Stay up to date: At PAN Klinik in Cologne, with more than 70 physicians across over 25 medical specialties, there are regularly new developments, medical topics, and events. Our news provides insights into current happenings at the clinic, as well as patient information evenings, professional training, and other events.
Professor Dr med. Dirk Müller-Wieland has made an outstanding contribution to the German Diabetes Association (DDG). In recognition of his many years of extensive commitment, the internist specialising in diabetology and endocrinology, who works at the University Hospital Aachen, was honoured by the professional society with the Hellmut Otto Medal in June. The award is named after Professor Dr Hellmut Otto, who is regarded as a pioneer in the research and treatment of diabetes in Germany.
One topic that is particularly close to Prof. Müller-Wieland’s heart is how the care of people with diabetes mellitus and comorbidities such as chronic heart failure can be improved with the help of digitalisation. This does not only refer to digital health applications (DiGA) for mobile phones, tablets and PCs or virtual advanced training and continuing education programmes for physicians, but also and above all to the implementation of the electronic diabetes record (eDA). “In recent years, the DDG as a professional society has already been able to establish acceptance for the eDA. Now the main question is how the electronic diabetes record can be implemented as a complement to the electronic patient record,” explains the internist.
A project close to the heart: the electronic diabetes record
The aim of the eDA, together with the associated diabetes register, is to bring together people with diabetes mellitus, treatment teams and research institutions through an efficient data pool. By analysing data patterns, new correlations, subgroups, clinical courses and therapeutic approaches are to be identified. Predictive models could also make it possible to identify individuals at risk at an early stage and with precision.
Well-designed digital infrastructure, high-quality care
“This enables us to treat patients according to the latest DDG standards and to continuously optimise therapies,” explains Prof. Müller-Wieland. In his view, a well-designed digital infrastructure could also help ensure comprehensive specialisation and interdisciplinary care. “That would be a decisive step towards making internal medicine fit for the future,” he emphasises. It is equally important to the internist to ensure that findings from diabetological research reach patients as early as possible. He sees this both as an ongoing challenge and as a responsibility for his field.
From his perspective, digitalisation and translation do not exclude one another but, working together and even across sector boundaries, provide important insights. Basic research addresses key questions in the life sciences, while new clinical developments generate interdisciplinary impulses, including the integration of digital innovations, for fields such as cardiology, nephrology, hepatology and neurology. His own clinical and scientific focus is on disorders of lipid metabolism in diabetes mellitus and metabolically induced cardiovascular complications.
“Whether in research, hospitals or medical practices – only together can we optimise the care of people with diabetes and lead our discipline confidently into the future with a strong DDG,” the diabetologist explains.
Active for the DDG for many years and with great dedication
From 2017 to 2019, Prof. Müller-Wieland served as President of the German Diabetes Association; since 2019 he has been spokesperson of the Digitalisation Commission. He originally founded the commission himself and remains active there, advocating “with determination” for “responsible digitalisation in diabetology”, as laudator Professor Dr Monika Kellerer emphasised during the award ceremony at the Diabetes Congress. In the Committee for Quality Assurance, Training & Continuing Education, Prof. Müller-Wieland also continues to serve as spokesperson – and has helped initiate several training and continuing education programmes as well as advancing important projects such as the module certificates.
In addition, Prof. Müller-Wieland was President of the Diabetes Congress in 2017; he had already assumed this role in 2016 following the death of Professor Dr Stephan Matthaei. Within the German Society of Internal Medicine, Prof. Müller-Wieland is Co-Chair of the commission “Structure of Hospital Care”.
From Hamburg via Boston to Cologne, Düsseldorf, back to Hamburg – and finally to Aachen
Professor Dr Dirk Müller-Wieland studied human medicine in Hamburg. This was followed by a two-year research stay at Harvard Medical School in Boston, USA. He completed his specialist training as an internist with a focus on endocrinology, diabetology and metabolism at the University Medical Centre Hamburg-Eppendorf and at the University of Cologne.
In 1997 he was appointed to a university professorship for Internal Medicine/Endocrinology in Cologne. Four years later, Prof. Müller-Wieland moved to the Chair of Clinical Biochemistry at Heinrich Heine University Düsseldorf and became Director at the German Diabetes Center.
From 2006 to 2015 he worked as Chief Physician at Asklepios Klinik St. Georg in Hamburg and, among other roles, helped shape what was then the first trans-European degree programme as Dean of the Asklepios Campus Hamburg of the Medical Faculty of Semmelweis University in Budapest, Hungary.
In 2016 he moved to the University Hospital of RWTH Aachen with a focus on cardiometabolic prevention. There he heads the Clinical Study Centre of the Clinic for Cardiology, Angiology and Internal Intensive Care Medicine (Medical Clinic I).
Source: Medical-Tribune report
If carpal tunnel syndrome needs to be operated on, local anaesthesia can be used for the short procedure. The WALANT method allows the procedure to be performed without a tourniquet - and significantly reduces stress and strain for the patient!
Carpal tunnel syndrome can rob you of sleep: the tingling in the fingers, which often occurs at night, wakes you up again and again... Later, pain is added, the fingers are numb and dexterity decreases. This is when you should see a neurologist at the latest and, if necessary, consider an operation - otherwise permanent and irreversible nerve damage can occur.
The median nerve of the arm (nervus medianus) is constricted, which is compressed at the level of the wrist in carpal tunnel syndrome. If conservative treatment attempts (e.g. by applying a splint to the wrist at night) no longer help, surgical treatment is often unavoidable in order to avoid permanent nerve damage. The carpal tunnel is then widened via a small incision in the palm of the hand and the pressure on the nerve is removed. This short but truly relieving operation can be performed under local anaesthetic, as it only takes around 10 minutes. The advantages for the patient are obvious: patients are awake and relaxed during the operation and can even talk to the operating theatre staff if they wish. Fasting is not necessary for the operation and the risks and side effects of a general anaesthetic or complete arm anaesthesia are eliminated. And best of all, patients can get up immediately after the operation and leave the practice after a short follow-up period walking upright. The entire procedure is therefore hardly more time-consuming than dental treatment.
The only disadvantage of local anaesthesia was the tourniquet that was previously required: In order to have a good view of all the important structures, a blood pressure cuff was inflated strongly on the arm and the blood supply to the arm was interrupted. This less pleasant part of the operation is no longer necessary with the "WALANT" method, which has been used successfully at the HANDZENTRUM KÖLN for years. WALANT stands for Wide Awake Local Anesthesia No Tourniquet. Adrenaline is added to the local anaesthetic so that the surgeon can see all important structures despite the free blood supply to the arm, thereby drastically reducing local bleeding. By eliminating the pressure on the arm, patients have a significantly more relaxed procedure. If necessary, the hand can even be moved during the procedure to check its function, and mobilisation of the fingers can begin immediately after the operation, thus shortening the rehabilitation period after the procedure.
The WALANT technique is also used for many other procedures - however, it should only be performed by surgeons who have extensive knowledge and experience in hand surgery and the use of local anaesthesia on the hand. At the HANDZENTRUM KÖLN, almost all surgeons have been awarded the "Expert Certificate in Hand Surgery" by the German Society for Hand Surgery and have the necessary many years of experience. Ultimately, it is not only the patients who benefit from the WALANT method - but also the surgeons: "There is no pressure on the upper arm and therefore no time pressure when operating under local anaesthetic - the patients are much more relaxed and so am I!" says Dr. v. Maydell, Medical Director of the Hand Centre.
