirements of diabetes management and ensuring optimal blood glucose control. Furthermore, regardless of age groups and level of self-sufficiency, type 1 diabetic children are in need of support during their time at school, which means that the supervision of school staff is of utmost importance. Because there is no school nurse at many schools, monitoring blood glucose levels and administering insulin doses are a responsibility assumed by parents and school personnel. We have been practicing the Diabetes at School program since 2010 in our country and conducting various activities within this framework. 
As the Pediatric Diabetes team of Koç University, we conduct the “Emergency Diabetes Care Program at School” on the last Saturday of each month as part of the overall program. So far, 60 teachers and nurses have taken part in these courses since October 2018. 
 

Diabetes Training Program

Our department has launched an online training program named “Diapedia” for the purpose of training the diabetic children under our supervision and their parents while also supporting training of other diabetic children and their parents around the country. All activities conducted within the framework of this program are posted on the Vehbi Koç Foundation Healthcare Institution live broadcast and video portal, where recorded videos can be viewed at any time. 

Our team has also recently published the course books “Diary of the Diabetic Child”, “Time to Befriend Diabetes” and “Learning to Live with Diabetes”. These books and other presentations are available on the My Friend Diabetes website.

 

My Friend Diabetes Basketball Show and Run 

One of the common issues encountered by diabetic children and youngsters is that the society does not really know much about type 1 diabetes. Most people meeting a type 1 diabetic child for the first time typically think that they cannot live a normal life, get married and have children like everyone else or carry on performing any sportive activity they may have taken up. What is more, some business owners and HR departments tend to be reluctant to employ type 1 diabetic youngsters. Because of all of these realities, some diabetic children cannot help but think that people will treat them differently after finding out about them being diabetic.

However, it is currently possible for diabetic children and youngsters to live a completely normal and successful life by receiving the appropriate treatment and do everything that their peers can by “Befriending Diabetes”. Basketballer Alper Saruhan and marathon runner Gürkan Açıkgöz are some of the successful diabetic athletes, to name a few. Alper Saruhan notes that diabetic children deserve the title of ‘survivor’ the most rather than the contestants on the television. He states that his life is an example that one can succeed as a diabetic athlete, underlining that diabetes is not an obstacle that prevents one from achieving their goals and all difficulties can be overcome by befriending diabetes.

To emphasize the fact that type 1 is not an obstacle for sportive activities and that type 1 diabetes patients can make a difference in their own lives by means of sports, the Turkish Basketball Federation’s Association of Coaches has been arranging show matches between famous basketballers and type 1 diabetic basketball players since 2017. Also since 2017, the Koç Sports Collective has been organizing the My Friend Diabetes Run in the Bağlarbaşı grove. 
 

Comprehensive Obesity Program

Obesity and related disease -particularly diabetes- have turned into the most urgent public health issue of our time. Mortality rates associated with obesity have even surpassed that of hunger in some parts of the world such as the USA. Recent research has also shown that over 30% of adults and 20% of children in our country are overweight and obese.

According to findings of the “Childhood Obesity Research” among second-grade children, which was conducted on the basis of the methodology proposed by WHO, prevalence of obesity is 8.4 and prevalence of overweight, which signals risk of obesity, is 14.3 in this age group. It has also been found out that prevalence of overweight is three times higher in urban areas than in rural regions. A similar difference exists between İstanbul/West and East/Southeast. This set of data clearly displays the extent to which lifestyle and dietary habits determine the increased risk of obesity for children. Children living in cities and in western regions overall encounter food items that instigate a sense of enjoyment upon consumption and create a lifelong habit more often, which results in them gaining weight early on. We all know how junk food is “readily available” everywhere, particularly supermarkets. It is also known that these products are usually described as cheap and “safe” -which is not entirely true; they may be safe, but also they are unhealthy-, and marketed as favorable items often by means of cartoon characters. Those children who are exposed to such advertisements consume 40 percent more stick crackers than those wo are not. This is all closely related to the high and rapidly absorbed sugar content found in “junk food” and processed products, which in turn causes “food addiction”.  

