Open laparotomy and sanitation of the abdominal cavity in endometriosis in the pelvic cavity in Hospital Nordwest Frankfurt am Main

About the department

According to the prestigious medical magazine Focus, the Department of Gynecology, Gynecologic Oncology, Urogynecology, Mammology and Obstetrics at the Hospital Nordwest Frankfurt am Main ranks among the best German medical facilities specializing in the surgical treatment of gynecological diseases!

The department offers all the options of modern medicine for the diagnostics and treatment of diseases of the female reproductive system. The treatment of gynecological and breast cancers is of particular interest to the department's gynecologists. Outstanding success in the treatment of female genital cancers is confirmed by the certificate of the German Cancer Society. The department performs all classic and modern operations, including minimally invasive procedures, plastic and reconstructive breast surgery. The specialized Breast Cancer Center, which is part of the department, provides effective treatment of various stages of breast cancer. The department has three modern delivery rooms and a highly qualified team of obstetricians who provide top-class medical care for expectant mothers before, during and after childbirth. The Chief Physician of the department is Prof. Dr. med. Jörg Engel.

One of the priority focuses of the department's clinical activities is the treatment of female genital cancers. Thanks to a perfect command of the very latest therapeutic methods for cancer treatment, the department's specialists regularly achieve high treatment success rates, even in especially complex clinical cases. The focus is on patients with cervical cancer, endometrial cancer, ovarian cancer and vulvar cancer. Each clinical case is considered individually, which is followed by the development of an optimal treatment regimen. The therapeutic process is preceded by comprehensive diagnostics using high-resolution sonography, CT, MRI, scintigraphy, biopsy, etc. The department has many methods for effective therapy: surgical treatment, radiation therapy, radiofrequency therapy and microwave ablation, chemotherapy, antibody therapy, laser surgery and many others. Depending on the stage of the disease and clinical indications, the patient is appointed an optimal type of treatment or a combination of several therapeutic methods. Particular attention is paid to the follow-up monitoring of patients in order to avoid cancer recurrence. The doctors from related medical disciplines, including oncologists, chemotherapists, radiation therapists, surgeons, urologists and other specialists, are involved in the diagnostic and therapeutic process.

The department carries out an innovative type of chemotherapy, namely hyperthermic intraperitoneal chemotherapy (HIPEC). The therapeutic procedure includes a single injection of a chemotherapy agent warmed up to 42-43°C into the patient's abdominal cavity, where it directly affects the tumor. Due to the fact that the chemotherapy drug is heated to a high temperature, it penetrates deeply into the tissues and inhibits the growth of cancer cells that remain there, which cannot be removed with surgery. The HIPEC procedure is highly effective, while the side effects of this type of therapy are mild or completely absent.

Many women with suspected breast cancer seek medical care in the department. At the initial consultation, the mammologist studies the patient's medical history and carries out a clinical examination, after which he appoints the necessary set of diagnostic tests. The diagnostic options offered in the department are quite extensive. They include digital mammography, digital tomosynthesis, high-resolution ultrasound examinations (2D and 3D sonography, Doppler ultrasonography and elastography), breast MRI and biopsy. Thus, the patients can count on reliable diagnostic data and, accordingly, the elaboration of the most effective treatment regimen. To fight against breast cancer, the department's doctors perform surgery to resect malignant tumors, including breast-conserving surgery at the initial stages of cancer, drug therapy for progressive cancer, as well as reconstructive and cosmetic interventions after extensive surgical resections. At the initial stages of oncopathology, breast specialists in cooperation with the Department of Radiation Oncology carry out intraoperative radiation therapy, which consists in intraoperative irradiation of the tumor bed and the areas of potential metastasis. This irradiation technique is highly effective, since it allows the doctors to direct the maximum dose of radiation to the pathological focus without damaging adjacent healthy tissues. During the therapeutic process, women also receive care from the competent psychologists. They help them cope with emotional distress and maintain a positive attitude towards treatment.