Source:
Article by Dr Bernd von Maydell Carpal tunnel syndrome surgery under local anaesthetic at the HANDZENTRUM KÖLN stress-free thanks to the WALANT method - Orthopress | Das neue Onlineportal rund um ihre Gesundheit (dp-verlag.de)
Our fertility centre – the MVZ PAN Institute – is pleased on behalf of the SEF (Endometriosis Research Foundation)
and the EEL (European Endometriosis League) about the recertification as an endometriosis practice for the next 3 years.
In July, the Hernia Centre Cologne celebrated its 10th anniversary under the direction of Dr Bernd Stechemesser. For this celebration, the kitchen of the PAN Klinik prepared an excellent buffet with starter and main course. The party went on late into the night with partner departments and friends of the Hernia Centre.
The practice team was particularly pleased about the visit of the surgical department from the Eduardus Hospital (Deutz), with whom they have been working together for many years. Dr Stechemesser was very pleased with the gift he made himself, which included a gold-plated hernia mesh and a scalpel!
Dr Stechemesser was delighted that the practice team had taken all the preparations for the party into their own hands. The Hernia Centre Cologne would like to thank all the guests for the wonderful celebration!
We are pleased to inform you that the PAN Clinic successfully passed its recertification audit in the area of quality management by LGA InterCert, part of TÜV Rheinland, on 12 and 13 July.
The clinic was able to maintain its certification with the following scope:
"Administration, patient management and admission; outpatient surgical non-medical treatment and inpatient medical, therapeutic and nursing patient care and treatment"
The fact that the PAN Clinic has been certified without interruption since 2007 proves that the departments and all employees of the PAN Clinic are aware of their responsibility with regard to quality management and that their actions always contribute to the safety and well-being of patients.
Viewing "quality as a kind of obligation" is what ultimately characterises the PAN Clinic's corporate guideline.
Neurosurgical symposium at the PAN Clinic
Topic: New and proven: Diagnosis and therapy of degenerative diseases of the lumbar spine
When: 27 August 2022, starting at 10 am
Where: PAN Klinik am Neumarkt, 4th floor
Training points have been applied for at the North Rhine Medical Association
Claes Oldenburg, the legendary pop artist and creator of our ice cream cone on the tower of the Neumarktgalerie, has sadly passed away at the age of 93. I still remember exactly how early in the evening in March 2001, in the presence of him and his wife, the now world-famous work of art was hoisted onto the tower with a huge crane and fixed in place. Neumarkt was closed to traffic for several hours for this. Carefully packed, the sculpture was transported by ship from the USA to Bremerhaven and then to Cologne on a large low-loader.
Initially, there was some resistance to this project. However, the upturned cone with the already somewhat melting vanilla ice cream has since become an integral part of our cityscape and contributes to a cheerful environment on Neumarkt. It has also become our trademark. We are very grateful to Claes Oldenburg and the initiators of the Neumarktgalerie, especially Thomas Koerver!
Stefan Palm, PAN Clinic
It is estimated that around 50% of the population in Germany over the age of 50 suffers from haemorrhoids. In principle, however, you are not protected from haemorrhoidal disease at any age. The number of unreported cases is very high and obviously slightly more men suffer from haemorrhoids than women. In Germany, there are more than 50,000 cases of haemorrhoids every year (57,524 cases in 2019).³
Previous studies1 have already shown the effectiveness of this method, and the results after 2 years confirm the medium-term effectiveness of the technique.
Priv.Doz. Dr Hartmut Schäfer designed and led the study together with colleagues from Münster:
We were able to include a total of 98 patients in the study at both centres. Both the short-term and long-term results show comparability of the relevant outcome parameters with surgical removal in the literature. A clear advantage of Rafaelo surgery over conventional methods is that it is less painful and can be performed on an outpatient basis without general anaesthesia. This demonstrates the progress made in haemorrhoid treatment with the new procedure, which is greatly appreciated by patients.
Dr Carlo Vivaldi, specialist in surgery, coloproctology and proctology, at the Panklinik rectal practice in Cologne, took part in the study. He says: "The results of the study2 are good, and after two years we don't see any major differences compared to the results in the shorter period. Many patients we have been able to interview are still satisfied. We usually ask them: "Would you do it again?", and so far I haven't heard a 'no'. They all answer 'yes'."
"Usually patients ask, 'How long will I be sick, will it be painful and will I have to miss work? The Rafaelo® procedure is quick, I think the likelihood of complications is lower than with other procedures and they can get back to normal quickly."
A local anaesthetic is sufficient so that the patient feels comfortable during and after the procedure. Symptoms disappear quickly after treatment and the risk of post-operative pain or other complications is minimised. No hospitalisation is required for the procedure. Patients can therefore quickly resume their daily activities.
Sources:
https://link.springer.com/article/10.1007/s00053-018-0250-z
Early and midterm results of radiofrequency ablation (Rafaelo® procedure) for third-degree haemorrhoids: a prospective, two-centre study;
Techniques in Coloproctology 2022
Expert certificate in hand surgery for Dr v. Maydell
Dr Bernd v. Maydell (Medical Director of the Cologne Hand Centre and Head of Hand Surgery at the PAN Clinic) was awarded the newly established "Expert Certificate in Hand Surgery" by the German Society for Hand Surgery (DGH) on 27 January. This makes him one of the first hand surgeons to be honoured in this way. The new certification procedure was only launched by the specialist society in September 2021. It is intended to give doctors the opportunity to qualify as hand surgery experts beyond the additional designation and to be able to demonstrate this in a verifiable manner.
Hand surgery with experience and at the cutting edge of science
The personal certificate is intended to emphasise the doctor's particular excellence in hand surgery. The catalogue of requirements includes specialist aspects of both a practical and scientific nature: participation in special practical courses, e.g. on the topics of "Bones and Joints" and "Microsurgery and Soft Tissues", is mandatory. In order to obtain the certificate, however, evidence of work (or at least one internship) at a major hand surgery centre must also be provided. In addition, regular participation in specialist training courses and congresses is required and it is assumed that the applicant has given lectures at congresses or published their own specialist publications.
Excellent hand surgery – with passion
Like all his colleagues at the Cologne Hand Centre, Dr v. Maydell has been involved in hand surgery for many years. He sees the award he has now received as confirmation and recognition of his particular enthusiasm for the speciality - after all, the demands are not low. "All of us colleagues – myself included – are still curious: we would simply like to know more about the hand!" Problems with the hand are often really complex. In addition to knowing the current treatment guidelines and the latest scientific findings, working in a team would also be particularly helpful. According to Dr v. Maydell, hand surgery is a lot of fun, especially with several experienced colleagues who are all curious and want to find the solution.
"It's hard to imagine, but very close by, just a two-hour flight from Cologne, people are suffering under a terrible war!" (BGK Association)
What is happening in Ukraine, in the centre of Europe, affects us all and shakes us all.
Millions of people are fleeing or staying to defend and support their homeland. These people are dependent on help. Many of them are children or babies.
Naturally, the events have not left the PAN Clinic indifferent, so we are launching an appeal for donations. We have informed ourselves carefully and decided to support an aid organisation. This aid organisation is the Blue-Yellow Cross German-Ukrainian Association.
