To learn more about the PRIVATE HOSPITALS AND MEDICAL CENTRES please visit our dedicated page here on this site

Our specialist treatment pages detail world-leading centres in their respective fields, but sometimes a local hospital or treatment centre is sufficient, so we have started to feature private healthcare facilities around the world. Check this site regularly for updated entries.

AVM and Neurosurgery	Breast Cancer - Interoperative Radiotherapy for Breast Cancer
Cardiology - Niobe Magnetically Guided Catherterisation	Continence - Treatments
Cyberknife Radiosurgery - Treatment and Centres	Da Vinci 'Robotic' Surgery
Eye Cancer	Lung Cancer
Neuropelvelogy	Onlcology
Orthopaedics	Prostate Cancer
Voice

AVM and Neurosurgery

AVM (Arteriovenous Malformation)

Because of their sensitive locations and/or complex shapes AVMs (also known as arteriovascular malformations) can be too difficult and dangerous to operate upon, leaving some patients with little more than palliative care, partial paralysis and the danger of bleeds and complications at any time.

CyberKnife® radiosurgery is a relatively new option for AVM patients, including those with spinal AVM, as it uses a large number of high precision radiation beams which can be moulded to the shape of the AVM.

CyberKnife can be applied in even fine and inaccessible areas where a surgeon would not be able to operate safely

Neurosurgery

Apart from cancers of the brain and spine, high precision CyberKnife radiosurgery offers pain-free and non-invasive treatment for conditions such as trigeminal neuralgia (tic doloreux) and acoustic neuroma (vestibular schwannoma).

Although these are not cancer conditions, the information relating to cancer treatments applies equally here, and in particular the ability to target tumours or AVMs with precision, even in difficult and inoperable locations or wrapped around nerves or blood vessels.

Please visit the CyberKnife page for more details, as much of the information there applies equally to AVMs and neurosurgery.

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Breast Cancer   A new form of radiotherapy is becoming available at a few centres around the world, which is applied in a single dose.

For patients having a lumpectomy the standard procedure is to deliver a course of daily external radiotherapy some weeks after the operation. This is a precautionary measure, to deal with any remaining tumour tissue in the area around the operation site.

The radiotherapy is typically delivered over a period of 4-5 weeks, which is inconvenient and disruptive both for the patient and for supporting relatives. Also some degree of radiation burn to the skin is common, and this can cause considerable distress.

Single dose intraoperative radiotherapy  With the Intrabeam® photon radiotherapy system some breast cancer patients who are having a lumpectomy can now have single day targeted intraoperative radiotherapy.

This offers the least disruptive treatment method available to patients with early stage breast cancer.

After removal of the lump, the immediately adjacent area is irradiated from inside the cavity, using a ball point X-ray applicator, while the patient is still in the operating theatre. This means that radiation is delivered at the earliest possible time and directly to the tumour bed.

The radiation falls away sharply from the point of delivery and only 1cm away from the applicator the intensity drops to just 25% of the original level. This spares the surrounding breast tissue from unnecessary irradiation.

The use of Intrabeam® intraoperative radiotherapy can reduce the subsequent external radiotherapy by 7-10 days or possibly even avoid it altogether, so the risk of radiation burn to the skin is greatly reduced too.

Single dose intraoperative radiotherapy  Originally designed to treat brain cancer tumours, this is now finding a place with breast cancer.

After a lumpectomy the patient usually has 4-6 weeks of external radiotherapy as a precautionary measure, though this often results in radiation burn to sensitive skin. In contrast, intraoperative radiotherapy is delivered in as part of the lumpectomy, directly to the desired target area. This saves weeks of radiotherapy later.and spares the skin and intervening healthy tissue.

Applying for treatment  Intraoperative radiotherapy is not suitable for all breast cancers and it is necessary to join a clinical trial, but treatments are now available. Cases cannot be determined for suitability until the lumpectomy is conducted. Suitable cases (we understand approx 50%) receive intraoperative radiotherapy as part of their operation. Other patients proceed to conventional radiotherapy as usual.

Intrabeam is made by Carl Zeiss Meditec AG. For more information on Intrabeam visit the Carl Zeiss web site

MHL currently features the following centre for intraoperative radiotherapy. More centres are now offering this form of treatment and we hope to add additional centres shortly.