Obesity is a complex problem that respectively leads to an increase in the overweight population in a society, prevalence of obesity and obesity-associated diseases like type 2 diabetes, shortened life expectancy due to these diseases and eventually epigenetic accumulation carried over from one generation to the other. From this point of view, it seems that protecting children from the risk of obesity and treating obese individuals constitute the most notable strategy for maintaining children’s and adults’ health, i.e. public health as a whole.

We are glad to serve obese children with 27 years of experience and the latest technology at our disposal as the Pediatric Endocrinology team of Koç University Hospital. Below are the services our team offers: 
  • A comprehensive evaluation at the time of first visit and determination of tailored approaches for each individual; 
  • Analysis and treatment of insulin resistance; 
  • Analysis of dietary habits and body mass components (fat, muscle and bone tissue ratios);
  • Structured healthy dietary training;
  • Dietary planning in accordance with level of obesity and personal features, and close review of progress; 
  • Tailored exercise planning;
  • Psychosocial assessment and support; 
  • Support at school and prevention of “stigmatization”; 
  • Treatment with the latest obesity medication available; 
  • “Metabolic Surgery” planning in collaboration with the Metabolic Surgery unit of Koç University Hospital, as may be necessary for adolescent obese individuals.

Pediatric Surgery

  • Neonatal surgery
  • Pediatric emergencies requiring surgical or endoscopic intervention
  • Surgeries involving abdominal organ systems
  • Day case surgeries (circumcision, inguinal hernia, hydrocele, umbilical hernia, undescended testis, string ligament etc.)
  • Urinary system surgery (kidney, ureter, bladder, urethra, testicle etc.)
  • Genital system surgery (labial synechia, sexual developmental discrepancies, buried penis, hypospadias etc.)
  • Urinary incontinence, urinary disorders, bladder diseases
  • Fecal incontinence
  • Noninvasive biofeedback therapy in urinary and fecal incontinence 
  • Pediatric tumors
  • I.V. port catheter placement in treatment of cancer patients
  • Head and neck surgery
  • Surgical pulmonary cases
  • Trauma
  • Organ transplantation
  • Dialysis catheter placement, if necessary, prior to kidney transplantation
  • Fetal surgery
  • Bronchoscopy, esophagoscopy, cystoscopy, ureterorenoscopy and laparoscopic surgery
  • Nephrourology, oncology, endocrinology-genetics and organ transplantation councils
  • Circumcision of neonates and other age groups, undescended or displaced testicles/ovaries,  swelling and pain in the groin and ovaries, crooked penile shape, buried penis, cosmetic disorders, abnormal location of external urethral orifice
  • Nocturnal and/or daytime urinary incontinence, hematuria, calculus in urinary tracts, stricture in kidney outflow tract, urinary leakage to kidneys-vesicoureteral reflux
  • Congenital intestinal atresia (atresia of esophagus, small intestine, colon, anus etc.), atresia of bile ducts, bladder calculus in upcoming periods, polyps, liver masses/cysts
  • Umbilical discharge, bleeding, swelling, rectal bleeding, blood in stool, anal cracks, constipation, fecal incontinence, pilonidal sinus, abdominal pain, suspected appendicitis, invagination-intestinal knotting
  • Oral feeding difficulty, dysphagia, gastroesophageal reflux-aspiration
  • Genital synechiae among girls, ovarian masses/cysts
  • Migration of foreign objects into the respiratory or digestive system
  • Swelling, mass, pain and discharge in the neck
  • Palpable abdominal masses or tumoral structures
  • Breast swelling, masses