"The Blau-Gelbes Kreuz e.V. is a state-recognised, non-profit association based in Cologne, which has been supporting the development of a free, democratic Ukraine since 2014 and provides aid for the victims of the war, especially children, internally displaced persons, injured and other people in great need from the regions affected by the war.
We organised projects such as "Holidays without war" (2016, 2017, 2018, 2019), with the main aim of providing children injured or orphaned by the war in eastern Ukraine with enjoyable and peaceful holidays. Since the outbreak of the war in Ukraine, we have been realising various measures to help the Ukrainians and their country" (BGK Association).
The entire PAN Clinic with all the associated practices in the building will support this organisation to help people in need.
On the following website you will find all important information and the most important data if you want to support the organisation with money:
https://www.bgk-verein.de/geldspenden/
Let's help these people together!
Your PAN Clinic
The flood disaster in Rhineland-Palatinate and North Rhine-Westphalia has shaken us all.
Even weeks after the disaster, the regions in the affected areas are still badly affected by the damage caused by the floods. Reconstruction will take years, so it is never too late to help the affected regions with a donation. We endeavoured to make a targeted donation that would directly benefit the people in the affected regions.
We believe that this wish has been completely fulfilled by the measures taken by "Johanniter-Unfall-Hilfe e.V.".
The PAN Clinic is delighted about the realisation of the "PAN donation campaign" by the doctors based at the clinic.
The donation will be used to finance various measures, including the establishment of mobile medical practices/medical contact points to close gaps in care, medical care as part of a medical mission, psychosocial support for affected persons and helpers on site, the construction of emergency shelters, support for facilities affected by the floods such as care centres, kindergartens or youth welfare facilities, the reconstruction of buildings and facility structures in the affected communities, the promotion of Johanniter's civil protection structures in order to be operational again as quickly as possible (replacement and, in some cases, replenishment of the equipment used in the flood response, etc.). replacement and in some cases replenishment of the equipment used in the flood operation) and much more.
We are delighted that PAN Klinik am Neumarkt-Handchirurgie has been recognised as a TOP Private Clinic 2021 by FOCUS-GESUNDHEIT (08/2020).
FOCUS-GESUNDHEIT has been recommending TOP doctors, TOP clinics and TOP rehabilitation clinics from all over Germany for over 25 years. For the first time, TOP private clinics are also being recognised for 2021. The PAN Klinik am Neumarkt is one of the TOP private clinics 2021 thanks to our hand surgery department.
Congratulations to our specialists Dr Bernd von Maydell and Mr Paul J. Altmann.
https://www.pan-klinik.de/fachbereiche/hand-und-fusschirurgie/
Cologne, 23.09.2020 – Since 2013, the mre-netz has been offering participation in a quality seal for hospitals. The main aim is to coordinate the infection hygiene management of multi-resistant pathogens in healthcare and community facilities in the participating districts in the interests of preventive health protection for the population. By participating in the seal, we are helping to protect patients from infections to which they may be exposed as a result of medical treatment. The main aim is to develop a standardised, quality-assured procedure to prevent the spread of problematic germs in hospitals, rehabilitation clinics, doctors' surgeries, outpatient and inpatient care facilities as well as in rescue and transport services. Networking the project participants at all levels is intended to promote communication between the facilities and enable optimised patient care.
We have demonstrated our participation in the quality seal through a quality audit coordinated by mre-netz. We have been participating since 2013 and were awarded the seal again this year. Further information on www.mre-rhein-ahr.net.
We have been the only licensed centre for pre-implantation genetic diagnosis (PGD) in cooperation with the Medical Genetic Centre (MGZ) in Munich (Prof. E. Holinski-Feder, PD Dr. A. Abicht) for several years and have already been able to help a number of couples. As part of an extensive re-licensing process by the Bavarian State Ministry of Health and Social Affairs, we have now received our licence again.
For years, our clinical endometriosis centre (II) has focused on treating patients with endometriosis, including those who wish to have children. We are delighted that it has now been re-certified by the German and European Endometriosis League.
Focus has been publishing lists of leading doctors in Germany for more than 20 years. In 2020, 5 of our doctors/specialisms were again listed among the top doctors and 12 doctors were particularly recommended by Focus.
This seal recognises the specialists and dentists who are highly recommended in the district in which they are based. The evaluation, carried out by the Hamburg Health Foundation and "Fokus Gesundheit", takes several medical, patient- and service-orientated factors into account. For example: Is the doctor recommended by colleagues, what professional experience does he have? Patient satisfaction, accessibility of the practice and other criteria are also taken into account. The recommendation is based on a total of more than 200,000 doctors and dentists.
Further information on the seal and the criteria on which it is awarded to doctors can be found here: here.
08.05.2020
We are expanding our services for you!
Last week we received the licence extension (§30 GewO) for our clinic from the health authority of the city of Cologne. This means that two in-patient departments will be restructured into main specialist departments, thereby improving the structural range of services offered by the PAN Clinic. These are the main specialist department of surgery with the sub-areas of general and hernia surgery, neurosurgery, vascular surgery and the main specialist department of gynaecology with the sub-areas of operative gynaecology and senology.
We are delighted to be able to offer you an even more comprehensive range of services!
01.03.2020
Recognising and treating osteoarthritis of the hand in good time.
The "Hand Centre Cologne" invites you to an information event for patients on 01.03.2020.
Cologne, February 2020 - Joint wear and tear, or osteoarthritis, is one of the most common causes of chronic, persistent pain. Osteoarthritis can affect all major joints in the human body. Such a condition is particularly stressful in the hand - just one painful joint can affect the function of the entire hand and make every grip and every other use of the hand a pain. On "Hand Day", which takes place every year on 1 March on the initiative of the German Society for Hand Surgery (DGH), hand surgeons throughout Germany provide information about arthrosis in the hand. In Cologne, hand specialist Dr Bernd v. Maydell and his team at the "Hand Centre Cologne", in collaboration with the practice for occupational therapy and hand rehabilitation Axel Heußen, will also be providing information about conservative and surgical treatment options for degenerative cartilage disease.
Osteoarthritis of the hand occurs most frequently in the thumb saddle joints, followed by the finger end joints and middle joints. Pain, swelling and stiffness can significantly impair the patient's quality of life. The aim of any treatment is therefore to effectively alleviate the pain and maintain the mobility of the joint as far as possible. Initially, conservative options such as hand therapy, immobilisation, pain and anti-inflammatory medication or injections are exhausted; if no improvement can be achieved and the disease progresses, surgery can help the patient.
However, only a hand surgeon can reliably decide when surgery is indicated. "In the case of finger osteoarthritis, it is important to recognise the right time for surgery," says Dr v. Maydell. "Timely consultation with a hand surgeon as a specialist can be important in order to retain as many treatment options as possible. We would also like to provide information about this on Hand Day."
The spectrum of surgical treatment options for finger arthrosis today ranges from denervation to innovative surface replacement prostheses. Procedures such as resection arthroplasty on the thumb saddle joint or stiffening of the end or middle joints have proven themselves in hand surgery for many years with very good results for patients. A consultation with a qualified hand surgeon can clarify which method is suitable for the individual patient.
Contact us
Hand Centre Cologne, Dr Bernd v. Maydell
Zeppelinstraße 2
50667 Cologne
Dr Moritz Perrech and Dr Dierk-Marko Czybulka joined the neurosurgery team at the PAN Clinic at the beginning of the year.
