ENDOPROSTHETICSORTHOPAEDICS/ VISCERAL MEDICINE

ASKLEPIOS NEWSLETTER Issue 2/2018

Photo: © Monkey Business/Fotolia.com

Dear Readers, Asklepios as a clinic operator

Not only is eating one of the vital functions by the Medical Travel Quality Alliance. The Asklepios is one of the largest operators of of the human body, but it also brings jury named the clinic “excellent for medical private clinics and healthcare facilities in pleasure. This often means gastro-intestinal tourists”, not only a tremendous success . Founded more than 30 years ago, diseases impact quality of life all the more. in the competition with other providers the chain of clinics follows a responsible Whether digestive tract tumours, chronic from around the world, but also shows the and sustainable strategy geared towards a inflammatory illnesses or other health extent to which our clinics focus on foreign high level of safety and quality. The group issues of these internal organs: In the patients. currently has more than 160 healthcare Asklepios clinics, our experts offer effective facilities spread across Germany between and gentle treatments. As always, several the Island of Sylt on the North Sea and examples from our hospitals will show this. Wishing you the best of Health! Lindau by Lake Constance and employs more than 47,000 employees. In the 2017 One of these is the Asklepios Klinik Regards fiscal year, Asklepios treated around 2.3 Barmbek in . I mention this million patients. location, because Barmbek has received Dr. Thomas Wolfram the accolade of the “World´s Best Hospital Chair Group Management Asklepios Klinik Medical quality management at the for Medical Tourists” for the second time GmbH & Co. KGaA highest level is an area in which Asklepios particularly excels. The clinic operators benefit from the group’s structure to promote knowledge transfer between the facilities and to provide particularly excellent treatment. The results are also published regularly. For instance, the Medical Findings Report is published annually at www.qualitätskliniken.de of which Asklepios is a charter member. Moreover, 25 criteria on patient safety are published regularly on the internet. Photo: © Udo Kroener/Fotolia.com

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VISCERAL MEDICINE

Keyhole surgery at the highest level

The GastroClinic of Asklepios Klinik Altona in Hamburg looks back on a long tradition of cross-functional links between visceral surgery and gastroenterology. Here, surgeons and registrars decide together which therapy is likely to provide the best possible result with the lowest stress on the body. Sub- sequently, the GastroClinic offers the patient minimally invasive therapy, whether surgical or endoscopic, explains Professor Gero Puhl, Chief Physician of the department for General, Visceral and Vascular Surgery. For this, the expert has access to a special intervention and operation area, which is specially equipped for minimally invasive therapy processes. The core element is the fully-integrated high-tech endoscopy operating theatre EndoAlpha with networked high-performance optical equipment and HD mini cameras at the tip of an extremely thin endoscope. Only very few clinics in With the da Vinci Xi surgical robot, the Minimally invasive operations in the Germany have equipment like this. It allows Asklepios Klinik Altona is the only clinic Asklepios Klinik Altona a particularly high quality and safety level. in northern Germany to have the world’s most modern system for robot-assisted ▪ Abdominal tumours While the clinic’s gastroenterologists carry interventions. It provides the surgeons a ▪ Benign and malignant diseases of out their endoscopic procedures through particularly good overview of the operating the digestive tract and stomach natural body openings, for example com- area and unique freedom of movement ▪ Benign and malignant diseases of pletely removing early forms of tumours for their instruments. Puhl uses the robot the colon and rectum in digestive tract, stomach or intestines, for example for complex anatomical ▪ Benign and malignant diseases of Puhl and his team or surgeons guide their conditions and for special interventions the pancreas instruments through several small incisions which would otherwise require an open ▪ Chronic inflammatory bowel in the abdominal wall. “We can do around operation, therefore stressing the patient diseases 75 percent of all operations in this gentle more. ▪ Liver tumours and cysts, portal vein manner”, Puhl reports. As well as standard hypertension operations for the therapy of hernias, The advantages of minimally invasive ▪ Groin and abdominal hernias gallstones or colonopathies, major cancer surgery are enormous, according to Puhl: ▪ Gall bladder and bile ducts operations on digestive tract, stomach, liver, “The minimisation of access trauma means ▪ Thyroid gland, parathyroid and pancreas and rectum are part of the range faster recovery for the patient after the adrenal glands of minimally invasive procedures carried operation, lower requirement for pain relief, out by his team. The clinic has special a lower complication rate, faster food intake, expertise in minimally invasive operations faster regeneration of intestinal function Contact: for digestive tract and rectal cancer. and a shorter stay in hospital.” Professor Gero Puhl Patients come from far away for these Chief Physician of the Department for interventions to be operated on by the General, Visceral and Vascular Surgery specialists at the Asklepios Klinik Altona. (GastroClinic) Resections of the liver and pancreas are Asklepios Klinik Altona also often performed in a minimally invasive Paul-Ehrlich-Straße 1 ▪ 22763 Hamburg manner here, and colon operations even Tel.: +49 (0) 40 18 18 81-16 01 ▪ Fax: -49 07 virtually in 100 percent of cases. www.asklepios.com/hamburg/altona/ experts/general surgery

