Лечение в Германии Center for medical treatment in Germany

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Category Archives: Surgery

Hurt crushing of spinal cord

Clinical diagnosis

МРТ и МРА головы

МРТ и МРА

Heavy spinal cord trauma. Unstable fracture dislocation of body. C6. Hurt crushing of spinal cord. Superior flabby Para paresis, lower paraplegia. Dysfunction of pelvis organs on central type. Condition after posterior and anterior spondylosyndesis. Condition after tracheostomy, epicystostomy. Sepsis. Septic shock on background of bilateral infiltrate pneumonia. Serious degree of anemia.

The patient was brought to Regional Medical Centre by these complains:pains on the neck part,nonmovement of hands.
Anamnesis morbi: According to information received from relatives the patient was crashed by crash. He was brought to regional Medical Centre, to reanimation.

Anamnesis vitae

According to information received from mother he didn’t have any skin diseases, never has derma to venerologik,tuberculosis.he doesn’t have genetic disease. The patient had an operation with  problems as anterior spondylosyndesis.C 5-C7 with Atlantis system, and by epicystostomy.After X-ray all problems are solved which he had before.The patient breaths by instrument.he can’t breath himself that’s why they did an operation by putting tracheotomy.His condition was so serious and he consulted at professor and he was advised to be at Regional medical centre..He was output for neurorehabilitation.

Anamnesis vitae

According to information received from mother he didn’t have any skin diseases, never has derma to venerologik,tuberculosis.he doesn’t have genetic disease. The patient had an operation with  problems as anterior spondylosyndesis.C 5-C7 with Atlantis system,and by epicystostomy. had serious type of anemia that’s why he took 473 ml of 2 dose blood transfusion.He doesn’t have bad habits.

Status praesense communis

Condition of patient is so hard,dysfunction of spinal cord.Body structure is normosthenic.Colour of skin is normal,clean,body temperature is  36 C,wetty.Condition of eyes are clean.Shape of nose is not changed, breathing is normal.Type of breathing is mixed.,rhythmical.Breathing is 18 time per minute.Vesicular breathing on lungs’ auscultation,there is not any vibration while breathing.On heart auscultation the sound of heart is normal,rhythmical.The colour of oral cavity is pink,clear.The shape of tongue is normal,dry.Inside is soft,there are n’t any peritonitis  symptoms.

Status nevrosus

He answers all questions very adequate. He has an orientation.Photoreaction is saved. D=S. Tongue’s position is by central stripe. The function of teeth is normal.Tetraplegia. Lower part of  chest  is nonsense to any medicine. Dysfunction of pelvis organs on central type. Pains on spinal cord.
Last: hemoglobin-134,  erythrocyte-3.8, leukocyte-6.6, monocyte-5.4, lymphocyte-35.3.
Previos:  protein-59.2, albumin-33.6, bilirubin-10,20, sugar-5,04, urea-5.1, creatinine-89.0

Treatment

After rehabilitation condition of patient is normal,but after treatment all pains such as Superior flabby Para paresis, lower paraplegia. Dysfunction of pelvis organs on central type is left.

Offers

  • Must be on the observation of neurologist,urologist.
  • Breathing gymnastic,acupuncture,massage.
  • Renal tea.
  • Doesn’t have complication of lungs.
  • To continue rehabilitation at Regional Medical Centre,neurosurgery section.

Paraparesis and lower paraplegia

Full information of diagnoses

МРТ шеи

Paraparesis and lower paraplegia

Heavy spinal cord trauma. Unstable fracture dislocation of body. C6. Hurt crushing of spinal cord. Superior flabby paraparesis, lower paraplegia. Dysfunction of pelvis organs on central type. Condition after posterior and anterior spondylosyndesis. Condition after tracheostomy, epicystostomy. Sepsis. Septic shock on background of bilateral infiltrate pneumonia. Serious degree of anemia,spinal cord trauma,paraplegia.

Anamnesis morbi

Carcrash on 16.12.12.Operation on 18.12.12. On 18.12.12 the patient had an operation with  problems as anterior spondylosyndesis.C 5-C7 with Atlantis system,and by epicystostomy.After X-ray all problems are solved which he had before.The patient breaths by instrument.he can’t breath himself that’s why they did an operation on 24.12.12 by putting tracheostomy.