Dr Perrech completed his medical studies in Münster and has been a specialist in neurosurgery since 2014. In 2016, he spent 3 months at the New York Presbyterian Hospital of Weill-Cornell University, NY, USA for the Spine Fellowship with Dr Roger Härtl. Until further notice, in addition to his work at the PAN Clinic, he is a senior physician for neurosurgery and co-head of the spine team at the Clinic for General Neurosurgery at the University Hospital of Cologne.
Dr Perrech has briefly summarised his work over the last few years for us:
"My clinical and scientific focus in recent years has clearly been the treatment of diseases of the spine. I have focussed in particular on "minimally invasive" surgical treatment methods, but also on complex spinal surgery. The spectrum of diseases has covered the whole range from wear-related to oncological diseases."
We were also interested in what new opportunities he sees in working at the PAN Clinic.
"Working at the PAN Clinic will give me the opportunity to provide patients with comprehensive personalised advice and to treat them both as inpatients and outpatients. My work as a senior physician at the university hospital, which I will continue in parallel, will also give me the opportunity to provide patients with the best possible advice on any neurosurgical issue and subsequently connect them."
After studying medicine in Marburg and Würzburg, Dr Czybulka was an intern at the University of Würzburg. He completed his further specialist training at Aschaffenburg Hospital and Merheim Hospital. He has been a specialist since 2009 and has attended national and international training courses in New York, Amsterdam, London and Cambridge, specialising in spinal surgery. In 2015, Dr Czybulka moved to the University Hospital Cologne as head of the spine team.
"Already during my specialist training and increasingly in my further professional career, I focussed my interests from the entire spectrum of neurosurgery on the treatment of spinal diseases. Early on, I had the opportunity to familiarise myself with modern minimally invasive and complex surgical techniques on the spine and to practice them. These techniques can be adapted for use in any area of the spine - from wear-related to oncological diseases."
Naturally, we also asked him about the benefits of working at the PAN Clinic.
"My main commitment at the PAN Clinic as well as other secondary activities give me the opportunity to combine the best of both worlds and to pass these benefits on to the patient: From the outpatient examination, consultation and treatment to the possible minor or major surgical treatment to post-operative care and, if necessary, follow-up treatment. This enables me to offer patients all-round (360-degree) care in the area of spinal disorders and to identify and implement the best measures for each patient."
Both doctors specialise in minimally invasive and complex spinal surgery and – together with Dr Harati – are proficient in a wide range of neurosurgical operations.
Further information can be found here: more
The PAN Clinic is delighted to announce the opening of its neurosurgery practice. In the new premises on the 4th floor, neurosurgeon Dr Ali Harati advises, treats and cares for patients. The practice will be further expanded in the new year.
Back pain continues to be the number one widespread disease and is often a major burden on many people's professional and private lives. Helping these patients in the long term is one of the tasks of neurosurgery. After all, the pain should not become an endless story of suffering. The practice will initially be managed by Dr Ali Harati. In the new year, two more neurosurgeons will join the team.
"I am very much looking forward to my new role here at the PAN Klinik am Neumarkt and am also happy to be working next door to a number of other experienced doctors," says Dr Harati.
The practice's core services include the entire spectrum of conservative spinal therapy, minimally invasive microsurgery for herniated discs and stenosis of the cervical spine, thoracic spine and lumbar spine as well as operations in the cervical spine and lumbar spine.
The complete scope of services and further information can be found on the practice's website: https://www.neurochirurgie-pan-klinik.de
The neurosurgery practice operates under the umbrella of the MVZ PAN Institute.
Contact & appointments under:
General Neurosurgery
Interdisciplinary Spine Centre
MVZ PAN Institute GmbH
Zeppelinstr. 1
50667 Cologne / Neumarkt Gallery
Phone: 0221/2776-310
Fax: 0221/2776-317
Practice for private patients and self-payers
neurochirurgie@pan-klinik.de
We have recently started offering heterozygote screening for patients who wish to have children in co-operation with the MGZ Munich.
In the general population, it is assumed that on average a person carries around 2-3 mutations that can be the cause of an autosomal recessive disorder. This means that the person is a carrier for a mutation on a corresponding gene (allele), but the second gene copy (diploid chromosome set) is intact. As a result, he/she usually does not develop any symptoms. If both partners happen to be carriers for the same autosomal recessive disease (approx. 1% in unrelated couples), their children (regardless of gender) have a 25% risk of inheriting the mutation from both parents and developing symptoms of the corresponding disease. In most cases (if no one in the family already has the disease) it is not known whether a person is a carrier and, if so, for which diseases. New methods developed a few years ago (so-called NGS panel analysis) now make it possible for couples who wish to have children to be tested for the most common mutations from the above-mentioned spectrum. At present, 437 genes (Kingsmore panel) are being analysed.
The analysed genes of the Kingsmore panel were selected and evaluated by experts according to the recommendations of the ACMG (American College of Medical Genetics), among others, according to the above-mentioned frequency in the general population but also with regard to possible clinical symptoms (e.g. early onset of symptoms, severity of the clinical picture, etc.).
In this context, the MGZ also offers an analysis of the genetic predisposition to spinal muscular atrophy (one of the more common genetic changes in Germany). For technical reasons, this analysis is not included in the Kingsmore panel mentioned above. If a mutation in the same gene is detected in both partners (or a mutation in the case of X-linked recessive inheritance), this should be discussed in a further consultation (see below), including a detailed explanation of the corresponding clinical picture, family planning options and other aspects that may arise.
This test is currently a self-payer service (individual health service), i.e. it is not usually covered by health insurance companies. An examination can be carried out after genetic counselling by appropriate doctors (human genetics, gynaecology with additional qualifications, etc.).
Around a year ago, the MVZ PAN Institute was approved by the Bavarian State Ministry of Health and Care as a cooperating reproductive medicine centre in the field of pre-implantation diagnostics (PGD). Since then, we have been offering these diagnostics in close co-operation with the MGZ Munich. Now there is great news. PGD is an option for couples who have a high risk of a serious hereditary disease due to their own genetic constitution. Therefore, the embryo is specifically searched for genetic abnormalities or a chromosomal disorder before being transferred to the uterus in order to avoid genetic damage and serious diseases. Only embryos without such a risk of disease are then transferred to the uterus.
Now a patient at the MVZ PAN Institute has become pregnant for the first time following preimplantation genetic diagnosis. Without the PGD test, the parents would have had to continue to worry about whether they would ever be able to give birth to a healthy child. In this particular case, both partners had a monogenic disease which, if passed on to the child, would lead to organ failure early on in life "We are extremely pleased that the pregnancy following PGD worked out and that the couple is now happy," said MVZ reproductive biologist Dr Bastian Schäferhoff. "We have achieved this thanks to our competent staff, state-of-the-art equipment and excellent collaboration with the doctors in Munich."
Preimplantation genetic diagnosis can only be carried out in the context of artificial fertilisation, as this is the only way to obtain the relevant cells for analysis. In Germany, PGD may only be carried out under certain conditions and with the approval of an ethics committee. Further information on the subject of pre-implantation genetic diagnosis can also be found on our website at www.pan-pid.de
An unfulfilled desire to have children is a particular psychological burden that causes very different thoughts and feelings in every couple. If this is compounded by the hectic pace and stress of everyday life or a professional crisis, experience has shown that it is helpful to seek competent mental support. Ongoing surveys by the MVZ PAN Institute show that an average of 25 per cent of patients are already very stressed by their desire to have children at the start of treatment and that accompanying psychosomatic care would certainly help them.