Pediatrics

All conditions/diseases of pediatric age and relevant complaints in addition to follow-up and immunity-building of healthy children are addressed by our department. Some of the conditions that are relevant to our department can be listed as follows:
  • Febrile diseases
  • Nutrition problems
  • Allergic diseases
  • Asthma
  • Atopic dermatitis (eczema)
  • Urticaria (rash and angioedema)
  • Allergic rhinitis (allergic flu)
  • Food allergies
  • Drug allergies
  • Anaphylaxis (allergic shock)
  • Bee allergies
  • Immunotherapy (allergy vaccine therapy) 
  • Mastocytosis
  • Airway diseases
  • Diabetes
  • Obesity
  • Growth deficit
  • Adolescent conditions
  • Diseases of stomach, intestines and liver
  • Urinary incontinence
  • Conditions involving urinary tracts and kidneys
  • Elevated blood pressure
  • Kidney failure
  • Dialysis
  • Organ transplantation
  • Neurological diseases (seizure, anomalies regarding brain development/structure)
  • Hematological diseases and pediatric cancers
  • Neonatal diseases
  • Pediatrics (General Pediatrics)
  • Pediatric Allergy and Immunology
  • Pediatric Endocrinology
  • Pediatric Infectious Diseases
  • Pediatric Gastroenterology, Hepatology and Nutrition
  • Pediatric Pulmonary Medicine
  • Pediatric Hematology and Oncology
  • Pediatric Cardiology
  • Pediatric Nephrology
  • Pediatric Neurology
  • Pediatric Rheumatology
  • Pediatric Intensive Care
  • Neonatal Intensive Care

Physical Medicine and Rehabilitation

  • Acute and chronic musculoskeletal pain
  • Neck pain
  • Back pain
  • Lower back pain
  • Shoulder pain
  • Elbow pain
  • Hand-wrist pain
  • Hip pain
  • Knee pain
  • Foot-ankle pain
  • Jaw pain
  • Pain, numbing and weakness in arms
  • Arthrosis (calcification)
  • Fibromyalgia
  • Stroke
  • Spinal paralysis
  • Gait disorders
  • Spasticity
  • Lymphedema
  • Restoring one’s daily route after orthopedic and spinal operations
  • Recovery of functional losses due to previous surgery or side effects of radiotherapy
  • Movement disorders, such as Parkinson’s disease
  • Weakness following hospitalization the intensive care unit
  • Acute and chronic pain
  • Spinal diseases
  • Musculoskeletal system ultrasound
  • Musculoskeletal system injections
  • Orthopedic rehabilitation
  • Muscle pain syndromes
  • Osteoarthritis
  • Neurological rehabilitation 
  • Rehabilitation in muscle diseases
  • Lymphedema
  • Hand rehabilitation
  • Jaw diseases
  • Osteoporosis
  • Pulmonary rehabilitation
  • Geriatric rehabilitation
  • Cancer rehabilitation

Plastic, Reconstructive and Aesthetic Surgery

Patients present with complaints listed under the following categories: 

 

Plastic Surgery

  • Facial aging and wrinkles, sagging skin, eyebrow ptosis, sagging skin and neck tissues, depreciated skin quality

  • Eyelid problems, excess skin, wrinkles, eyelid ptosis
  • Cosmetic and breathing-related nasal problems, cosmetic and breathing concerns associated with previous procedures
  • Asymmetric or thin lips, barcode lines
  • Prominent ears, ear deformities, earlobe tear
  • Breast hypoplasia/hypertrophy, sagging, asymmetry; nipple abnormalities, sagging male breasts
  • Abdominal cracks, sagging and herniation occurring after giving birth or losing weight
  • Increased fat deposition in abdomen, arms or legs; broad hips
  • Low butt size, butt flattening or sagging 
  • Excess sagging in breasts, arms, face, neck, legs and abdomen following gastric surgeries
  • Sexual organ deficiency, asymmetry, defect or loosening; hymen repair; penis enlargement
  • Hair transplantation and restoration

 

Non-surgical Cosmetic Procedures

  • Facial wrinkles, crow’s foot, barcode lines, brow wrinkles
  • Purple spots, sagging and bagging in eyelids
  • Depreciated skin quality, facial spots and marks
  • Permanent facial lines, asymmetries, non-surgical nasal cosmetic procedures
  • Augmentation of sexual organs
  • Temporomandibular joint pain, teeth grinding and worn teeth
  • ​Hyperhidrosis

 

Reconstructive Surgery

  • Skin lesions (cysts, moles, warts, lipomas, all types of lesions)

