Minimal invasive surgery

The endeavor to make gentle surgery with minimal tissue trauma through high tech, such as precision instruments and high definition (4k UHD, 3D and NIR) on the one hand and experts who operate the devices on the other hand, has become a reality .

For some time now, I and my team have been performing operations on the large intestine (diverticulum), rectum, small intestine, appendix, gall bladder and esophagus (reflux) with these high-end devices with great success. Many cancer and tumor operations can also be performed using this concept. With the minimally invasive technique, pain is significantly reduced and the hospital stay is shortened accordingly.

The concept of NIR (near infrared) is a new technique based on laser technology that I use every day and that brings a quantum leap in minimally invasive laparoscopic surgery. In addition to a razor-sharp resolution, which further increases patient safety during operations and expands the feasibility of laparoscopic operations, the strength of this technology lies in the visualization of structures that cannot be seen or can only be seen with difficulty with conventional LED optics. ICG (indocyanine green), a fluorescent dye, is injected before an operation. ICG accumulates in certain tissue structures and can be made visible by NIR. The conventional 4K UHD or 3D technology is extended by this feature and organs and individual structures can be displayed in LED, in NIR and in hybrid mode. The main areas of application in general and visceral surgery are the "difficult gallbladder surgery" in which the otherwise invisible or difficult to see bile duct can be made clearly visible by NIR, thus avoiding injuries. In bowel surgery, NIR is mainly used after bowel resection and subsequent reconstruction of bowel ends to assess their blood flow. The intestinal blood flow can also be assessed with conventional LED optics, but not nearly as precisely. Excellent blood circulation is a basic requirement for good healing of the intestinal union (anastomosis) and a smooth, complication-free course. It is hoped that NIR will further reduce the already low complication rate in intestinal operations, in particular a reduction in anastomotic dehiscences (leakage in the area of ​​the intestinal fusion). An additional important indication for NIR lies in the assessment of the blood flow to the parathyroid bodies in the course of a thyroid operation. These are microscopic blood vessels that can be injured intraoperatively. Unfortunately, it has so far been difficult to judge whether there is actually an injury to the vessels or not. For the first time, a reliable assessment is possible with NIR. This is intended to further reduce the rare but dreaded complication of an underactive parathyroid gland, which is crucial for the patient.

I am very pleased to be able to offer you even better and safer operations with this revolutionary technology.

Thanks to the concept of tailor-made therapy, the course of the disease can be shortened accordingly, and pain can be minimized in both duration and intensity through a modern, particularly gentle and efficient treatment concept (fast track) together with minimally traumatic surgical techniques.

The optimal track therapy concept was created to respond to individual needs here as well. With this strategy, in addition to minimizing pain and the associated early mobilization, a shorter hospital stay is guaranteed.

In recent years, a new method has become established and has given minimally invasive surgery (keyhole surgery) yet another challenge. In contrast to conventional, laparoscopic surgery, in which several 5-12mm incisions (abdominal incisions) are necessary for one operation, it is now possible to carry out various abdominal operations through a 2cm long incision in the navel - that is later virtually invisible. This step was only possible through the development of angled instruments and thinner, high-resolution and high-light optics.

This technique is reserved for specialists or experienced surgeons in the field of minimally invasive, laparoscopic surgery. I offer the following operations:

  • Appendectomy (removal of the appendix)
  • Cholecystectomy (gallbladder operation)
  • Inguinal hernia (inguinal hernia)
  • Incisional hernia (incisional hernia)
  • Colectomies (large intestine operations)
  • and fundoplication (operations for diaphragmatic hernia or for reflux disease - GERD)

At the moment the gallbladder and appendix operations are also the most common operations I perform.

The technique is difficult and demanding for the surgeon and cannot be performed automatically for all patients. Nor do all patients benefit to the same extent. Depending on the illness, previous operations, concomitant illnesses, constitution and patient requirements, the optimal therapy is selected and discussed.

The most important advantages of the method are certainly the cosmetically very appealing result and the lower risk of bleeding due to less trauma.