If the desired pregnancy does not materialise within the expected time frame, the patient's disappointment, fear and uncertainty increase - which further increases the need for mental support.
Mental support directly in-house
In line with the interdisciplinary treatment approach, the MVZ PAN Institute therefore also includes the PAN mental department. In addition to their medical fertility treatment, patients can receive psychological support from the psychological psychotherapists Andrea Gilles and Diana Enke on request. The aim of this support is to intervene as early as possible, as early treatment of psychological symptoms can often avert a worsening of the symptoms and make a quick recovery more likely.
Below, psychologist Andrea Gilles answers frequently asked questions on this topic:
What advice would you give to couples/people who are under a lot of psychological strain due to the unfulfilled desire to have children?
The German Medical Association recommends psycho-social counselling for unfulfilled desire to have children. I advise every affected couple and every affected person to make use of a psycho-social counselling session. The counselling session provides strategies for dealing with the unfulfilled desire to have children that are based on guidelines (see also the counselling network for the desire to have children in Germany) and can have a psychologically relieving effect.
What are symptoms of those affected that you should seek psychological support for?
Frequent involuntary crying, reduced drive, persistent sleep disorders, fears that can hardly be coped with, reduced self-esteem and doubts about one's own body, relationship problems such as impaired sexual contact between partners or mutual reproaches, to name just a few symptoms.
What psychological support/counselling options does the MVZ offer as part of fertility therapy?
The MVZ PAN Institute offers individual consultations, couples' consultations and, on request, groups for dealing with the unfulfilled desire to have children. The advantage of an MVZ is that the topic can be approached holistically, as different specialist areas work together at the patient's request.
You can contact PAN metal by e-mail or by telephone on: 0221/2776-200.
Many women are affected and yet the disease endometriosis is still not sufficiently well known. To change this, information events are being held throughout Germany in September. Here at the MVZ PAN Institute, too, there will be a patient information evening on 26 September in cooperation with the Endometriosis Association Germany (Endometriose-Vereinigung Deutschland e.V.) - with a focus on the unfulfilled desire to have children.
"We are delighted that so many certified endometriosis centres want to take part in the campaign. Cooperation between patients and the healthcare system is very important in order to improve the situation for endometriosis sufferers," says Sabine Steiner, Chairwoman of the Endometriosis Association Germany.
Endometriosis is a chronic disease that is often accompanied by severe pain, especially pain in the lower abdomen. In endometriosis, cells similar to those of the uterine lining (endometrium) colonise organs such as the ovaries, bowel, bladder or peritoneum. These endometriosis centres cause chronic inflammation, severe, chronic abdominal pain, bleeding and adhesions in the abdominal cavity and often infertility. Endometriosis is the underlying cause in around 40 to 60% of women who remain unintentionally childless. Although benign, endometriosis lesions can grow invasively and cause permanent damage to organs.
Even conservative estimates assume 30,000 new cases per year in Germany and almost one in ten women will develop endometriosis in her lifetime. Despite its high prevalence and serious effects, the disease is little recognised by society. Most women have never heard of endometriosis before their diagnosis.
In this year's awards, 7 doctors from the PAN Klinik were again honoured with the golden FOCUS medical seal. At the beginning of each summer, the magazine FOCUS-GESUNDHEIT publishes the corresponding seal category: 'Germany's Top Doctors'. The judgement is based, among other things, on recommendations from medical colleagues, recommendations from patients and publications published by the doctor.
In 2019, they were honoured as 'TOP Doctors' in Germany:
To be included in a FOCUS doctors' list, doctors must fulfil the minimum requirements set by the independent research institute Munich Inquire Media (MINQ). In particular, they must have above-average results in terms of colleague and patient recommendations. read more
Back in spring, 17 doctors from the company were awarded the "Recommended Doctors in the Region" seal:
This seal recognises the specialists and dentists who are worth recommending in the district in which they are based. The evaluation, carried out by the Hamburg Health Foundation and FOCUS-GESUNDHEIT, takes several medical, patient- and service-orientated factors into account. For example: Is the doctor recommended by colleagues, what professional experience does he have? Patient satisfaction, accessibility of the practice and other criteria are also taken into account.
The recommendation is based on a total number of more than 200,000 doctors and dentists read more
"Not every clinic has to do everything"
The conference room at the PAN Clinic was filled to capacity. And for good reason: every month, Health Care Rheinland e.V. (HCR) organises interesting presentations and discussions at various venues. As a long-standing member of the HCR, this time the meeting took place at the PAN Klinik. With a lecture topic that could hardly be more fitting: The hospital landscape of the future. More than 50 listeners from the fields of medicine and business did not want to miss it.
Günter Wältermann gave a presentation on this important topic that evening. The chairman of the AOK Rheinland/Hamburg presented extracts from the AOK hospital report and derived some theses from it. It quickly became clear that he was not satisfied with the current state of the hospital landscape.
After being welcomed by HCR Chairman Dr Hans Jürgen Ahrens and PAN Clinic Director Dr Stefan Palm, Wältermann clearly advocated the creation of more specialised centres. These should provide selected medical services, but with a high level of expertise among the treating and operating doctors. "The studies clearly show it," explained Wältermann, "The success rates and recovery of patients are better in specialised centres. The quality of surgery is higher and so is the chance of survival in serious operations." There are still clinics in NRW that only perform difficult operations one to four times a year. And this is not a problem of patient distribution, according to Wältermann: "We don't have a problem of undersupply in NRW."
Recognising the problem
It is crucial to recognise the problem in order to shape the future of the hospital landscape in a meaningful way. "We need active, competent hospital planning. And we need to involve patients." People need to realise the added value of change and what they stand to gain, otherwise protests and rejection will ensue.
"So far, hospital planning has only been implemented unsatisfactorily," said Wältermann, who emphasised several times: "This shaping of the hospital landscape can only work together. "Health insurance funds, hospitals and other players in the healthcare system should work together towards one goal, namely the best possible medical care for patients. And this, as Wältermann's presentation made clear, is best achieved in specialist medical centres.
The fact that the federal states are not so intensively involved in hospital planning increases the hospitals' room for manoeuvre. But at best in the direction of specialist and maximum care in specialised centres "Not everyone has to do everything," said the AOK CEO. "And not everything has to be operated on immediately if patients have not previously undergone therapy or have been treated conservatively for four quarters.
Interlinking outpatient and inpatient structures
The PAN Clinic had already decided years ago in favour of a focussed approach. Only core competences are operated on here - by proven specialists with extensive surgical experience. This is complemented by the "cross-sector integration of outpatient and inpatient structures", as clinic director Dr Stefan Palm described it. A model that more and more medical centres are adopting because it offers patients numerous advantages.
Günter Wältermann also had words of praise for the PAN hospital model: "I am an absolute fan of cross-sector planning", but this is not yet an issue across the board. What is needed first is sensible hospital planning. "But perhaps the time is now ripe for this, as long as everyone involved recognises the problem and finds a joint solution."
Dr Hans Jürgen Ahrens had already emphasised to the assembled guests at the beginning: "The PAN Clinic is an outstanding clinic with a great reputation and a wide range of specialist areas."
Many people are unhappy with their teeth but do not want fixed braces for visual reasons. With Invisalign, they now have a new option for correction. These braces are almost invisible. Every 2nd Tuesday of the month, there is now an information evening at PAN Dentistry to provide information about the treatment options.