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VISCERAL MEDICINE

Chronic inflammatory “We are a member of the Germany-wide country, with whom she works together on a centre of excellence ‘Inflammation at scientific level. bowel diseases (CED) interfaces’, which is sponsored by the under control Federal Ministry for Research”, explains A decisive factor in the selection of the Kühbacher regarding the special importance appropriate therapy is thorough diagnostics, of his outpatient clinic. “This allows us to which should be done as early as possible The chronic inflammatory bowel conditions offer everything which is available globally in the course of the illness. “Here in the (CED) Morbus Crohn and Colitis Ulcerosa in terms of therapies or therapy studies.” Westklinikum we have all possibilities are so complex and different from patient This is particularly important for patients for diagnostics, from capsule endoscopy to patient, that therapy for those conditions where the usual approved treatments are through to lung function tests, endoscopy provides a major challenge for the doctors not suitable. In the Westklinikum, they and magnetic resonance tomography, even treating them. Even though the technical can benefit from therapies which are still ecotrophology.”, explains Kühbacher. For and molecular genetic possibilities available in the approval process or in clinical trials. the comprehensive diagnostics of a chronic today have brought many new insights “Generally that is not possible elsewhere”, inflammatory bowel disease, Kühbacher’s and treatment approaches, these illnesses according to Kühbacher: “We treat many team of specialists generally need a week. It remain incurable. But nevertheless, the patients from overseas, especially from may take longer however until the therapies modern therapies can enormously improve Russia and the USA, who come here take effect: “We can offer the approach the quality of life of the affected patient. regularly for particular therapies.” via the university outpatient hospital, The more sophisticated and targeted the but also as an outpatient.” Only patients treatment processes become, the greater Not all medicines need to be administered with a chronically active disease require the importance of science and experience locally in the outpatient department, permanent therapy. This affects roughly of the treating doctors becomes in the emphasises Kühbacher: “We can also 50 percent of the patients, the other half selection of the correct medications and the prescribe many active ingredients as do not need to be treated the whole time, monitoring of the therapy. subcutaneous injections, and in the future explains Kühbacher. For this reason, early even as tablets with the same effectiveness comprehensive diagnostics is so important. Professor Tanja Kühbacher is one of the as the biologicals, and then check the most renowned national and international therapy progress every 3 to 4 months.” A further speciality of the Westklinikum is specialists for chronic inflammatory During these checkup appointments on the large department for Psychosomatic intestinal diseases. In order to use site, the therapies are then adjusted based Medicine, according to Kühbacher: “With this expertise in the optimum manner, on the current infection stage, and the chronic illnesses, the whole person is the university outpatient department necessary investigations scheduled for important, and not just individual organs.” for specialised gastroenterology of the the ongoing treatment. If participation in In addition, these illnesses can also affect Schleswig-Holstein University Hospital is a therapeutic study would be beneficial, other organs outside the digestive system, located in the Gastroenterology Department Kühbacher also puts international patients such as eyes, joints, liver or skin. For this in the Asklepios Westklinikum Hamburg. in touch with specialists in their home reason, the cross-functional cooperation of the experts in the Westklinikum is also major factor in the success of the treatments.

