Humanitas
Research Hospital

The Department of Colorectal Surgery focuses on the diagnosis and treatment of colon and rectal cancer (including hereditary tumors), chronic inflammatory bowel disease (Crohn’s disease and ulcerative colitis), complicated diverticular disease, functional disorders, and proctological diseases.

To ensure optimal patient outcomes, the team employs cutting-edge, minimally invasive surgical techniques, such as traditional and single access “single port” laparoscopy and robotic procedures for treating lower digestive tract disorders. For instance, they use trans-anal approaches like Trans-anal Minimally Invasive Surgery (TAMIS) or Trans-anal Total Mesorectal Excision (TaTME) for the removal of large polyps and certain rectal cancers, reducing surgical invasiveness significantly.

With a patient-centric approach, the Department follows personalized post-operative clinical pathways, aiming to minimize the surgery’s impact and expedite recovery as well as resumption of normal activities. Specialized nurses are involved in advanced wound therapeutics and stoma management during the post-operative period to ensure comprehensive care.

The Department maintains close collaboration with other Humanitas departments, including Oncology, Endoscopy, Gastroenterology Hepatobiliary Surgery, Radiology, Radiotherapy, and Pathological Anatomy, offering a comprehensive multidisciplinary approach for patients with tumors. They work particularly closely with the Humanitas Centre for the Study and Treatment of Inflammatory Bowel Disease, for integrated and multidisciplinary care. Additionally, the Department has dedicated sub-teams, including one specifically for patients with Ileal Pouch-Anal Anastomosis after restorative proctocolectomy. Collaborations with the Gynecology Department for combined treatment of deep pelvic endometriosis are also part of their expertise.

Apart from their clinical activities, the Department actively engages in clinical research, exploring new technologies and advancements for colorectal surgery. Collaborations with several laboratories for basic scientific research delve into the molecular basis of intestinal diseases.

Moreover, the Department has initiated an innovative project for International Clinical Fellowships in Colorectal Surgery and maintains strong connections with major international centers of reference.

The Department of Otorhinolaryngology provides care for over 10,000 patients annually. Their comprehensive scope of work covers all sub-specialties within ENT, encompassing both diagnostic and therapeutic aspects.

Employing cutting-edge equipment such as lasers, microdebriders, and intra-operative monitoring of cranial nerves, the surgeons can perform various complex procedures. This includes otologic and otoneurologic microsurgery for chronic otitis, cholesteatoma, otosclerosis, acoustic neuroma, vertigo surgery, cochlear implants in adults, and semi-implantable digital prostheses.

The Department utilizes advanced technology for functional endoscopic surgery of the nose and paranasal sinuses and also employs micro-endoscopic surgery for juvenile fibrosarcoma and anterior cranial base conditions (CSF fistulas, neoplasms, etc.), as well as microscopic surgery for the lateral cranial base and salivary gland procedures.

Furthermore, the department’s expertise extends to oncological surgery, focusing on head and neck tumors after careful, multi-disciplinary patient assessment. Collaborations with the School of ENT Specialization at the University of Pavia and the Faculty of Medicine at the University of Insubria further enhance the Department’s capabilities.

The Department of Chronic Inflammatory Bowel Diseases is dedicated to delivering innovative care and advanced treatment strategies for patients with ulcerative colitis and Crohn’s disease, based on the latest scientific evidence. Handling over 3,800 patients annually, the department adopts a multidisciplinary approach, enlisting the expertise of specialists and professionals in the field, while staying abreast of the latest medical technology developments. Their primary objective is to provide each patient with a personalized and comprehensive program for diagnosis and treatment.

Recently, the Center’s accomplishments underwent an objective assessment by the British branch of KPMG, responsible for monitoring the quality of referral centers. In May-June 2014, the department, along with seven other Chronic Inflammatory Bowel Diseases centers across Europe and Canada, was recognized as a model of global excellence in overall quality of care. Distinguished by its inclusion of a psychologist specializing in chronic inflammatory bowel diseases, the Center prioritizes patients’ overall wellbeing, extending beyond pure medical treatment.