  • Skin cancers (melanoma, basalioma, epidermoid cancer etc.)
  • Nipple and breast reconstruction after breast cancer
  • Absence of breasts
  • Cancers and tumors of maxillofacial bones and scalp
  • Temporomandibular joint problems
  • Congenital anomalies (cleft lip-palate, cranial anomalies known as craniosynostosis, absence of ears, prominent ear, giant moles etc.)
  • Hand anomalies (polydactyly, syndactyly etc.)
  • Hemangiomas, vascular malformations, eyelid ptosis, velopharyngeal insufficiency
  • Facial traumas (soft tissue traumas, facial and mandibular fractures, fractures of the orbital base and brow)
  • Facial paralysis
  • Wound care, scar revision, keloid scars, bed sores, wounds of hands and feet
  • Vaginal reconstruction, hypospadias, penile anomalies
  • Treatment of burns, burn marks and contractures
  • Microsurgical reconstruction of all types of tissues (maxillofacial area, breast, vagina, esophagus, hands, feet, legs, arms etc.)
The department’s fields of activity can be broken down into the following branches:


Plastic Surgery

  • Nasal surgery and functional surgery (rhinoplasty, concha reduction, septoplasty etc.) 

  • Cosmetic surgery on eyelids, ears, lips, brow, face and neck, bichectomy 
  • Cosmetic breast surgery (reduction, augmentation, lift, gynecomastia, nipple etc.) 
  • Truncal cosmetic surgery (abdominal lift, liposuction, post-bariatric 360-degree abdominal plastic surgery etc.)
  • Arm lift, thigh lift, liposuction on arms and legs
  • Genital cosmetic surgery (labiaplasty, hymen repair, vaginal rejuvenation, penis surgery)
  • Fat injections (facial, leg contouring, butt augmentation) 

 

Non-surgical Cosmetic Procedures 

  • Botox injection (wrinkles, sweating, masseter muscle, smile lines, meso-botox)

  • Filling (lips, nose, mandibula, eyelids, face, hands, genitalia etc.)
  • Mesotherapy (skin rejuvenation, eyelid lightening, light filling)
  • Dermaroller, laser and plasma applications
  • Stem-cell, PRP

 

Reconstructive Surgery (covered by insurance)

  • Skin lesions (cysts, moles, warts, lipomas, all types of lesions)

  • Skin cancers (melanoma, basalioma, epidermoid cancer etc.)
  • Breast cancer (breast reconstruction, implant, microsurgery, latissimus dorsi, Diep)
  • Poland syndrome
  • Cancers and tumors of maxillofacial bones and scalp
  • Congenital anomalies (cleft lip-palate, cranial anomalies known as craniosynostosis, absence of ears, prominent ear, giant moles etc.)
  • Hand anomalies (polydactyly, syndactyly etc.)
  • Hemangiomas, vascular malformations, eyelid ptosis, velopharyngeal insufficiency
  • Facial traumas (soft tissue traumas, facial and mandibular fractures, fractures of the orbital base and brow)
  • Facial paralysis
  • Wound care, scar revision, keloid scars, bed sores, wounds of hands and feet
  • Vaginal reconstruction, hypospadias, penile anomalies
  • Treatment of burns, burn marks and contractures
  • Microsurgical reconstruction of all types of tissues (maxillofacial area, breast, vagina, esophagus, hands, feet, legs, arms etc.)

Pulmonary Laboratory

The standard tests performed at our laboratory are as follows: 
  • Spirometry, reversibility test;
  • Methacholine bronchial provocation test;
  • Diffusing capacity of lung for carbon monoxide (DLCO test);
  • Pulmonary volume measurement by body plethysmography;
  • Impulse oscillometry; 
  • Intrathoracic pressure measurement (MIP, MEP);
  • Cardiopulmonary exercise test (KPET);
  • Exhaled nitric oxide (FENO) measurement; 
  • 6-minute walk test;
  • Arterial blood gas analysis.

Spirometry and Reversibility (response to bronchodilators) Test

This is a test where pulmonary functions are measured with a device called spirometer. When necessary, a short-acting bronchodilator is inhaled to measure the level of obstruction in the airway and response to the bronchodilator (reversibility). There may be some drugs that your physician may ask you to discontinue prior to starting the reversibility test. This test is used for the purposes of diagnosing specific respiratory conditions like asthma and chronic obstructive pulmonary disease, and also for following up on response to treatment. This respiratory function test can be performed during the working hours without having to schedule an appointment beforehand. 