Invisalign is a clinically proven therapy that has already been used successfully on 6 million patients worldwide. These braces are customised, transparent aligners that move the teeth into the correct position with invisible attachments. A procedure in which the entire treatment planning takes place on the computer, which means maximum short treatments by your dentist.
Further information can be found on the Website of the PAN dentists.
"Our anaesthetics are maximally well tolerated"
Since the middle of last year, the joint practice for anaesthesia at the PAN Clinic has had a new specialist in its ranks. Priv.-Doz. Dr Holger Herff, was most recently a senior physician at the Clinic for Anaesthesiology and Operative Intensive Care Medicine at Cologne University Hospital and has settled in very well here at the clinic.
The 42-year-old doctor's interest in the field of anaesthesia arose during his work as a paramedic during his community service. This was followed by medical studies and specialist training in anaesthesiology and special anaesthesiological intensive care medicine.
While Dr Herff loves his profession, there are still quite a few people on the patient side who get queasy at the thought of a general anaesthetic. But without reason, as the health risks associated with anaesthesia have continued to decrease. New statistics have just been published by University Professor Dr Rudolf Likar (Klagenfurt): whereas in the 1960s there were still around 80 deaths per 100,000 anaesthetics, this is no longer a relevant risk today. "As part of the professionalisation of our still young specialist field, we have now reached a level that is really extremely good," says Herff. "Anaesthesia is one of the safest procedures in the hospital in terms of the range of side effects and in view of the enormously high number of cases. Patient safety always takes priority, of course, says Herff, but now the well-being of patients after an operation is also at the forefront of medical endeavours.
No cause for concern
People who undergo surgery at the PAN Clinic can rest assured. "We make sure that our anaesthesia, in addition to a system with maximum multiple safeguards, is set up to ensure that the procedures we perform here are as well tolerated as possible," confirms Herff, adding: "This also means that patients wake up quickly after an operation, that we consistently prevent nausea and vomiting and, of course, that we provide sufficient pain therapy. In painful procedures, we can often supplement the latter with regional anaesthesia procedures under ultrasound control and thus further optimise it."
And even if you are very nervous before an operation, the PAN Clinic is of course prepared. Patients are given a sedative tablet on request the evening before an operation. Before the operation, they are also given a sedative intravenously for maximum reliability. "It is indeed an important aspect that people here are relaxed when undergoing anaesthesia," says Herff.
Remifentanil increasingly in use
Nothing "groundbreaking" has happened in the use of new anaesthetics in recent years. The drugs of choice have largely remained the same. However, some drugs are more widely used today. One example is remifentanil, an ultra-short-acting painkiller that is now increasingly being used in intensive care units following the expiry of its brand protection, says Herff. "Because you can really control when the patient falls asleep and wakes up."
Herff has certainly not regretted his decision to work in the joint practice for anaesthesia at the PAN Clinic. On the contrary: "We have very good equipment here and, even more importantly, an excellent team." Herff also enjoys working at the PAN Clinic with the "outstanding specialists in their fields, with whom we have a very high quality of care in what we offer."
Up to now, 2D mammography has been used for most early breast cancer detection examinations. However, the technology is already one step ahead, which is why selected practices now also offer 3D mammography. In contrast to conventional digital mammography (2D), this procedure, known as tomosynthesis, produces a series of thin-layer images that enable a three-dimensional (3D) visualisation of the breast. This allows tumours to be detected earlier.
Mammography is an uncomplicated and quick X-ray examination of the breast that only takes a few seconds. The images, known as mammograms, can be used to assess the normal, age-dependent condition of the breast and differentiate it from pathological changes. Tumours that are not palpable can also be detected at an early stage. The better the imaging procedure, the higher the probability of detecting abnormalities in the tissue.
The MVZ Radiology/Nuclear Medicine Centre here at the PAN Clinic has also recently started offering state-of-the-art breast tomosynthesis (3D mammography) from the market leader Hologic as an alternative to the 2D mammography that continues to be offered.
"In our radiology practice, we have the opportunity to examine private patients using modern 3D tomosynthesis," says Dr Judith Scherer-Berg. Specialist in Diagnostic Radiology at the PAN Clinic. "This allows us to obtain detailed, seamless individual images of the tissue layers for the first time, which virtually rule out overlaps. Tumours can then be detected earlier and unnecessary biopsies can be avoided. Unfortunately, 3D mammography is not yet included in the statutory catalogue of services."
The examination procedure is very similar to a conventional 2D mammogram. Within just four seconds, 15 tomograms are taken. The examination position of the body or breast is identical to the 2D procedure.
To ensure comparability with older existing 2D preliminary images, an artificial 2D mammography image is also created by the computer from the 3D mammography data set. This synthesised 2D image is equivalent to a digital 2D mammogram.
In Europe, one in eight women will develop breast cancer in the course of her life. Doctors and scientists agree that early detection is the best way to combat breast cancer. Successful treatment and the chance of survival depend to a large extent on the time of diagnosis. If breast cancer is detected early, before metastases appear in the lymph nodes, the 5-year survival rate is almost 100 %. This makes it all the more important for every woman to take the issue of early breast cancer detection and appropriate medical examinations seriously.
Reasons in favour of 3D mammography (tomosynthesis)
If you would like to make an appointment or have any questions about early breast cancer detection or the examination methods, please contact the staff at the MVZ for Radiology & Nuclear Medicine:
MVZ Cologne Neumarkt
Innovative radiological procedures, nuclear medicine and digital computerised X-rays
Zeppelinstr. 1 / Neumarkt Gallery
50667 Cologne
Phone: 0221/2776-500
Fax: 0221/2776-501
E-Mail: kontakt@mvz-koeln-neumarkt.de
In Germany alone, more than 23 per cent of adult men and women (aged 18-79) are obese, i.e. very overweight. The consequences can be life-threatening.
Obesity patients live with a disease that can have serious health consequences. Obesity can reduce life expectancy by two to ten years and is the fifth most common cause of death worldwide due to the associated comorbidities.
However, many people with obesity do not receive sufficient support in their efforts to lose weight. "Obesity is a disease that can be associated with stigmatisation and blame. We are only now beginning to understand obesity," said Dr Sylvia Weiner, a surgeon from Frankfurt. Obesity is on the rise and is therefore a highly relevant issue that urgently needs to be tackled.
Recognising obesity as a chronic disease in society and in the healthcare system is the necessary basis for improving the situation for people with obesity in Germany. "The implementation of disease management programmes (DMP), as in diabetes care, could also be a step in the right direction," said Weiner.
Those affected must become active themselves
In principle, obesity patients have access to conservative treatment methods such as nutritional advice and exercise programmes. However, these are not covered by health insurance, so patients have to pay the costs themselves. Weight loss medication is also excluded from reimbursement. Surgical procedures are only available in individual cases after application to the health insurance companies and authorisation.
If you have any questions on this topic, please do not hesitate to contact one of the various specialist departments. For example, the hormone centre, utritional advice or exercise therapy at the PAN Prevention Centre.
You can find an overview of the departments here.
Source: Presseportal.de / Obesity Day of the AcSDeV / Obesity in Germany
Is there a general ban on exercise in coronary artery disease? Patients were followed for 30 years in a long-term study. The results are now available.