Anamnesis vitae

According to information received from mother he didn’t have any skin diseases, never has derma to venerologik,tuberculosis.he doesn’t have genetic disease.

Status nevrosus

Level of consciousness of 15 points on a scale of Glasgow. Photoreaction is alive, symmetrical face, swallowing and phonation are not violated. urinating by epitsistostome. muscle strength in the legs and in the bones is 0. Dysfunction of pelvis organs.

Local

Injury without signs of inflammation with sluggish granulation and fibrin coating in the area of ​​the scar in the area of ​​the projection of the vertebral.C4-Th1.

Survey

Indicators of laboratory and instrumental examinations for admission to the respective lists of hospitalization at Scientific Medical Centre. fracture-dislocation of the spine, chronic bronchitis, blood negative for HIV, hepatitis B negative blood, some reduction in the size of the left kidney;
Conclusion urologist: disruption of the pelvic nitrogen bladder, cystitis secondary.
Operation 1: Front access parafaringialny left, the removal of metal, resection of the body.
Operation 2: rear access, spinal fusion neurological status in the dynamics unchanged, there is not any active movement of the lower limbs.Was output home in a satisfactory condition. recommended: observation by a neurologist, avoid colds and physical activity, occupational therapy courses at the neuropathologist.

Rehabilitation treatment

Some reduction in the size of the left kidney;

Course of rehabilitation treatment is completed, the patient is discharged home in a satisfactory condition. during treatment with positive dynamics. improved overall health. stable hemodynamics, pain in the cervical vertebra.
When you receive a complaint: pain in the cervical spine, enhancing when turning the head. Weakness  and violation sensibility in the limbs, limitation of movement in the hands, disruption of the pelvic weakness.

Physiotherapy

A laser-projection of the bladder: magneto-on the distal upper and lower extremities. bladder to the distal upper and lower extremities: mineral wax on the distal lower extremities massage of the lumbosacral spine of the lower extremities.
postural exercises in neck braces, dosed.

Heavy spinal cord trauma

Clinical diagnosis:

Heavy spinal cord trauma. Unstable fracture dislocation of body. C6. Hurt crushing of spinal cord. Superior flabby Para paresis, lower paraplegia. Dysfunction of pelvis organs on central type. Condition after posterior and anterior spondylosyndesis. Condition after tracheostomy, epicystostomy. Sepsis. Septic shock on background of bilateral infiltrate pneumonia. Serious degree of anemia.

The patient was brought to Regional Medical Centre after car crash with spinal cord trauma

Patient’s complains: Pains of the neck, pains during the movement, paraplegia.

Anamnesis morbi: According to information received from relatives the patient was crashed by crash. He was brought to regional Medical Centre, to reanimation.