Contact: Professor Tanja Kühbacher Chief Physician Gastroenterology Asklepios Westklinikum Hamburg University outpatient department of the UKSH at Asklepios Westklinikum Suurheid 20 22559 Hamburg Tel.: +49 (0) 40 81 91-27 53 Fax: +49 (0) 40 81 91-27 99 www.asklepios.com/hamburg/westklinikum/ experten/gastroenterologie

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VISCERAL MEDICINE

Endoscopic therapy of early-diagnosed stomach and bowel tumours

We have the large advances in endoscope technology to thank for the fact that malignant changes in the digestive tract, in the stomach, in the duodenum and the colon are found more and more frequently at an early stage, when they have not yet extended deep into the organ wall. And the Barrett early carcinoma in the distal oesophagus Marking of the resection edges with safety margins to the tumour modern endoscopes make it possible to remove these pre-tumours or early tumours in a particularly gentle manner – as part of a stomach or colonoscopy, without traditional operations.

Professor Siegbert Faiss and his team from the Department for Gastroenterology and Interventional Endoscopy at the Asklepios Klinik Barmbek belong to the pioneers of this innovative process. The specialists in the clinic have particularly large experience in so-called endoscopic submucosa dissection (ESD). Using this technology, Resection area in the distal oesophagus after complete ESD Resection pinned to cork with the central complete removed tumour even large early flat-growing carcinomas can be removed in one piece and with the necessary safety margins from the stomach require a lot of practice and experience. spread deeper into the organ wall. To date or bowel, protecting the affected organ. For this reason, the endoscopic submucosa this new technology has been used in “First we inject a fluid into the submucosa, dissection should only be carried out by particular in cases of adenoma recurrences i. e. the layer located below the mucous experienced specialists in larger, technically or incomplete removal of stage I carcinomas membrane, to lift the tumour away form the well equipped centres such as in the in the colon and rectum. muscle layer”, Faiss explains the process. Asklepios Klinik Barmbek. “After this we cut the affected mucous membrane with special endoscopic scalpels Typical applications of ESD are early Contact which are only a few millimetres in size, carcinomas of the stomach as well as Professor Siegbert Faiss first around the tumour and then sever the so-called Barrett early carcinomas. With Chief Physician of the Department for connective tissue of the submucosa, to healing rates of 80-90 percent, endoscopic Gastroenterology and Interventional remove the suspect tissue from the organ therapy has equally successful outcomes Endoscopy in a single step with the endoscope.” As over the long term as traditional and Asklepios Klinik Barmbek well as preserving the affected organ and much more stressful operations. For early Rübenkamp 220 reducing stress on the patient, the distinct carcinomas with a diameter of more than 22307 Hamburg edges of the removed tissue are a major two centimetres, ESD is the endoscopic Tel.: +49 (0) 40 18 18 82-38 11 advantage of this process. In this way, therapy process of choice, since other more Fax: +49 (0) 40 18 18 82-38 09 the pathologists at the clinic are able to widespread endoscopic processes can only www.asklepios.com/hamburg/barmbek/ tell very well whether the tumour really remove such tumours piece by piece, and experten/gastroenterologie was removed in its entirety, or whether entail a significantly higher recurrence risk. malignant cells may have been left behind. With endoscopic full wall resection (FTRD), In this case, a traditional operation would Professor Faiss and his team offer an still need to be carried out for safety. The additional highly innovative procedure. This disadvantage of ESD is that this procedure also allows such tumours to be removed is technically so complex that the doctors gently with the endoscope, as have already

