Department of Gynecology, Gynecologic Oncology, Mammology and Obstetrics - Knappschaft Hospital Dortmund

About the Department of Gynecology, Gynecologic Oncology, Mammology and Obstetrics at Knappschaft Hospital Dortmund

The Department of Gynecology, Gynecologic Oncology, Mammology and Obstetrics at the Knappschaft Hospital Dortmund offers the full range of medical services in the areas of its specialization. Of particular interest to the department's gynecologists is the treatment of malignancies of the female reproductive organs and breast cancer. Since the successful cancer treatment requires an interdisciplinary and comprehensive approach, the experts in the field of oncology, radiology, radiation therapy, chemotherapy, palliative care and other doctors are actively involved in the therapeutic process. The department has modern diagnostic rooms, as well as high-tech operating rooms for sparing minimally invasive interventions. Since 2011, the department has been performing robotic interventions using the innovative da Vinci Surgical System, including for the treatment of gynecologic cancers. The field of the department's ​​competence also includes integrated management of pregnancy, delivery and the provision of postnatal care for both mother and newborn. The department is headed by Dr. med. Frank Schmolling.

In the field of gynecologic oncology, the department's patients are provided with services for the prevention, diagnostics and treatment of ovarian cancer, uterine cancer, cervical cancer and vulvar cancer (malignant tumors of the external genital organs in women). The initial stage of treatment is a comprehensive diagnostic examination. Depending on a particular clinical case, the patient may require ultrasound scanning, radiography, CT and MRI scanning, cytological and histological examinations, biopsy and other methods. With appropriate clinical indications, the department's specialists also resort to hysteroscopy and other invasive diagnostic methods in order to detect possible metastases in other organs and anatomical structures. With the diagnostic results, the specialists from related fields cooperatively develop an individual treatment regimen, taking into account the particular type of tumor, its stage, localization, the presence or absence of metastases, the general health, the presence of concomitant diseases, the patient's age, etc.

The treatment of gynecologic cancers is based on surgical resection of a malignant tumor, which can be supplemented by such conservative treatments as chemotherapy, radiation therapy, etc. At the advanced stages of oncology, it may be necessary to perform total removal of the organ, for example, ovaries, uterus. Since the department has state-of-the-art technical devices, in most cases, the surgical treatment involves the use of sparing minimally invasive techniques. The department's medical team has rich and successful experience in robotic interventions using the da Vinci Surgical System for the treatment of uterine and cervical cancer. Nowadays, robot-assisted surgery is a breakthrough in surgery, since such operations are characterized by impeccable accuracy of surgical manipulations. Only a few small skin incisions are required to provide surgical access, through which the robotic "slave manipulators" insert special instruments and a miniature camera for the transmission of images of the surgical field to a large screen. Thanks to the multiple zooming during the intervention, the surgeon can clearly see the smallest anatomical structures, vessels, which eliminates the risk of damage to the healthy tissue. In fact, the operation is performed by a robot, but it only runs the commands of a competent surgeon, who carefully controls the entire process and gives commands to the robot sitting at a special control panel. After robot-assisted surgery the patient does not need a long period of hospitalization – she can leave the hospital in a few days. In addition, miniature skin incisions virtually eliminate the risk of profuse bleeding and infections.

The department's priority clinical focus is also on breast cancer treatment. The department provides high quality screening, diagnostics and treatment of breast cancer. To detect breast cancer, the department's doctors carry out such high-precision examinations as ultrasound scanning, mammography, MRI, biopsy and others. The treatment regimen for each patient is developed individually during the interdisciplinary tumor boards. Should surgical treatment be required, minimally invasive techniques are used, if possible. If the patient requires total mastectomy, she is additionally offered breast reconstruction surgery using implants and/or autologous tissues, which is performed in cooperation with the Department of Plastic and Aesthetic Surgery. The therapeutic options are also complemented by chemotherapy and radiation therapy. As a rule, these types of treatment are carried out on an outpatient basis. In addition to classic irradiation, intraoperative radiation therapy can also be provided.

The department has all the modern resources for the integrated management of pregnancy, labor management and follow-up care for both mother and child. Depending on the course of childbirth and the patient's clinical indications, it is possible to carry out natural childbirth or perform a C-section in a specially adapted operating room. To relieve pain during childbirth, the patients are offered homeopathy, acupuncture and epidural anesthesia. The baby is delivered by experienced obstetrician-gynecologists who make every effort to ensure the fast and safe childbirth.

The department's key clinical focuses include:

• Gynecologic oncology
  • Diagnostics and treatment of uterine cancer
  • Diagnostics and treatment of cervical cancer
  • Diagnostics and treatment of ovarian cancer
  • Diagnostics and treatment of vulvar cancer
    • Surgical treatment, including laparoscopic and robot-assisted operations
    • Chemotherapy
    • Radiation therapy
• Mammalogy
  • Diagnostics and treatment of breast cancer
    • Surgical treatment, including follow-up reconstructive surgery using implants or autologous tissue
    • Chemotherapy
    • Radiation therapy, including intraoperative radiation therapy
• General gynecology
  • Diagnostics and treatment of uterine fibroids
    • Drug therapy
    • Uterine artery embolization in the case of uterine fibroids
    • Enucleation of uterine fibroids
    • Hysterectomy
  • Diagnostics and treatment of endometriosis
    • Hormone therapy
    • Surgical removal of the foci of endometriosis
  • Diagnostics and treatment of pelvic organ prolapse (bladder, bowel or uterus)
    • Vaginoplasty
    • Correction of prolapse using a special mesh
    • Hysterectomy
    • Vaginal sacrospinal fixation according to Amreich-Richter and sacrocolpopexy
  • Diagnostics and treatment of genital warts
    • Laser surgery (CO2 laser)
• Obstetrics
  • Integrated management of pregnancy
  • Labor management (vaginal childbirth and C-section)
  • Postpartum care for both mother and newborn
• Other diagnostic and therapeutic options

The department's range of surgical services includes:

• Robot-assisted surgery using the da Vinci Surgical System
  • Hysterectomy for uterine and cervical cancer
  • Surgical repair of pelvic organ prolapse
  • Endometriosis surgery
• Minimally invasive surgery
  • Laparoscopy
    • Tubal sterilization
    • Chromopertubation (method for infertility diagnostics)
    • Surgery to treat ectopic pregnancy
    • Surgery to treat infertility
    • Surgery to treat endometriosis
    • Surgery to remove ovarian cysts
    • Surgery to remove ovaries and fallopian tubes
    • Surgery to remove uterine fibroids
    • Hysterectomy
    • Surgery to eliminate adhesions caused by previous interventions
  • Hysteroscopy
    • Surgery to remove polyps and uterine fibroids
    • Hysteroscopy to diagnose infertility
    • Hysteroscopy to diagnose haemorrhages
    • Surgery to remove uterine septum
• Laser surgery
  • Removal of genital warts using the CO2 laser
• Outpatient surgery
  • Hysteroscopy and endocervical curettage of the cervix and its cavity
  • Tissue sampling for biopsy
  • Minor breast surgery
  • Curettage in the case of miscarriage
  • Assessment of the tubal patency in the case of an unfulfilled desire to have children
  • Minor surgery on external gental organs in women
• Other methods of surgical treatment of gynecologic diseases