The Center boasts state-of-the-art diagnostic tools and procedures, enabling early diagnosis and continuous monitoring through endoscopic and radiological tests.

Complementing their clinical activities, the Center actively engages in research and the development of effective therapies for ulcerative colitis and Crohn’s disease. The Humanitas laboratory conducts basic research across various aspects of these conditions, striving to understand the molecular mechanisms underlying them.

Collaborating with major referral centers worldwide, the Center participates in numerous scientific research projects and contributes to the formulation of international guidelines on the clinical management of chronic inflammatory bowel diseases.

In particular, the Center maintains a close daily collaboration with the Humanitas Department of Colorectal Surgery. This partnership facilitates the performance of specialized surgeries for chronic inflammatory bowel diseases, utilizing laparoscopic approaches and cutting-edge postoperative protocols to optimize patients’ recovery. 

The primary objective of the Department of Medical Oncology and Hematology is to provide high-quality diagnostics and treatment for  various cancerous and hematological diseases, providing care to over 16,000 patients annually.

Their extensive research efforts concentrate on developing innovative treatments, particularly for high-incidence tumors such as breast cancer, lung cancer, and gastroenterological cancer, aiming to address these “big killers” effectively.

The department comprises four specialized sections:

1. The Center for the development and application of biological therapies in oncology focuses on experimental therapies, including anti-EGF (Iressa) for lung cancers, gastrointestinal cancers, and low malignancy sarcomas. Additionally, they work on anti-angiogenic therapies for lung cancer, biological medicines for prostate and kidney tumors, and monoclonal antibody therapies for lymphomas, breast cancer, and lung cancer.

2. The Center for diagnostics and treatment of hematological neoplasms specializes in non-Hodgkin’s lymphoma, Hodgkin’s disease, acute and chronic leukemia, and multiple myeloma.

3. The Center for high-dose therapy explores innovative ways of applying anti-cancer drug dosages in myeloablative therapy with autologous stem cell support. They also conduct a program for allogeneic bone marrow transplantation with non-myeloablative therapy.

4. The Center for diagnostics and treatment of sarcomas and rare cancers manages clinical trials for neoplastic diseases like rare soft tissue sarcomas, mesotheliomas, thymomas, medullary thyroid carcinomas, and skin rashes. Their focus lies in evaluating the effectiveness of new therapeutic strategies, chemotherapy combinations, and new drugs for these diseases.

The Department conducts various types of stem cell transplants, including adult-to-adult transplants, umbilical cord blood transplants, and haploidentical stem cell transplants.

The Department of Hepatobiliary Surgery, conducts more than hundreds of operations annually for primary liver tumors and liver metastases from colon tumors. Surgery remains the preferred treatment option for these patients, complemented by advances in medical and radiotherapy practices.

A highly specialized multidisciplinary team, consisting of hepatologists, oncologists, radiologists, interventional radiologists, radiotherapists, nuclear medicine physicians, anatomical pathologists, and specialized nurses, has been effectively treating hepatobiliary conditions for years, often achieving complete remission of liver cancer.

Liver surgery is a complex field, rapidly evolving into a separate specialty. While the liver can regenerate, removing a significant portion or performing incorrect resections can lead to its failure. Therefore, the surgeon’s expertise and guidance tools, such as ultrasonography, are crucial for successful operations. The Humanitas Department of Hepatobiliary Surgery has emerged as a global leader by adopting novel surgical techniques that conserve healthy liver tissue, making surgery feasible for patients who were once deemed inoperable. The department’s techniques have reduced mortality and complication risks to an exceptional 1%, making it the safest approach worldwide.

As an international benchmark for advanced liver operations, the Department of Hepatobiliary Surgery shares its knowledge and new techniques among surgeons through annual courses attended by specialists from around the globe. Additionally, the department leads numerous clinical studies aimed at refining surgical methodologies, with participation from esteemed foreign centers worldwide. These include the University of Tokyo, Juntendo University (Tokyo), Nihon University (Tokyo), the University of Paris, the MD Anderson Cancer Center in Houston, John Hopkins Medical School in Baltimore, and the Italian Hospital in Buenos Aires.