Maintaining or even increasing regular physical activity is highly desirable for patients with coronary heart disease (CHD). Those study participants who did a lot of sport over the entire observation period had a 36% lower risk of death than those without regular physical activity. And those who only exercised occasionally also had a 19% lower risk. The risk decreased with increased activity.
Of course, it is important not to overexert yourself and to make sure that you take part in suitable physical activity. Cardiac sports groups, for example, are ideal for CHD patients. However, a clear recommendation can be made to ensure regular physical activity despite or precisely because of coronary artery disease!
In a large Norwegian study with over 3000 CHD patients who were observed over a period of 30 years, scientists analysed the effects of weight changes and regular physical activity on the risk of death.
Compared to exercise, weight loss in CHD patients showed no positive effects. On the contrary: in normal-weight patients, a weight reduction of more than 0.1 points in BMI (body mass index; kg/m²) per year was associated with an increased risk of death, while weight gain was even associated with a reduced risk of death.
This tendency also applied - albeit to a lesser extent - to overweight patients. However, weight gain did not have a positive effect here.
"This is not intended as a recommendation to gain weight or not to pay attention to a healthy diet, but the study results indicate that the focus should be on physical activity and not primarily on weight reduction in the case of coronary artery disease," says cardiologist Prof Dr C. A. Schneider, whose practice is based at the PAN Clinic.
Doctors used to recommend that antibiotic packs should always be used up. This recommendation still applies in some cases today - but no longer generally. It is therefore extremely important for patients to consult their doctor individually.
The general total consumption of antibiotic medication is based on the false idea that resistance is caused by residual germs that were not eradicated when antibiotics were administered because treatment was stopped too early. However, resistance develops primarily while patients are taking an antibiotic - or it already exists beforehand, writes the health magazine "Apotheken Umschau"
The bacteria only benefit from their resistance during treatment: they can "escape" the antibiotic. If antibiotics are taken for longer than necessary, more resistant bacteria sometimes develop. It is by no means only those bacteria against which the treatment is directed that become resistant. It can also unintentionally affect the usually peaceful co-inhabitants that colonise the skin and mucous membranes. If they trigger an infection themselves at some point, many antibiotics can no longer harm them.
Long-term use not necessarily required
Studies from recent years have shown that often no long treatment is necessary to cure an infection, such as pneumonia or cystitis. Nevertheless, there are treatments for which too short a course of treatment would be dangerous, for example inflammation of the inner lining of the heart and severe bone and joint inflammation.
Doctors must therefore always make an individual decision, as Prof Gerd Fätkenheuer, Chairman of the German Society for Infectiology, emphasises. The type of bacteria, the course of the disease, the patient's immune defence and much more all play a role. Patients should therefore never stop treatment on their own initiative if they feel better. "Everyone should discuss this with their doctor, anything else would be negligent," warns Fätkenheuer.
Source: "Apotheken Umschau" 3/2018 B
People can specifically prevent depression with just one hour of exercise per week. This is shown by a recent study from Norway. It is interesting to note that a higher intensity or longer duration of sporting activity did not significantly increase the positive effects.
This was shown by Norwegian scientists as part of a large cohort study. In this study, 22,564 study participants were observed over a period of 9-13 years and questioned about their regular physical activity. At the beginning, these test subjects were mentally healthy; after 9-13 years, 7% of the study participants were suffering from depression and 8.7% from anxiety disorders.
The study participants who stated that they did not exercise at the beginning of the observation period had a 44% higher risk of developing depression than those who exercised 1-2 hours per week. These results were independent of the age or gender of the test subjects. There was no such correlation for anxiety disorders.
More sport does not necessarily have more effect
It is interesting to note that a higher intensity or longer duration of physical activity did not significantly increase the positive effects. Just one hour of moderate physical activity per week was enough to significantly reduce the risk of depression. Statistically, the study results mean that 12% of depression could be prevented if all adults were to engage in at least one hour of physical activity per week. Possible explanations for this correlation include the social environment created by physical activity in a group, increased self-confidence and neurobiological factors, such as the release of messenger substances in the body, which could influence the development of depression.
The conclusion: even a small amount of physical activity is worthwhile – not only for the body, but also for the soul!
Study: (CH, CAS) (Harvey et al. Am J Psychiatry 2018; 175:28-36)
Text source: Newsletter by Prof. Dr C. A. Schneider, specialist in internal medicine & cardiology at the PAN Clinic Cologne
An absolute must-attend event is approaching for specialists in the field of hernia surgery. The '15th Hernia Days' will take place at the Maritim Hotel in Cologne on 2 and 3 March 2018. Dr Bernd Stechemesser, Head Physician of the Hernia Centre here at the PAN Clinic, will be one of the scientific directors.
This is the 15th anniversary of the popular specialist congress. Alternating annually with Berlin & Hamburg, this time the cathedral city is once again the venue. The planned programme of events and lectures is varied. The main theme of the congress is: "Hernia surgery beyond the guidelines - problem cases and possible solutions". Special emphasis will be placed on controversies in the treatment of inguinal and primary abdominal wall hernias.
Most common operation in general surgery
Medically, the term hernia refers to a hernia of the intestines. The term is not so familiar to the general public, but inguinal hernia surgery is the most common operation in general surgery. "This operation is performed around 200,000 times in Germany," says Dr Bernd Stechemesser. At 80 per cent, inguinal hernia is the most common form of hernia. Men are affected nine times as often as women.
"Here at the Hernia Centre, we also perform inguinal hernia surgery most frequently, either endoscopically or openly, by incision," says Stechemesser. "This is followed by abdominal wall hernias, umbilical hernias and incisional hernias in terms of frequency."
On the first day of the congress this year, the live video transmission of the operation into the congress centre is particularly eagerly awaited. It will be moderated by experts Bernd Stechemesser, Ralph Lorenz and Wolfgang Reinpold.
The Hernia Days are aimed at both hospital doctors and doctors in private practice who deal with hernias. Registrations are still possible.
Further information:
15th Hernia Days Cologne
Hernia centre at the PAN Clinic
Hernia Centre Cologne
15th Hernia Days in Cologne: Youtube-Video
Is the body designed to get older and older? In any case, the more years we live, the more signs of wear and tear we develop. One of these is osteoarthritis - and this can be very painful for individuals. However, with the right treatment concept, those affected can be helped in a targeted manner at a medical level.
All conservative treatment options are utilised and surgical joint-preserving options are included. The joint cartilage's inability to regenerate means that arthrosis management must be customised for each patient. This is precisely the approach of the Arthrosis Centre Cologne, which is based at the PAN Clinic as an affiliated practice
The German Society for Osteoarthritis Management, the DGFAM, certifies facilities, so-called osteoarthritis centres, which offer conservative and surgical treatment of osteoarthritis in line with international guidelines. This includes the Cologne Osteoarthritis Centre. Under the direction of orthopaedic surgeon Dr Rudolf Ziolko, specially trained specialists can offer all treatment options for osteoarthritis and joint preservation. Regenerative medicine methods in particular play a major role here.
Wide range of conservative therapy approaches
The great success of arthroplasty should not obscure the fact that around 20% of knee replacement patients are not satisfied with their knee prosthesis! "In any case, all other treatment options must be exhausted before implanting a prosthesis," demanded the German Society for Arthroplasty at a press conference on the occasion of its annual congress in Hamburg on 30 November 2017.
There are a variety of different non-surgical treatment approaches. With the involvement of the family doctor, the course of osteoarthritis and the symptoms and progression of the disease can be favourably influenced.