Methacholine Bronchial Provocation Test

This test is performed to detect airway hypersensitivity among individuals, whose conditions suggest asthma, yet there is no respiratory function test finding supportive of this diagnosis. Some medications may need to be discontinued. Make sue that you consult your physician prior to the provocation test in this regard. The methacholine bronchial provocation test is performed after scheduling an appointment in advance.


Diffusing Capacity of Lung for Carbon Monoxide (DLCO Test)

DLCO is a test that assesses gas exchange in lungs. It is primarily practiced to diagnose and follow up on some respiratory conditions like interstitial lung disease, and also as a means of preoperative evaluation. A small amount of (0.3%) CO is inhaled during this test to calculate the lungs’ diffusing capacity. Stopping smoking 24 hours in advance is recommended, as it would otherwise increase the presence of CO in alveoli. A blood count may be requested before the test so as to identify the patient’s current hemoglobin level. DLCO test can be performed during the working hours without having to schedule an appointment beforehand.


Pulmonary Volume Measurement by Body Plethysmography

This is a test method for evaluation of lung volumes. Thanks to use of advanced devices, it can be performed within a brief period of time during normal respiration. This test requires scheduling an appointment in advance. 


Intrathoracic Pressure Measurement (MIP, MEP)

This test is performed in case there is a suspected weakness of respiratory muscles or for the purpose of diagnosing and following up on muscular diseases. Maximum inspiration pressure (MIP) is used as an indicator of inspiratory muscle strength and maximum expiration pressure (MEP) as an indicator of strength in abdominal and other expiratory muscles. Intrathoracic pressure measurements can be conducted during working hours without scheduling an appointment beforehand. 


Six-minute Walk Test

A very simple way of evaluating cardiopulmonary and functional capacity, this test displays efficiency of current treatment and prognosis. It basically requires the patient to walk as long as they can on a predetermined path within six minutes without utilizing any specific equipment. Prior to starting and after completion of the test, blood pressure, fingertip oxygen saturation, heart rate and dyspnea parameters are monitored. If deemed necessary, the patient walks under oxygen support. Data collected by the end of the test are compiled into a report. The six-minute walk test can be conducted during working hours without scheduling an appointment beforehand.  


Cardiopulmonary Exercise Test (VO2 Max test)

This test, which enables differential diagnosis of dyspnea and preoperative evaluation of pulmonary and cardiac capacity, is performed on a stationary bike and under standard exercise protocols. It can be required for differential diagnosis of pulmonary diseases, in cases of vascular diseases and their follow-up (pulmonary arterial hypertension), cardiac diseases, muscle diseases, preoperative evaluation and evaluation for incapacity. 

Specific preparations should be made for this test. One is recommended to wear comfortable clothing, avoid smoking and caffeinated beverages, and start fasting two hours in advance. Bringing along all previous respiratory function tests, chest x-rays, tomography scans, lab results, consultations notes and investigation results like ECG and echocardiogram is also recommended. If you are on an inhaler, you should take your dose on time before arriving for the test. Contact your physician and our laboratory, if you are on a beta blocker or calcium channel blocker (heart rate regulators). This test requires an appointment. 


Exhaled Nitric Oxide (FENO) Measurement

FENO is a test procedure that measures non-microbial inflammation in the airways. FENO may be used for COPD and asthma patients and also patients presenting with chronic coughing. It is a simple measurement made by performing a 10-12-second exhalation maneuver. FENO measurement can be conducted during working hours without scheduling an appointment beforehand.
In addition to performing routine laboratory services, our laboratory trains medical faculty students and assistants. 
Respiratory function training courses are also organized in regular intervals prior to and after graduation periods for pulmonology specialists, assistants and laboratory technicians. 
 