The Department of Neurosurgery and Oncology specializes in the surgical treatment of various tumors affecting the central nervous system, including intrinsic, extrinsic, primary, and metastatic tumors. In addition to brain tumors, the Unit also addresses brain lesions associated with drug-resistant epilepsy.

The Department’s expertise lies in the treatment of intrinsic tumors, particularly low-grade malignancy gliomas, making it a recognized reference point for national, European, and international treatment standards. Each year, the skilled surgeons of the Department treat more than 1,500 patients.

Their treatment approach is founded on the concept of functional neuro-oncology, where surgical resection is determined based on functional limitations. This involves considering the brain’s cortical and subcortical functional areas and connections. Through brain mapping and monitoring, extensive removal of brain tumors located in critical areas can be achieved while preserving the patient’s functional integrity.

The methodology relies on studying each patient’s unique brain functioning preoperatively and intraoperatively using neuropsychology, advanced imaging techniques like functional resonance (fMRI), tractography, DTI, and intraoperative PET scans. 

Neuropsychology provides valuable information about the operation and organization of various functional networks within the brain, and this is complemented by imaging methods’ findings.

During surgery, functions such as motor, language, visual, visuospatial, and cognitive abilities are identified using intraoperative neurophysiology while the patient is awake. This, combined with intraoperative imaging methods, allows the surgeon to achieve extensive surgical resection, going beyond the visible tumor edges in resonance images (supratotal resection) to ensure successful long-term control of the disease.

The success of this approach relies on the collaboration of expert surgeons in neuro-oncology, functional neurophysiologists, neuropsychologists, and experienced anesthesiologists specializing in brain mapping techniques. Department is a world leader in using these methods for tumor resection and lesions related to epilepsy, including metastatic tumors, extrinsic tumors (meningiomas), and vascular lesions like cavernous angioma.

The Department’s efforts are integrated with the neuro-oncology unit at the Cancer Center, following a multidisciplinary treatment approach. This involves a team of experts, including neurosurgeons, radiotherapists, oncologists, neuro-oncologists, neurologists, neuroradiologists, nuclear medicine physicians, and neuropathologists. The multidisciplinary approach enhances treatment effectiveness and safety, with personalized treatment paths for each patient based on the type of cancer, surgical requirements, age, and neurological clinical performance.

The Department of Oesophago-gastric Surgery is dedicated to providing surgical treatment for patients dealing with functional and cancerous conditions affecting the esophagus and stomach. This includes reflux disorder (with complications like Barrett’s esophagus), achalasia, pharyngeal-esophageal diverticulum (Zenker), epiphrenic diverticulum, as well as benign and malignant tumors of the esophagus and stomach, such as leiomyoma, GIST, adenocarcinomas, squamous tumors, and rare tumors.

At Humanitas, the preference is for minimally invasive surgery for all treatments, following international guidelines and promoting this approach globally.

Among the resective surgeries performed, esophagectomy and gastrectomy are two of the most complex procedures, necessitating coordinated multidisciplinary collaboration in perioperative management (before, during, and after surgery). To ensure the best treatment outcomes, a specialized team at Humanitas comprises surgeons, anesthesiologists, physical therapists, dietitians, nutritionists, oncologists, radiotherapists, anatomical pathologists, radiologists, endoscopists, and gastroenterologists. This cohesive team collaborates to determine the most suitable treatment plans for each patient.

The department actively engages with other units at the Cancer Center through weekly multidisciplinary meetings. These gatherings aim to define optimal treatment strategies for patients with both benign and malignant tumors, enhancing patient care and improving treatment outcomes.

The Pancreatic Surgery Department possesses extensive experience in managing pancreatic and duodenal diseases. Due to the relative rarity and intricacy of pancreatic disorders and tumors, specialized expertise and a dedicated team are essential for effective treatment.