Further information and contact details for the Arthrosis Centre Cologne can be found at: www.arthrose-zentrum-koeln.de
Artificial insemination is offered as a medical service by various clinics in Germany. For many patients who wish to have children, however, it is difficult to judge who they should entrust with fertility treatment and which criteria make successful reproductive medicine possible in the first place.
We will tell you the key decision factors for treatment and explain why you are making the right choice with fertility treatment at the MVZ Pan Institut.
The laboratory environment
The embryo is not adapted to the environment in the laboratory, which can lead to stress that reduces the likelihood of pregnancy.
Three stress factors damage the embryo and influence the likelihood of successful treatment: pollutant content of the air, oxygen content in the incubator and constant conditions after fertilisation until transfer to the uterus. Our laboratory has excellent conditions for preventing embryo stress: The air in the incubator has the ideal oxygen content (5%), pollutants are filtered out and incubation after fertilisation until transfer is trouble-free.
The latest technology
The basis for ideal conditions is the use of the latest technology. For clean air, we rely on the clean room air conditioning system and dust & carbon filters. The Miri Benchop Multi-room Incubator ensures the best possible conditions for the cells with a low oxygen content before fertilisation. And the best incubation conditions after fertilisation are made possible by using the Embryoscope. Our centre has been working with the 'Original' model since 2012. More recently, we have been using its successor, the Embryoscope +, which has only recently come onto the market and is the best device in its class.
The Embryoscope is a new method in reproductive medicine with which pregnancy rates in IVF/ICSI can now be significantly improved. It is an incubator with a special microscopic camera.
The decisive factor is this: In no other device are the embryos so well monitored and can develop so well under constant incubation conditions. More information.
This is also shown by the success rates (per transfer after ICSI):
Conventional incubator:
Age up to 35: 43.9%
Age from 36: 21.7%
(total 32%)
Use of the embryoscope:
Age up to 35: 46.0%
Age from 36: 41.4%
(total: 44%)
The success rate with the new devices has improved by 19.7% in the 36+ age group in particular
Experience & Expertise
It is not only the best conditions and first-class technical equipment that influence the results of fertility therapy, it is also the experience of the doctors involved in dealing with the technology and methodology.
Our doctors and staff are experts who have been working intensively in this field for years, are certified, receive regular training and can build on a wealth of experience thanks to many successful fertility treatments. This further increases the quality of treatment for our patients.
If you are interested in an informative discussion or have any questions on the subject. The team at the MVZ PAN Institute will be happy to answer your questions: Your contact enquiry..
Endoscopic or minimally invasive surgical procedures have become an integral part of surgery today. When the first gall bladder operations were performed using the so-called keyhole technique in the early 1990s, this was still a minor sensation.
Today, in addition to gallbladder operations, this technique is also used for operations on the large and small intestine, stomach and oesophagus and, of course, hernia and hernia operations. The state of surgical skills always reflects the technical development of video and camera technology. After the initial relatively low-contrast and poorly illuminated video devices came the high-resolution video cameras with the corresponding HDTV screens and finally the 3D video endoscopes.
The disadvantage of wearing 3D glasses is clearly outweighed by the advantages of spatial vision. Scientific studies have shown that 3D technology can be used to perform operations much more safely and quickly than 2D technology. This means that operations can be performed faster, safer and more complex than before with the help of this technology.
Dr Bernd Stechemesser | Specialist for Surgery"Since the middle of last year, 3D technology has been used for all laparoscopic and endoscopic procedures at the Hernia Centre Cologne, and all patients undergoing endoscopic or laparoscopic surgery will benefit from this.
The outstanding full HD visualisation in combination with the latest 3D technology leads to optimum hand-eye coordination. This helps the surgeon to maintain a high level of concentration. Only spatial vision enables "unerring" work. Targeting delicate structures, optimising the positioning of suture needles or precisely separating the finest tissue structures becomes child's play. The 3D system at the Hernia Centre Cologne makes it possible to achieve better surgical results. Even long and demanding procedures are less tiring with the 3D system at the Hernia Centre Cologne compared to a 2D Full HD system."
Quelle:
Dreidimensionale Videobilder für die endoskopische Chirurgie
AF Durrani et al. Comput Biol Med 25 (2), 237-247. 3 1995.
3D HD versus 2D HD: Chirurgische Aufgabeneffizienz in standardisierten Phantomaufgaben.
Surg Endosc. 2012 May;26(5):1454-60. doi: 10.1007/s00464-011-2055-9. Epub 2011 Dec 17. Storz P(1), Buess GF, Kunert W, Kirschniak A.
Do you have any questions? We are happy to answer any questions you may have.
Hernia Centre Cologne
Phone: 0221 2776 431
www.hernienzentrumkoeln.de
The embryoscope is a new method in reproductive medicine that is now improving pregnancy rates in extracorporeal fertilisation (IVF/ICSI) worldwide. It is an incubator with a special microscopic camera that takes seven to eight images of each embryo every 20 minutes. For the first time, these images enable the continuous non-invasive observation of cellular and molecular changes.
This is a ground-breaking development in embryo culture and has major advantages:
The embryos are spared: they no longer have to be removed from the incubator for observation.
The embryos can be assessed much better and errors can be recognised more easily: One quality indicator, for example, is the cell division cycle - it can only be determined in fast motion.
In incubators without a special camera, the growth of egg cells and embryos is only checked once a day. This makes it possible to determine whether fertilisation has taken place and whether the embryos are developing on time, but developmental disorders remain undetected.
The Embryoscope, on the other hand, enables significantly better identification of the embryo suitable for transfer - with the help of Vitrolife's innovative KidScore d3 software, among other things. This not only leads to a higher pregnancy rate than with normal incubation, but also reduces the number of therapies required until pregnancy occurs. A publication Rubio 2014 Fert. Stert. hows this, as does the data from the MVZ PAN Institute for Endocrinology and Reproductive Medicine.
Prior to the development of the embryoscope, invasive methods were also used in an attempt to better assess oocyte and embryo development. For example, Polar body biopsy (PKB, PBB) was intended to provide more precise information about further cell development. However, this invasive "screening" (PGS) has not led to an improvement, but rather to a reduction in pregnancy rates. For this reason, invasive procedures are currently only of importance in the pre-implantation diagnosis of monogenic diseases (PID).
In order to recognise embryos that are capable of development and to determine the appropriate time for transfer, extensive and continuous processing of the respective image data is required. By comparing the individual personal data with a continuously expanding data pool, it is possible to recognise early cellular abnormalities more and more accurately and to identify the embryo suitable for pregnancy more and more precisely. A positive side effect of this is that the chances of transferring a single embryo are significantly higher and unwanted multiple pregnancies are increasingly avoided.
Currently, health insurance companies do not usually cover the costs of these additional laboratory diagnostics. They amount to around 550 euros and must therefore be borne by the patients themselves.
Dr Bastian Schäferhoff | Head Biologist MVZ PAN Institute for Endocrinology and Reproductive Medicine:
"We have been using the embryoscope at our institute since 2012. In addition to us biologists, the reproductive physicians treating patients also have access to the embryoscope's image data, so patients have the opportunity to track the development of their embryos on a tablet during their medical appointments."
Do you have any questions?
Please do not hesitate to contact us.
MVZ PAN Institute for Endocrinology and Reproductive Medicine
Phone: 0221 2776 200
www.mvz-pan-institut.de
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