Page 4 of 5 Standorte der Asklepios-Gruppe ASKLEPIOS NEWSLETTER Issue 2/2018

Sylt

Langenhorn

Fuhlsbüttel Barmbek Osdorf Eppendorf Winterhude Ostseebad Trassenheide St. Georg Altona Horn Neustadt Hamm Bad Schwartau Bad Oldesloe Elmshorn Norderstedt Wilhelmsburg Uetersen Crivitz Hamburg Waren (Müritz) Pasewalk Neugraben/Fischbek Plau am See Seevetal/Meckelfeld Parchim

Schwedt

Soltau Bad Bodenteich

Birkenwerder Lingen Rathenow Teltow Schönefeld OT Hannover* Brandenburg/Hv. Potsdam Waßmannsdorf Werder Königs Bad Münder Ludwigsfelde Wusterhausen Teupitz

Horn-Bad Meinberg Goslar Seesen Coswig Lübben Bad Harzburg Burg Höxter Clausthal-Zellerfeld Vetschau Cottbus Göttingen Bad Düben Essen Rosdorf Großröhrsdorf Leipzig * Oschatz Neustadt in Weißenfels Radeberg Sachsen Bad Wildungen Melsungen Naumburg Hohenmölsen Sebnitz Reichshof-Eckenhagen Schwalmstadt Tabarz Gera Sankt Augustin Bad Salzungen Stadtroda Bonn-Dottendorf Pößneck Wildenfels Greiz Asklepios: acute-care clinic for somatic diseases Lich Butzbach Asklepios: specialist clinic for psychiatry Bad Salzhausen (Nidda) Bad Elster Asklepios: post-acute/rehab clinic Königstein-Falkenstein Bad Orb Wiesbaden Seligenstadt Asklepios: other healthcare facilities Langen Bayreuth (including day-care hospital, psychiatric outpatient clinics (PIA), Bad Sobernheim health centre, care facility) Alsbach-Hähnlein Bad König Oberviechtach St. Wendel Facility under management Schwandorf Blieskastel Bad Rappenau Asklepios: Akutklinik Somatik Germersheim Burglengenfeld Cham MediClin: acute-care Asklepios: clinic Fachklinikfor somatic Psychiatrie diseases Kandel Bad Kötzting Kelheim Bad Abbach MediClin: specialist Asklepios:clinic for Postakut-/Rehaklinik psychiatry Schaufl ing Asklepios: Sonstige Gesundheitseinrichtung Gernsbach MediClin: post-acute/rehab clinic Achern (u.a. Tagesklinik, Psychiatrische Institutsambulanzen (PIA), Aidenbach Offenburg Durbach MediClin: other healthcareGesundheitszentrum, facilities Pfl egeeinrichtung) Freudenstadt Bad Griesbach (including day-care hospital, * Einrichtung health unter centre, Management care home) Bad Peterstal-Griesbach Lahr

Triberg Königsfeld Gauting MediClin: Akutklinik Somatik Villingen-Schwenningen Donaueschingen MediClin: Fachklinik Psychiatrie Bad Tölz Bad Bellingen MediClin: Postakut-/Rehaklinik Lindau (Bodensee) MediClin: Sonstige Gesundheitseinrichtung See also: (u.a. Tagesklinik, Gesundheitszentrum, Pfl egeeinrichtung)

Asklepios Klinik Altona Asklepios Klinik St. Georg ■ Professor Gero Puhl ■ Professor Carolin Tonus Tel.: +49 (0) 40 18 18 81-16 01 Tel.: +49 (0) 40 18 18 85-21 88 Photo: Asklepios [email protected] [email protected]

Asklepios Klinik Barmbek Asklepios Westklinikum Hamburg ■ Professor Siegbert Faiss ■ Professor Tanja Kuhbacher Tel.: +49 (0) 40 18 18 82-38 11 Tel.: +49 (0) 40 81 91-27 53 [email protected] [email protected] Unternehmenskommunikation & Marketing, [email protected], www.asklepios.com, Stand: März 2018

Asklepios Klinik Radeberg ■ Professor Jürgen Weitz Tel.: +49 (0) 3528 459-53 01 [email protected]

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