Collaboration with other specialized departments at Humanitas, including Gastroenterology, Endoscopy, Oncology, Radiotherapy, Radiology, Nuclear medicine, Diabetology, Endocrinology, and Anatomical Pathology, ensures access to the latest medical expertise and technology for diagnosing, treating, and researching these conditions.

The team also collaborates with several Italian and foreign scientific centers, such as the Karolinska in Stockholm and Dublin St. Vincent Hospital, to expand clinical knowledge, particularly concerning the biological, metabolic, and immune classification of pancreatic tumors for more effective therapies.

Pancreatic surgery ranks among the most complex abdominal surgical procedures and carries inherent risks. The Pancreatic Surgery Unit at Humanitas Research Hospital is skilled in both standard pancreatic resections and atypical operations, preserving the pancreatic parenchyma in cases of benign or low-grade malignant tumors.

While the majority of operations necessitate “traditional” surgery with a classic abdominal wall incision due to the technical challenges involved, in certain cases, a laparoscopic approach can be employed. This minimally invasive technique offers benefits such as reduced post-operative pain and equivalent treatment effectiveness.

The Pancreatic Surgery Unit also places significant emphasis on perioperative management, including pain management, mobilization, and nutrition. They adopt enhanced recovery programs in close collaboration with anesthetists and specialized nurses, contributing to improved patient outcomes and overall care.

The Radiotherapy Department covers an area of approximately 1,000 square meters and houses five state-of-the-art rooms equipped with the latest generation of linear accelerators, such as EDGE and TrueBeam. Annually, the team treats over 6,000 patients.

The EDGE system is a cutting-edge technology employed to treat primary tumors, metastases in the brain and liver, early-stage lung tumors, and prostate tumors through stereotactic radiation therapy and radiosurgery. It delivers precise radiation beams in short durations, protecting healthy tissues and enhancing the patient experience. Humanitas was among the first three hospitals globally to adopt this advanced system.

True Beam is an innovative linear accelerator that enables doctors to administer highly targeted and potent doses of radiation in a matter of seconds. This system facilitates treatments that were previously not possible and extends the range of curable tumors, making it a groundbreaking approach for patients with abdominal metastases and inoperable tumors in the liver, pancreas, and lungs.

Apart from utilizing advanced linear accelerators, the Unit incorporates various state-of-the-art supporting technologies, including:

• OBI System (On-board imaging system), which includes an X-ray tube and an amorphous silicon detector integrated with the accelerator.
• Software tools for care plan development, featuring modules for Stereotactic Radiosurgery and intensity-modulated radiation therapy (IMRT).
• Software for image fusion from different imaging techniques (MRI / PET / CT).
• RPM (respiratory Gating): Respiratory-synchronized imaging and treatment, employing a system of infrared cameras to monitor the patient’s breathing and deliver doses only during the pre-selected phase by the physician.
• Virtual simulation, consisting of TAC and a dedicated system of three mobile lasers.
• RapidArc and Optimized Intensity Modulated Arc Therapy.
• Cone Beam Computed Tomography (CBCT) software for a complete CT scan directly at the accelerator, facilitating precise patient positioning and verification.

The utilization of these advanced technologies ensures high therapeutic effectiveness while minimizing side effects, thanks to more accurate localization and targeting of the treatment areas.

Beyond treatment optimization and quality, the Radiotherapy team strives to enhance patient comfort within the treatment rooms and waiting area. They achieve this by incorporating natural light, wood, and uplifting colors into the spaces.

The Department of Sarcoma, Melanoma, and Rare Tumor Surgery is dedicated to addressing neoplastic pathologies that can be treated through surgical means. Annually, the team provides care for over 1.500 patients.

The Department focuses on several key areas, including sarcoma and melanoma surgery, endocrine surgery, peritoneal surgery, and complex digestive system surgery. To ensure comprehensive patient care, the Department collaborates closely with Humanitas Oncology and Radiotherapy departments, offering beneficial pre- and post-operative treatments.