Anamnesis vitae: According to information received from mother he didn’t have any skin diseases, never has derma to venerologik,tuberculosis.he doesn’t have genetic disease.
Status praesense communis: Condition of patient is so hard,dysfunction of spinal cord.Body structure is normosthenic.Colour of skin is normal,clean,body temperature is  36 C,wetty. Condition of eyes are clean.Shape of nose is not changed, breathing is normal.Type of breathing is mixed.,rhythmical. Breathing is 18 time per minute.Vesicular breathing on lungs’ auscultation,there is not any vibration while breathing. On heart auscultation the sound of heart is normal,rhythmical. The colour of oral cavity is pink,clear. The shape of tongue is normal,dry. Inside is soft,there are n’t any peritonitis  symptoms.
Status nevrosus: He answers all questions very adequate. He has an orientation. Photoreaction is saved.D=S.Tongue’s position is by central stripe.The function of teeth is normal.Tetraplegia. Lower part of  chest  is nonsense to any medicine.Dysfunction of pelvis organs on central type.Pains on spinal cord.
Result of analysis:unstable discolation,crushing spinal cord.
It was an operation by intubation.After operation there was problems with vertebra,C-6-C5 vertebras are fully dislocated.All problems was received to neurosurgery and suggested to do an operation. The patient had an operation with  problems as anterior spondylosyndesis.C 5-C7 with Atlantis system,and by epicystostomy. After X-ray all problems are solved which he had before. The patient breaths by instrument. He can’t breath himself that’s why they did an operation by putting tracheostomy.On auscultation part of lungs there is vibration,pneumonia. There is purulent  liquid  by tracheostomy instrument,body temperature is 37-39 C.On status nevrosus there is superior flabby paraparesis,lower paraplegia,dysfunction of pelvis organs on central type.
The history of patient was informed and suggested to invite other neurosergeons and neureanimations to other Medical Centre.
The patient was at professor. He advised to continue antibacterial theraphy,vitamin theraphy,eating by  probe,to find out sensibility to antibiotics.
The patient  was again at professor. He found out the vibration on the right side of auscultative lungs.
By analysis his hemoglobin was 75 g\litre,that’s why doctor advised to do bloodtransfusion,and change all antibiotics because he has reaction to them.
Blood to sterility – Blood is sterility.
Nowadays the condition of patient is feet and can breath himself.
Nevrosus status is clear,but superior flabby paraperesis,lower paraplegia,dysfunction of pelvis organs are left.
The patient was output for rehabilitation.

Offers:

  • Must be on the observation of neurologist,urologist.
  • Breathing gymnastic,acupuncture,massage.
  • Renal tea.
  • Doesn’t have complication of lungs.
  • To continue rehabilitation at Regional Medical Centre,neurosurgery section.

Gastric cancer

gastric cancer

gastric cancer

Patient:

A female friend of mine ( aged  25 ) from Dubai was diagnoses as having gastric cancer  2 months ago.  She has had part of her stomach removed in a hospital in Shiraz  ( Iran ).  She has been told by the doctor who did the operation, to go immediately to Germany for the continuation of her treatment.  Please kindly advise as to exactly where in Germany is best for her to go for the continuation of her treatment.
Thanking you for your kind attention, I look forward to hearing from you soon.

Answer:

Thank you for contacting our Medical Services  for information on obtaining medical care for you.
In order for our physicians to properly review this case and determine an appropriate course of treatment, we would need additional information.
Please complete the attached New Patient Form and sign the Financial Policy statement and return the forms along with all pertinent medical records in German or English (including any CT scans, MRIs or x-rays, etc).

In order to give a 2nd opinion the doctors need to know/receive:

  1. Clinical notes, medical history,
  2. Treatment he has received up till now Chemo? Dosage & frequency?
  3. Radiation? Dosage & frequency?
  4. His symptoms?  
  5. Current list of medication
  6. List of operations/surgeriesOperative report
  7. Pathology slides and reports.
  8. A copy of the images of his PET CT Scan on a CD sent to our address below.

Also, as of January 1, 2000 we are required to verify patient identity. Please review the attached document which list acceptable forms of identification.
Please send a copy of his photo identification to our Medical Services Department with his completed patient forms and medical records and be prepared to show his original photo documentation when he arrives for his appointment(s).
You may return the forms/medical records via e-mail and you can return these forms to our office via regular mail, DHL, Fed Ex or UPS to our address.
Once we have received this information, our physicians will review the case and advise accordingly.  Please be advised that there may be a fee associated with this consult.

Tummy Tuck

Tummy Tuck in Germany

Abdominoplasty

Abdominoplasty in Germany

Patient:

I have had loose skin in and fat stored in my abdominal area since I can remember.

I am seriously considering having a Abdominoplasty Tummy Tuck but first would need some more information before going through with it.
I’m not over weight i just have a small belly that hangs out with some loose skin which i would like to be removed through this procedure. Firstly how much does the operation cost because in my country the price is extraordinary and are seeking alternative’s price wise. So roughly could you tell me how much the operation would cost including the 1-3 day stay in your hospital. Also when your happy for me to leave your care after 1-3 days would i need to then see a doctor in my country to get the stiches removed? or would you recommend me staying in Berlin for two weeks to get the stiches removed there before flying back to the UK?

