Constipation treatment with botulinum toxin (program ID: 497480)
PAN Clinic Cologne
Hartmut SchäferSpecialized in: proctology, endoscopy
Department of Proctology and Endoscopy
- Initial presentation in the clinic
- clinical history taking
- physical examination
- review of medical records
- laboratory tests:
- complete blood count
- general urine analysis
- biochemical analysis of blood
- TSH-basal, fT3, fT4
- indicators of inflammation (CRP, ESR)
- indicators blood coagulation
- abdominal ultrasound
- treatment with botulinum toxin
- symptomatic treatment
- control examinations
- nursing services
- nutrition recommendations
- explanation of future recommendations
- Medical records
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About the department
The Department of Proctology and Endoscopy at the PAN Clinic Cologne offers the full range of medical services in these fields. The department's doctors provide all modern diagnostic and therapeutic procedures for the patients suffering from rectal diseases. In addition, the patients with stomach and colon diseases can get medical care here. The key focus is on endoscopic examinations and endoscopic therapy. The department has a unique experience in the treatment of fecal incontinence and offers many innovative methods, including the Gatekeeper surgical procedure and percutaneous tibial nerve stimulation (PTNS). The diagnostic and treatment rooms in the department are equipped with modern devices, which allows maintaining the high quality of medical care. The department strictly adheres to the hygiene and safety standards. The health of patients is in the safe hands of highly qualified doctors who have undergone training in the best hospitals in Germany, other European countries and the USA. The Chief Physician of the department is PD Dr. med. Hartmut Schäfer.
Every day, the department's doctors perform diagnostic endoscopic procedures: gastroscopy, colonoscopy, rectoscopy and anoscopy. A gastroscopy is used to examine the esophagus, stomach and duodenum, while a colonoscopy is carried out to assess the inner surface of the colon. When conducting rectoscopy, the department's doctors examine the mucous membrane of the rectum and distal sigmoid colon. An anoscopy is indicated for the patients with suspected anal canal pathology. Each of the above mentioned diagnostic procedures requires preparation. For example, 6 hours prior to gastroscopy, the patient is prohibited from eating food, and 1-2 hours prior to anoscopy, an enema is required. To ensure the maximum comfort for the patients, the doctors use conscious sedation (medication sleep) during endoscopic examinations. Thus, the patient is conscious, but at the same time the harmful effects of anesthetics on the heart and nervous system are excluded.
The department can offer not only diagnostic tests. With appropriate clinical indications, gastroscopy, colonoscopy, rectoscopy and anoscopy can also be performed for therapeutic purposes. For example, gastroscopy and colonoscopy can be used for removing foreign bodies in the stomach or colon, taking measures to stop gastrointestinal intestinal bleeding, removing polyps, small stomach and colon tumors. When performing anoscopy, the department's doctors can provide sclerotherapy and ligation of enlarged hemorrhoids, treatment of anal fissures, coagulation of pathological foci, etc.
The specialists of the medical facility demonstrate excellent results in the treatment of fecal incontinence. The department uses innovative therapies, including the Gatekeeper surgical procedure, percutaneous tibial nerve stimulation (PTNS) and sacral nerve stimulation. The Gatekeeper surgical procedure is most commonly indicated for the patients with severe anal sphincter weakness. The essence of the operation is to implant a special fixing device between the muscles of the internal and external anal sphincter, which contributes to a tighter closure of the anal sphincter and, accordingly, to the elimination of fecal incontinence. Percutaneous tibial nerve stimulation (PTNS) also provides excellent results in the treatment of fecal incontinence. The therapeutic procedure is a non-invasive treatment method, the effectiveness of which is many times superior to drug therapy. During the procedure, a thin electrode is inserted into the area where the tibial nerve passes through and is connected to a neurostimulator. Prior to a therapeutic manipulation, the specialists assess if the electrode is properly placed. Percutaneous tibial nerve stimulation (PTNS) is usually carried out once a week. As a rule, the treatment course lasts 12 weeks.
The department specializes in the diagnostics and treatment of the following diseases:
- Anal venous thrombosis
- Hemorrhoidal anal skin tags
- Anal fissures
- Anal abscesses and fistulas
- Rectal prolapse
- Gastrointestinal tumors (stomach, colon, rectal tumors)
- Anal and perianal tumors (benign and malignant)
- Anal and perianal warts
- Inflammatory bowel disease (Crohn's disease and ulcerative colitis)
- Fecal incontinence
- Other proctological pathologies
The department's range of medical services includes:
- Esophagogastroduodenoscopy (gastroscopy)
- Sonography and 3D endosonography of the rectum
- PCR detection of human papillomavirus
- Anoscopy (for example, for anal cancer screening)
- Gastroscopy for therapeutic purposes (for example, to remove a foreign body in the stomach, eliminate gastrointestinal bleeding, remove stomach polyps)
- Colonoscopy for therapeutic purposes (for example, to remove foreign bodies in the colon, remove colon tumors, eliminate colon bleeding)
- Rectoscopy for therapeutic purposes (for example, to remove rectal neoplasms)
- Anoscopy for therapeutic purposes (for example, for sclerotherapy and ligation of enlarged hemorrhoids, treatment of anal fissures, removal of mucosal polyps)
- Treatment of hemorrhoids with radio waves (Rafaelo procedure)
- Gatekeeper surgical procedure for fecal incontinence
- Percutaneous tibial nerve stimulation (PTNS) for fecal incontinence
- Sacral nerve stimulation for fecal incontinence
- Other diagnostic and therapeutic options
Higher Education and Professional Career
- Study of Human Medicine at the University of Cologne.
- 1989 Internship in the Department of Surgery at the University Hospital Cologne.
- 1991 Doctoral thesis defense. Subject: "Chronic heart failure caused by intake of ibopamine".
- 1991 - 1993 Internship abroad, Rome (Italy), scholarship of the German Research Foundation.
- 1993 Resumption of work at the University Hospital Cologne.
- 1995 Board certification, University Hospital Cologne.
- Until 31.07.2012 Senior Physician and Head of the Section of Surgical Endoscopy and Proctology in the Department of General, Abdominal and Cancer Surgery at the University Hospital Cologne.
- Assistant Professor at the University of Cologne and Member of the State Commission for Final Examination of Medical Students at the University of Cologne.
- Since 01.09.2010 Chief Physician in the Department of Proctology and Endoscopy at the PAN Clinic Cologne.
- Board certification in Surgery.
- Board certification in Coloproctology – certificate of the European Board of Surgical Qualification (EBSQ).
- Board certification in Proctology.
Clinical and Research Interests
- Treatment of colorectal diseases.
- Endoscopic diagnostics and treatment of gastrointestinal diseases.
Photo of the doctor: (c) PAN Klinik