The Department’s extensive experience with a wide range of cases has earned it a reputation as a prominent national and international surgical referral center for sarcomas. Given the complex nature of sarcomas and their location, collaboration with specialists from other disciplines, including plastic, vascular, and thoracic surgery, is often required to achieve complete tumor removal while preserving the functionality of affected areas.

Notably, working closely with Humanitas Neurosurgery department enables the surgical team to manage lumbar-sacral paravertebral tumors using advanced multidisciplinary approaches. Additionally, their continuous collaboration with the Oncological Orthopedics department at the Orthopedic Institute “G. Pini” allows them to handle delicate conditions like primitive bone tumors that necessitate complex pelvis resections.

In the realm of digestive and abdominal pathology, the Department boasts considerable expertise in treating peritoneum tumors, gastric tumors, advanced abdominal and pelvic neoplasms with involvement of multiple organs, and Gastrointestinal Stromal Tumors (GIST). The Department houses the Peritoneum Malignant Tumor Program, which is dedicated to treating primary (mesothelioma, pseudomyxomas) and metastatic (from colorectal cancer, ovaries) tumors of the peritoneum. Addressing these pathologies requires intricate and prolonged surgical interventions, sometimes involving simultaneous removal of multiple organs, and may involve intraoperative intraabdominal perfusion of chemotherapy drugs at elevated temperatures (chemo-hyperthermia).

Melanoma, another area of focus for the Department, receives a comprehensive range of treatments based on disease staging, such as radicalization operations, sentinel lymph node biopsy, axillary and inguinal-iliac-obturator lymphadenectomy, and metastasectomies. A multidisciplinary team, comprising specialists from Humanitas Departments of Oncology, Dermatology, and Plastic surgery, collaboratively determines the most suitable personalized treatment for each melanoma patient.

Moreover, the Department conducts thyroid and parathyroid surgery using minimally invasive techniques, including intraoperative determination of PTH and intraoperative monitoring of the recurrent laryngeal nerve to promptly detect any functional changes in the vocal cords and minimize the risk of post-operative dysphonia. Collaborating with the Department of Interventional Radiology, the team also performs thermoablation of thyroid nodules and lymph node metastases, offering treatment options where none were available before. 

The Department has developed protocols, in conjunction with the Department of Anesthesia, to reduce post-operative nausea and vomiting using acupuncture and natural medicine techniques. Furthermore, the Department is committed to implementing fast track pre-operative protocols designed to decrease patient stress by reducing postoperative pain and fasting times, encouraging early mobilization, and shortening hospital stays.

In terms of clinical research, the Department actively contributes to peer-reviewed publications, focusing on surgical treatments for sarcomas and gastric tumors, as well as peritoneum and thyroid surgeries, as evidenced by numerous publications in international scientific journals. Their research is integrated into clinical practice, offering patients the opportunity to participate in international multi-center experimental treatment protocols. The specialists also engage in studying the bio-molecular aspects of malignancies through scientific collaborations with various basic and translational research groups.

The Department of Sarcoma, Melanoma, and Rare Tumor Surgery is affiliated with several prominent clinical-scientific groups, including the Italian Sarcomas Group (ISG), the Trans-Atlantic Retroperitoneal Sarcoma Working Group (TARPSWG), the Italian Group for Gastric Cancer Research (GIRCG), the Inter-group Italian Melanoma (IMI), and the Club of Endocrine Surgery Units (UEC). These groups serve as forums that bring together major specialized centers and doctors in their respective areas.

Lastly, the Department’s specialists play a crucial role in teaching at the Faculty of Medicine of Humanitas University and the International Medical School of the University of Milan, as well as at the General Surgery Specialization Schools of the same universities.

The Department of Thoracic Surgery covers a wide range of thoracic surgical areas, with a primary focus on addressing primary tumors and lung metastases. The unit prides itself on adopting innovative surgical techniques and adhering to modern guidelines for both diagnostic and treatment procedures. Additionally, it maintains a close collaboration with the Operating Unit of Medical Oncology and Radiotherapy.