I would also like to ask if you have had someone visit you for a similar  operation before from the UK? If so would you need someone to come with you or would you manage ok on your own after and operation like this?

If I’m happy with the information provided i would like to go ahead with the procedure and book the next available appointment. I can provide pictures of my abdomen from different angles if requested.

Answare:

Thank you very for contacting our center. We do have a lot of patients coming to Munich for the same procedure. The  surgery price depends on the amount of the skin to be removed and varies. We need to know your health history, weight, height and all the pictures and any additional information you can provide  to tell you the price range.

Patient:

Yeah sure I understand in order to get an accurate price I can provide this information: I’m 22, 168cm tall/5ft.5, I weigh 65kgs, I’m not on any medication, I don’t have any disability’s or health conditions, and I’m not allergic to anything. Any I have attacked 3 pictures of the area of skin I would like removed/tightened.

Answare:

Can you,please, send us a copy of your passport for the authentication.
We will send you an estimate later this week. Thank you for choosing us!

Treatment of Barrett’s esophagus

Treatment of Barrett's esophagus in Germany

Treatment of Barrett’s esophagus in Germany

Question:
In 2008 I was diagnosed with esophagus  Barrett. Sigmenta length of 6.5 cm
All these years I was taking rabeprazole (40) and Gaviscon and regularly made gastroscopy.
But the improvement was not observed.

The latest survey showed presence of polyps in the stomach and easy dysplasia in the esophagus. My doctor believes that as my case I for the treatment of esophageal shown BARRX Radiofrequency aplation (HALO 360). But in Moscow, this device is not present.

I am wondering whether there was in your clinic treatment of Barrett’s esophagus. Treatment by BARRX radioyaastotnoy ablation is crucial when choosing clinic in Germany.

Answer:
Certainly we have at the disposal of the unit BARRX Radiofrequency aplation and on par with other modern methods of treatment Barrett’s esophagus in Munich is used and the method of treatment BARRX.

To concretize our offerings, you will need to sign an agreement with us, send us a copy of the first page of your passport and your case history.

Mammary cancer

Mammary cancer

Mammary cancer

Mammography

Examination was accomplished in standard projections: straight and oblique. The mammary glands are symmetrical.
The areolas are output at a contour. The skin is not thickened, not condensed. The bands of fibrous tissue – Cooper’s ligaments are left from the skin. The premammary space is not constricted. A tissue of the mammary gland is presented in central and lateral areas by the glandular tissue, in medial by adipose and line diffuse fibrosis in all quadrants. The density of both breasts has the 2nd grade.
At this background of pathological masses, no micro calcinations are detected
Single micro calcifications are visualized on the border of inferior quadrants of the left breast.
A vascular grid is well defined.
No abnormalities of the lymph flow zones on the right and on the left.

ECHO MAMMOGRAPHY

The mammary glands are symmetrical. The skin is not changed.
The mammary glands have the usual structure for this age.
The differentiation of tissues is evident sufficiently.
Cooper’s ligaments which go deep are thickened and condensed.
Galactophorous ducts are moderately dilated till 2.0-2.5 mm.
No pathological parts of vascularization are detected.
Parts near areola are without any changes.

Impression: No signs of malignizalion are detected. ACR1 is for the right and ACR2 is for the left breast. The density of both breasts has the 2nd grade. Ultrasonic signs of diffuse changes of the breasts by the type glandular mastopathy.

General examination: The patient complaints for having a mass in the upper-internal quadrant of the left breast, which she noted in August 2012. She has felt enlargement of this mass in sizes from August till today.
Data of previous consultations – 28 of May 2012 – mammography, Breast use – ACR1 is on the right, ACR2 is on the left.
For the period from May till November felt changes in hormone therapy, climate changes (lived in Uzbekistan in summer).
St. localis: The mammary glands are symmetrical, and the regular color. The skin is not condensed under them. A mass of rounded form with solid non-crushing consistency and unconsolidated with surrounding tissues till 2 sm is palpated in the upper-internal quadrant of the left breast. Palpation is without pain. The axillary lymph nodes are not palpated.
Breast ultrasound: The mammary glands are placed typically; the skin is without any changes. The differentiation of tissues is expressed in both breasts. The correlation of adipose and glandular tissue: 1/3.
The Galactophorous ducts are thickened a little in both breasts till 2.0-2.1 mm. Cooper’s ligaments are not thickened and not expanded.
A dimensional, massive, hypo echoic and avascular mass of oval form 17.4×10.3 mm, which has calcinations in the center is located in the left breast in the upper-internal quadrant. No areas of pathological vascularizations. The regionary lymph nodes are not increased.

