General and visceral surgery

General and visceral surgery deals with the surgical treatment of diseases and injuries of the internal organs. Depending on the specialty, this can include diseases of the hormone-producing glands such as the thyroid (goitre), the oesophagus, the gastrointestinal tract, the liver, the pancreas and the bile ducts. Surgical proctology and coloproctology also frequently fall under general and visceral surgery.

Relevance of neuromonitoring for general and visceral surgery

During general surgery, motor and sensory nerves often traverse the operation site and are therefore at risk of being affected. Neuromonitoring can be used to minimise the risk of vocal cord paresis due to mechanical manipulation during thyroid resection. Thanks to the use of intraoperative neuromonitoring, the incidence of vocal cord paresis during thyroid surgery is less than one percent. Neuromonitoring can also offer legal protection.

Around 200 million people worldwide are affected by goitre.^[1] At around 90 percent, the most common cause of goitre is still diet-related iodine deficiency.

Apart from thyroid diseases, intraoperative neuromonitoring is also becoming increasingly important in surgical proctology. During total mesorectal excision (resection of colorectal cancer) for example, pelvic intraoperative neuromonitoring plays an increasingly important role in safeguarding the patient’s quality of life following these surgeries.

References

1. Hotze, A. & Schumm-Draeger P. Schilddrüsenkrankheiten, Diagnose und Therapie, p. 149 (2003).

Hörmann R. Schilddrüsenkrankheiten, Leitfaden für Praxis und Klinik (2005).

Operative Therapie benigner Schilddrüsenerkrankungen. Available at: http://www.awmf.org/leitlinien/detail/ll/088-007.html. (Last accessed on: 6 November 2025).

Dralle et al. „Intraoperatives Neuromonitoring in der Schilddrüsenchirurgie: Empfehlungen der Chirurgischen Arbeitsgemeinschaft Endokrinologie“, Der Chirurg 84, No. 12 (2013).

Oexmann und M. Wienzek, „Medizinrecht: Diagnostik und Therapie der Schilddrüsenerkrankung; Komplikationen bei der Schilddrüsenoperation (Strumaresektion/Strumektomie): Recurrensparese (Stimmbandlähmung) und Stridor in der Artzhaftung“, (2006).