Pulmonary Medicine

  • Respiratory function test
  • Preoperative evaluation of respiratory function
  • Cardiopulmonary exercise tests
  • Bronchoscopy
  • Endobronchial ultrasonography (EBUS)
  • Diagnosis and minimally invasive staging of lung cancer
  • Allergy tests
  • Detection and treatment of drug allergies
  • Polygraphic and polysomonographic studies for diagnosing sleep apnea problems
Complaints that patients often present with include:
  • Coughing
  • Sneezing
  • Postnasal drip
  • Dyspnea
  • Wheezing
  • Fatigue without exertion
  • Exertion-induced dyspnea
  • Hemoptysis
  • Chest pain
  • Back and flank pain, fever
  • Inappetence
  • Malaise
  • Weight loss
  • Snoring
  • Daytime somnolence

The following may sporadically be associated with pulmonary conditions too:
  • Hoarseness
  • Dysphagia
  • Shoulder pain
  • Constriction of pupils
  • Dysmorphic changes in nails and digits

Radiation Oncology

The science of radiotherapy consists of planned and controlled use of ionizing beams in regional and predetermined doses. As a treatment method employed in treatment of at least one out of every two cancer patients, radiotherapy is performed for curative, adjuvant, palliative and prophylactic purposes. 

Radiation is produced by LINAC, linear acceleration, devices. Electrons are made to collide with a metal barrier to produce strong X rays called photons. Over a portal capable of moving 360 degrees, photon beams are conducted to the patient on the therapy pad. Each application of radiation is called a ‘fraction’.   

While radiotherapy ensures maximum impact on the tumor, it also aims to preserve healthy tissues around the tumor. Therefore, it requires careful planning, where the first step is simulation. In this process, the immobilization devices that are aimed at keeping the patient stable during treatment are tested. Tomography images are also obtained in the meantime. It may essentially be described as a rehearsal to radiotherapy. Data collected from the simulator allows radiation oncologists to calculate dosage prior to starting treatment.
Radiotherapy is one of the most significant approaches employed in treatment of various diseases, primarily cancer. More than half of all cancer patients receive chemotherapy. Concurrent chemotherapy and radiotherapy are preferred as a reliable and effective route of treatment in some cases.  

It is often chosen as the initial treatment approach especially in cases of lung, prostate, skin, head-neck cancers, early-stage Hodgkin’s disease, non-Hodgkin’s lymphoma and some tumors like cervical cancer. It is also widely used following surgical intervention in breast, endometrium, testis, bladder, thyroid, pancreas and brain cancers.  

Neoadjuvant radiotherapy is quite common in rectum and soft tissue cancers as well.

Pediatric cancer cases are evaluated individually in line with a multidisciplinary approach and guidelines.
A patient receiving radiotherapy may be treated at doses ranging between 20 to 78 Gy (1 Gy = 1 joule of energy absorbed per 1 kg of tissue) in accordance with the diagnosis, staging and purpose. The fact that the x-ray dosage a person is exposed to in a modern mammography device is approximately 1 per 10 thousand of 1 Gy could be a good indicator of the scope of radiotherapy. The total radiation dose is usually delivered in small doses over the course of 5 days in a week.
Physicians, radiotherapy technicians and patient relatives need to stay out of the room during radiotherapy in order to avoid exposure to radiation. Even though the patient is alone in the treatment room, they can be viewed on a monitor located out of the room. An audio system makes it possible to communicate as well.
A patient does not experience any kind of pain while radiation is being delivered to the target. There is actually no physical discomfort aside from mild irritations that may be experienced during brachytherapy practices. Furthermore, any pain that may be secondary to side effects can be communicated to the supervising physician throughout the term of treatment to receive necessary medical support.
Possible side effects of radiotherapy vary in accordance with numerous factors. Our physicians explain possible side effects that might occur during or after treatment to each patient. The majority of such side effects are entirely temporary and subside after treatment. It should also be noted that mitigating medication can be used for all side effects. In this regard, side effects should be conceived as temporary issues experienced almost by everyone, not at all as an indication of adverse course of treatment or disease.

Healthy cells that are within the target area radiotherapy are influenced by treatment too. Furthermore, the actual location and width of the treatment site matters. Side effects tend to be more frequent in wider areas. Daily doses, total doses and medication taken at the same time may modify side effects. Profile of side effects is directly relevant to performance and age status as well as to choice and quality of radiotherapy.   