The team of the department's gynecologists also specializes in the treatment of urinary incontinence and pelvic organ prolapse in women. In this field, the department cooperates closely with the Department of Urology. The preference is always given to conservative therapeutic methods (for example, drug therapy, physiotherapy to strengthen the pelvic muscles). Surgical treatment is the last-line therapy when drugs and other non-invasive methods do not allow achieving the desired result and cannot restore the woman's health.

The department ranks among the leading Prenatal Centers in Germany. It provides expert ultrasound examinations, which allow the doctors to monitor the course of pregnancy at all its stages, timely detect the slightest deviations in the development of the fetus and find the optimal options for their correction. The department employs a team of obstetricians, doctors and nursing staff who work round-the-clock to deliver babies and provide medical care in urgent clinical cases. In case of natural childbirth the women are offered pain relief – epidural anesthesia. C-section can be performed according to clinical indications. The birthing rooms are made in a modern design and have the necessary equipment for safe childbirth. More than 800 babies are born in the department every year.

The department's key clinical focuses include:

• Diagnostics and treatment of common gynecological diseases
  • Uterine fibroids
  • Ovarian cysts (for example, endometrial or dermoid)
  • All types of endometriosis (peritoneal endometriosis, ovarian endometriosis, adenomyosis and deep infiltrating endometriosis)
  • Urinary incontinence and pelvic organ prolapse (in collaboration with the Department of Urology)
    • Conservative treatment methods
    • Minimally invasive procedures
• Diagnostics and treatment of gynecologic cancers
  • Cervical cancer
  • Ovarian cancer
  • Endometrial cancer
  • Vulvar cancer (tumors of the external female genital organs)
    • Surgical treatment, including minimally invasive interventions
    • Outpatient drug therapy (chemotherapy, antibody therapy, hyperthermic intraperitoneal chemotherapy (HIPEC) for peritoneal metastases)
    • Radiation therapy
    • Radiofrequency therapy and microwave ablation
    • Laser surgery for metastases
    • Image-guided (CT-guided) pain therapy 
• Diagnostics and treatment of breast cancer
  • Breast-conserving surgery and intraoperative radiation therapy (at the initial stages of pathology)
  • Drug therapy (for progressive stages of pathology) – chemotherapy, hormone therapy, antibody therapy
  • Reconstructive and cosmetic procedures after radical surgical treatment
• Diagnostics and treatment of urogynecological diseases
  • Urinary incontinence
  • Pelvic organ prolapse
    • Conservative treatment
    • Surgical treatment
• Obstetric services
  • Integrated management of pregnancy, including high-risk pregnancies
    • Enhanced first trimester screening (IGeL)
    • Non-invasive prenatal testing (NIPT)
    • Ultrasound screening (in accordance with pregnancy management guidelines)
    • 3D and 4D ultrasound examinations (optional)
    • 3D vaginal sonography for the diagnostics of gynecological diseases
  • Childbirth (natural childbirth, C-section, water childbirth)
  • Pain therapy during childbirth (epidural anesthesia)
  • Postnatal care for both mother and baby
• Other services

The department's range of surgical services includes:

• Hysteroscopic interventions
  • Removal of polyps, cysts and uterine fibroids
  • Removal of the endometrium in case of its hyperplasia or neoplasms
• Laparoscopic interventions
  • Infertility interventions, assessment of the fallopian tube patency
  • Laparoscopic surgery for chronic pain in the lower abdomen
  • Laparoscopic surgery for cervical cancer
  • Laparoscopic surgery for endometrial cancer, including removal of the pelvic and para-aortic lymph nodes (laparoscopic Wertheim's procedure)
  • Laparoscopic sentinel lymph node biopsy
  • Sterilization
  • Laparoscopic surgery to remove the ovaries and fallopian tubes
  • Laparoscopic supracervical hysterectomy
  • Total laparoscopic hysterectomy (total removal of the uterus)
  • Laparoscopic interventions for stress urinary incontinence
  • Laparoscopic interventions for pelvic organ prolapse
  • Laparoscopic interventions for ovarian and peritoneal endometriosis of any severity
  • Extensive laparoscopic interventions for deeply infiltrating endometriosis
• Other surgical interventions