Impression: Ultrasonic signs of moderate diffuse changes of both breasts by the type of glandular mastopathy. Signs of dimensional mass of the left breast (fibro adenoma?). Biopsy of the pathological mass of the left breast is recommended.

HYSTOLOGY EXAMINATION

Tissue labeling, number of objects: №1 – biopsy of the tumor of the left breast.
Clinical diagnosis: Malignized tumor of the left breast.
Macroscopic description: 4308-01, 02 – two (2) grey color bands with brown areas and with the length of 1.7 sm each.
Microscopic description: Conclusion: Enlargements of invasive ductal carcinoma Grade III are revealed in all biopsy samples in the tissue of the mammary gland.

Mammography

Examination was accomplished in oblique views. The mammary glands are symmetrical and not deformed. The skin is not thickened, not condensed.
The bands of fibrous tissue – Cooper’s ligaments are left from the skin. The premammary space is not constricted.
A tissue of the mammary gland is mainly presented by glandular tissue, in medial areas by adipose tissue and line diffuse fibrosis in all quadrants.
High intensity without clear contours of rounded mass till 18 mm in diameter, which is located retromammary, containing single polymorph micro calcinations is revealed at this background on the border of internal quadrant of the left breast. Behind the mass, a single line calcination is visualized. Abnormality of architectonic of structured picture of the central part of the left breast due to stroma deformation is revealed. A vascular grid is well defined.
No abnormalities of the lymphatic flow on the left and on the right.
IMPRESSION: ACR1 is for the right and ACR4 is for the left breast. X-ray signs of dimensional mass of the left breast.

MAGNETIC RESONANCE IMAGING BREASTS

Description of the research:
A mass of rounded form with even contours and sizes 16x11x17 mm due to active accumulation of contrast material more on the periphery with washing-out to the 3rd minute is revealed in the left breast in the deep areas of the breast in the upper-internal quadrant. The mass is surrounded by the rich vascular grid.
No pathological changes in the right breast. No areas of accumulation of contrast material in the lymphatic nodes are detected.
No bone destructive changes.
IMPRESSION: MR picture of the left breast damage, probably, having neoplastic nature. Biopsy is recommended to make verifications.
Magnetic resonance tomograph EXCELART Vantage Atlas-X 1,5 T Toshiba

Complaints: for having occasional pain in the breasts and having a tumor-like mass of the left breast.
History of the disease: After self-palpation in April 2012, the patient noted a tumor-like mass for the first time.
General examination: Micromastia. The breasts are asymmetrical in the inferior-internal quadrant of the left breast. Vertically oriented tumor-like mass of the solid consistency with sizes 20-27 mm is palpated (the patient notes enlargement of the tumor after biopsy). No skin symptoms. Regionary lymph nodes are palpated not clear. No nipple discharge.
Diagnosis:
C50.3 Cancer of the left breast T3NxMx
Differentiated diagnosis: diagnosis is verified. Plan of examination: Mammography.
Treatment: Additional consultation of oncomammologist and chemotherapist for defining indications to have possible neoajuvant chemotherapy.

Рecommendation

Treatment in Germany.
Ideal: treatment in Munich.

Liposuction in Germany

Liposuction in Germany

Liposuction

Total liposuction

Liposuction is a bariatric surgery to change surgically mass deposition of fat in certain areas of the body. As a rule it is the abdomen, thighs and buttocks. Liposuction can certainly is a method for the treatment of obesity, it does not affect the pathogenesis of obesity. With the help of liposuction can not remove all the fat. However, the visual effect of liposuction for a figure greater than the reduction in fat mass in other ways.