Side effects on the skin occur in direct proportion to dosage increases and at later stages of treatment. Likewise, likelihood of side effect is higher in thin or creasing tissues where adequate hygiene and aeration may be difficult, such as the armpits, neck, anus and mouth. Initially appearing in the form of mild redness similar to sunburn, these may turn into purulent open wounds. Radiotherapy on the head and neck may impact the teeth, rendering them more prone to decay. This is why regular dentist checks are essential in these cases. As intraoral tissues are more sensitive to radiation, they may form oral sores. This also requires proper oral care. Other common side effects are drying in the mouth and difficulty swallowing because of lower salivary production. 

The patient’s sense of taste might become disrupted and skin sores could emerge during radiotherapy on the neck. Patients are advised to avoid alcohol and smoking while receiving radiotherapy because of their irritant effects. Impacts associated with lower appetite, voice changes, hair loss, difficulty swallowing in radiotherapy applications on the chest, vomiting, nausea, malaise, fatigue, dyspnea and dry coughs can be listed as the most common side effects. Diarrhea is also quite common with radiotherapy targeting the stomach and upper/lower abdomen. Gastric cramps and bloating may be accompanied with nausea, vomiting, low appetite, weight loss and painful urination.
Radiation oncologists draws up a treatment plan specifying the total days of treatment, number of sessions and radiation dose. They are also responsible for detecting and addressing medical problems that could occur during the course of treatment.
Taking into consideration the radiobiological characteristics of healthy and cancerous cells, high-dose radiotherapy is often performed in numerous sessions rather than at once. While this may change depending on the diagnosis, a period of 4 to 8 weeks on average is necessary for treatment. Spreading the process over time in this manner allows the body to dispose of the effects of radiation.

Rheumatology

Our specialized physicians of internal medicine and rheumatology closely collaborate with the departments of physical medicine and orthopedics in order to manage the diagnostic and treatment processes of our patients as optimally as possible.
Musculoskeletal pain, deformation or difficulties are among the most prominent chief complaints presented. Pain in the lower back and joints of the hands and feet are also frequently reported to our department. 
Because numerous other systems may be involved in inflammatory rheumatic diseases, findings might vary quite a bit. 

Among others, fever, weight loss, skin eruptions, edema in extremities, weakness, recurrent abdominal pain and recurrent oral sores could be signs of rheumatic conditions as well.
  • Inpatient ward integrated to the department of internal medicine
  • Outpatient intravenous medical therapies
  • Differential diagnosis via ultrasonography of joints
  • Intraarticular therapies

Smoking Cessation Polyclinic

Nicotine is a highly potent psychological stimulant, so much that it is even more powerful than heroin, cocaine and alcohol when it comes to developing addiction. One out of every 3 people who try smoking for the first time becomes addicted.
 
Once you start smoking, the nicotine that is absorbed through the cheeks reaches the brain within approximately 10 seconds and causes secretion of some hormones by stimulating the center that is also typically stimulated by substances like heroin and cocaine. These hormones give rise to reward-like sensations like enhanced enjoyment, relaxation and boosted concentration, which in turn further increase the craving for nicotine. As your tolerance to these effects builds up over time, the number of cigarettes you smoke increases gradually. At this point, your body has to take in this substance, even if it does not need it. It can be difficult to manage on your own deprivation-induced feelings such as short temper, tension, disrupted concentration, increased appetite and depression.
 
Receiving assistance from our Smoking Cessation Polyclinic makes it easier to overcome these impacts.
Within 20 minutes after quitting smoking, your heart rate and blood pressure normalize. Risk of cardiac arrest decreases on day 1. Senses of taste and smell improve 2 days later. By the time it has been 2 weeks, your blood circulation gets regulated. Three months later, pulmonary functions start improving as well. Risks of cardiac disease and lung cancer decrease by half by the end of 1 year and 10 years, respectively. After 15 years, the risk of cardiac disease becomes equal to that of non-smokers.
Deprivation-specific complaints are most prominent during the initial 3 weeks. The most common symptoms of deprivation are restlessness, short temper, sleeplessness and concentration disorder. Two out of every 3 people who quit experience these symptoms. Support offered by the smoking cessation polyclinic (consultancy, nicotine replacement therapy and medical treatment) mitigates these complaints and improves the level of comfort during the process. Quitting thus becomes easier for you. 