The specific responsibilities of the Department of Thoracic Surgery include:

• Surgical treatment of benign and malignant mediastinal tumors, whenever possible using a minimally invasive approach. Thymectomy for Myasthenia Gravis is performed through videothoracoscopy.
• Videothoracoscopy and minimally invasive procedures to address diagnostic needs in thoracic oncology and treat benign tumors of the lungs, mediastinum, and esophagus. Pulmonary lobectomy is conducted for primitive malignant or benign tumors.
• Videothoracoscopy for thoracic sympathectomy, addressing conditions like palmar hyperhidrosis and Raynaud’s syndrome.
• Videothoracoscopy for spontaneous pneumothorax, often coupled with a partial pleurectomy to reduce the risk of recurrence.
• The treatment of advanced stage lung cancer (N2) after induction of chemotherapy and radiotherapy, with Humanitas ranking among the top ten specialized centers in Italy.
• The treatment of lung cancer (T4) that extends to large vessels, the trachea, the chest wall, and the spine, using modern reconstruction techniques. The Operating Unit stands at the forefront nationally and internationally for surgical treatment of spinal tumors.
• Thoracic endoscopy with the use of a rigid endoscope to unblock obstructed airways of the bronchial tubes or trachea.
• Bronchoscopy for foreign body removal from the airways.
• Esophageal surgery combined with Cervical Laparoscopy and Thoracotomy, utilizing minimally invasive anterior thoracotomy for faster functional recovery (“muscle-sparing” approach).
• Corrective surgery for chest wall deformities, with a traditional approach, and in select cases, a minimally invasive technique for correction.
• Surgical treatment of lung metastases, employing the most modern techniques, including laser, for complete removal whenever feasible.

The Humanitas Thoracic team adopts a novel approach known as robotically-assisted surgery, which enhances precision during operations. The team has been early adopters of the Da Vinci surgical system for lung and mediastinal surgery and has contributed to its widespread use in Italy and Europe.

Collaboration with the Department of Rehabilitation ensures that patients receive appropriate postoperative recovery support in a suitable environment.

Regarding research, the Department concentrates on molecular biology and early detection of lung cancer. Collaborating with the National Cancer Institute (NCI-USA), the team conducted a study on the Genetic Epidemiology of Lung Cancer (GELCS). Other molecular biology studies are ongoing with the Department of Experimental Oncology at the Cancer Institute of Milan.

The Department of Urology focuses on the prevention, diagnosis, and treatment of conditions affecting the urinary tract and male reproductive system, demonstrating remarkable expertise and conducting over thousands of operations each year.

Emphasizing modern technologies and minimally invasive techniques, the team effectively manages a wide range of urological diseases, including urogenital cancers, benign prostatic hyperplasia, bladder stones, nodular adrenal disease, pelvic joint stenosis, urinary incontinence, and urethral pathologies.

The Department has acquired extensive experience in minimally invasive laparoscopic and robotic surgeries for urogenital cancer treatment, kidney stones, and urinary incontinence. They excel in focal therapy for renal cell carcinoma and prostate cancer, preserving tissues and organ functions while targeting specific tumor-affected areas.

Internationally recognized for their groundbreaking contributions, the team has achieved numerous milestones. Notably, they conducted the first laparoscopic adrenal gland removal in Europe, the first laparoscopic prostate gland removal in Italy, the first laparoscopic cryoablation for a renal tumor, the first brachytherapy intervention for prostate cancer, the first laparoscopic seminal-sparing cystectomy for bladder cancer, and the world’s first laparoscopic robotic pyeloplasty using the new platform “Single Site.”

Furthermore, the Department excels in the application of Holmium laser enucleation of the prostate (HoLEP) technique for benign prostatic hypertrophy treatment. This approach efficiently resolves obstruction, even in enlarged prostates, while minimizing blood loss, pain, and postoperative hospitalization duration.

Additionally, the team skillfully performs diagnostic procedures such as prostate biopsies, employing image fusion techniques with MRI and ultrasound for precise targeting.