During the initial consultation, the German experts will demonstrate the opportunities and limitations of liposuction, will give an overview of different methods and techniques and.
Males have only about 30,000 of fat cells, while the women have about 40,000. The location on the body of the cell, and therefore justified gineticheski are hereditary. Problems arise only when they are enlarged, irregular and often in places where they do not really need. The concept of “problem areas” is the key to these cases.

Diet? Sports? Both approaches are undoubtedly correct and are recommended, depending on the physical condition and medical history. However, compared with liposuction are very important differences and the results: for example diet is recommended if the weight has to be reduced as a whole.
The downside of the diet is that a woman loses weight in the wrong places .  Another undesirable consequence of the diet is the effect of the so-called “yo-yo.” After each diet, the body tries to compensate for the loss of weight, and more often  adds additional pounds of weight.

Special exercises and sports for fitness, health and the development of character is always useful. But it is not always possible with the help of sports at certain locations to reduce fat and come to their ideal figure. As with any diet, weight loss is not enough if the patient feels that with additional shoulder and thigh muscles are even thicker than before.

Benefits liposuction

Unlike diet and intense exercise liposuction does not reduce the weight of the body and does not increase muscle mass. But liposuction solves problems in those places where it is desirable to: flab disappear where they seem unattractive or just plain ugly. Even in these hard to reach areas such as the chin, knees and ankles. Thus, you can actually talk less about liposuction, but rather about lipo-formation. This kind of modern approach allows for outpatient treatment in Germany and is a very gentle way to implement bodyforming.

Underarm hyperhydrosis

Treatment of axillary hyperhidrosis

Axillary hyperhidrosis

Treatment of axillary hyperhidrosis in Germany.

Axillary hyperhydrosis – is a very strong selection of underarm sweat or excessive sweating.

Hyperhydrosis treatment in Germany.

Axillary hyperhydrosis is a disproportionate  sweating  of armpits. Most people find it is annoying, because hyperhydrosis often goes along with no perspiration control  and a strong body odor.

In the past, attempts were made to treat this condition, including by injection of botulin toxin ( Botox ). Unfortunately it  provides only short-term results and therefore should be repeated regularly.

German experts have developed a new technique for extraction of sweat glands  that allows 90% of patients to get a long term results. The method of  an extraction of the sweat glands is based on the technique of liposuction (fat removal). Only experienced surgeons can do it successfully.

Analysis of the extent and function of the sweat glands is needed to make a proper recommendations.

Tummy Tuck in Germany

Skin tightening stomach and abdominoplasty in Germany

Skin tightening stomach

Abdominoplasty

A tummy tuck or abdominoplasty in Germany is only when this becomes necessary. For example, after pregnancy or as a result of the strong weight loss. A simple pull on the skin may not be sufficient to eliminate the excess skin or wrinkles on her. Another indication for surgery is called an overhanging belly or so-called hanging belly. German surgeons in this situation, at the same time spend and reduce fat.

There are so-called big tummy tuck and so-called small abdominoplasty.

For large abdominoplasty simultaneously moves navel. In the general case, the incision is made above the symphysis, ie at the level of the pubis. Incision placed in such a way that it can not be seen in a swimsuit or bikini. Significant excess skin is removed with or without removal of excess fatty tissue, so that the abdominal wall is tightened. In some cases, banding and adaptation of muscles. This is partly determined at the time of surgery, or sometimes when the preliminary study.
To prepare for the surgery required to pass a preliminary examination and preparation for surgery in Munich. In Germany, the German doctors will help determine which method is best suited to each individual case. This may be pure liposuction or skin sufficiently flexible and simple tummy tuck will be sufficient.

Operations of this kind are usually not very expensive, and it takes no more than 3 hours. A tummy tuck operations in Germany are carried out only under general anesthesia. Patients after their stop in 1-2 days.
Postoperative control will require multiple visits for inspection and preoverki zazhivaemosti. Alternating weeks after surgery, the patient will be placed on the so-called top, which will promote good healing. In this case, individual counseling in Munich will also be important.

For more information about Tummy Tuck in Germany please go to medical advice.