It is quite normal for you to experience difficulties while you are quitting smoking. Please do not despair and keep trying. You can consult our “Smoking Cessation Polyclinic” for assistance with regard to difficulties encountered.
E-cigarettes and IQOS products, which heat tobacco instead of burning it, are among the top marketing items and the most recent products of the tobacco industry that primarily target the young population. These products are typically introduced as “less harmful” for the purpose of resuming smoking addiction by replacing tobacco products, which have been proven to have harmful impacts on health. However, these products should not be considered as alternatives for quitting smoking. It should be noted that e-cigarettes also contain carcinogenic and volatile organic components, and cause addiction by imitating the visual aspect and behavior of smoking.

Stem Cell Transplantation Unity

Our unit serves patients diagnosed with hematological malignancies (such as acute leukemia, lymphoma and myeloma) as well as those who are diagnosed with benign hematological conditions (such as aplastic anemia and thalassemia cases). Patients diagnosed with other conditions like testicular cancer may be referred to our department by medical oncologists as well.
Internal medicine and hematology specialists serve under our unit.
 

Thoracic Surgery

The department of Thoracic Surgery is a clinic capable of responding to all complaints that may directly or indirectly be relevant to the thoracic surgery discipline; and provides long-term follow-up services to patients beyond diagnosis and treatment.
  • Robotic and thoracoscopic surgery
  • Pulmonary malignancies
  • Surgeries on pleura, thoracic wall and diaphragm
  • Esophageal malignancies
  • Mediastinal masses
  • Multidisciplinary treatment of thoracic malignancies: Robotic/thoracoscopic and open surgery, oncology council, chemo/radiotherapy, immunotherapy
  • Surgical treatment of thoracic deformities 
  • Pneumothorax surgery
  • Diagnostic minimally invasive and open surgical approaches
  • Regional hyperhidrosis therapy
  • Treatment of blunt or penetrating chest trauma

Undersea and Hyperbaric Medicine

Diseases treated by means of HBOT include diabetes, bone infections, vascular occlusion and conditions that require oxygen for healing, such as burns and lesions that may result from radiotherapy. Various other conditions and diseases like sudden hearing loss, sudden compromised vision due to occlusion of optic vessels and decompression disease -which is also known as nitrogen narcosis and occurs as a result of rapidly changing pressure while diving- are also treated with hyperbaric oxygen therapy. Patients experiencing sudden hearing or vision loss, bone narcosis, small nonhealing wounds, carbon monoxide poisoning and diseases associated with diving should consult for hyperbaric oxygen therapy.

Urology

  • Uro-oncology and prostate diseases
  • Andrology conditions
  • Calculi of the urinary system
  • Pediatric urology cases
  • Functional urology, female urology, neuro-urology and reconstructive urology cases
  • Renal transplantation as part of the organ transplantation department 
  • Urination difficulties or frequent urination secondary to prostate diseases
  • Urinary incontinence secondary to bladder and prostate diseases 
  • Hematuria secondary to bladder, kidney and prostate diseases
  • Pain and hematuria associated with calculi in kidneys and urinary tracts
  • Burning sensation during urination, hematuria and fever associated with urinary tract infections
  • Male infertility
  • Male sexual dysfunction
  • Urinary incontinence
  • Urinary disorders (difficulty voiding the bladder)
  • Frequent urination, urinary urgency and accompanying urinary incontinence (hyperactive bladder)
  • Uterine and bladder prolapse
  • Chronic pelvic pain (bladder pain)
  • Sexual dysphoria
  • Congenital vaginal agenesis
  • Renal dilatations and urinary tract disorders among childhoods and diagnosed during pregnancy
  • Urinary incontinence among children
  • Urinary tract infections among children
  • Hypospadias
  • Bladder exstrophy
  • Epispadias
  • Inguinal hernia among children
  • Hydrocele
  • Undescended testis

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