Radiotherapie Hirslanden, Zurich and Aarau, Switzerland

Radiotherapie Hirslanden is part of the Hirslanden Group, Switzerland's largest private healthcare provider, and is centred in the group's flagship hospital Klinik Hirslanden in Zurich.

Klinik Hirslanden invests heavily in the latest medical technologies, including Trilogy® stereotactic radiotherapy, CyberKnife® radiosurgery, da Vinci® minimally invasive robotic surgery, Niobe® magnetically guided heart catheterisation and much more.

Visit the Radiotherapie Hirslanden page

Cardiology

Niobe® magnetically guided catheterisation

Heart centres around the world use catheterisation as part of both diagnostic and therapeutic procedures. Until recently this involved the insertion of catheters elsewhere and navigating them through the body and into the heart using guidewires.

Now the advanced software of the Niobe system uses magnetic guidance from outside the body instead of wires. This enables enables the surgeon to navigate the catheter through the body and to place it in position with great precision and reduces exposure to X-rays.

Occluder Closure

An occluder is an innovative technique for percutaneous transluminal closure of defects in the septum of the heart (without resorting to heart surgery).

A fine synthetic tube (catheter) is inserted through the skin in the region of the groin and advanced via the vascular system into the heart. A 'folded up' wire-mesh implant is then advanced as far as the defect to be closed (hole), where it is opened up.

This does not constitute a cardiac surgical procedure in the conventional sense and normally, the patient can be discharged 1-2 days later.

This technique can be used to repair Atrium Septal Defect (hole in the septum of the atrium) and Patent Foramen Ovale (passage/slit in the septum of the atrium)

Source: Kardiologische Praxis Bremen

Niobe®
Magnetically guided catheterisation

 

 

 

What is catheterisation? Catheterisation is an important procedure, widely used for both diagnosis and treatment of many heart conditions.

The catheter is a short, flexible tube which is placed in the heart, typically to dilate a narrowed artery (angioplasty) instead of resorting to surgery or to detect blockages in the blood vessels leading from the heart and to assess the functioning of the heart itself, as part of a coronary angiogram (also referred to as a dye test).

Does it involve surgery? The use of a catheter can avoid open surgery, but it still has to be placed in the correct position. In most hospitals and cardiac centres around the world this is done by inserting the catheter into the groin, or sometimes the armpit and then guiding it into position with wires, using X-ray based imaging techniques.

There is always some risk involved in any such procedure, but this must be balanced against the potential benefits of avoiding open surgery and the value of the diagnostic information obtained.

Magnetic guidance replaces wires The Niobe® system represents a major advance in heart care by abolishing the use of guide wires. Instead the patient lies between two large magnetic coils, which are used to manipulate small magnets integrated into the tip of the soft and flexible catheter.

The surgeon views the catheter on his monitor and re-aligns the magnetic field, to guide the catheter very accurately, to the millimetre, into the heart chamber. The electrophysiologist can advance and retract the catheter in the heart with a separate control module.

The strong magnetic field and special flexible catheter ensure particularly stable contact with the heart muscle. In addition, the catheters used are extremely soft and flexible to minimise trauma to the heart and blood vessel walls.

X-ray exposure is considerably reduced for doctor and patient alike.

In each case the clinician decides whether to use Niobe® or treat manually, depending upon an individual assessment of the patient including the size of the atrium, secondary disorders, general condition and the course of any irregular heart rhythm. Where Niobe® is used, the specialist’s experience plays a vital role in analysing and co-ordinating the information provided by the various systems: X-rays, stereotaxis, the mapping system (Carto, NavX) and the electrical signals.

Treatment applications for Niobe® include atrial fibrillation, atrial flutter, Wolff-Parkinson-White syndrome and AV nodal reentry tachycardia.

For full details visit the Stereotaxis web site.

Note: MHL has no contractual or financial relationship with Strereotaxis, the manufacturers of the Niobe® system.

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Continence

Urinary incontinence has a huge impact on a person’s self-worth and quality of life. Any involuntary leakage of urine is extremely unpleasant and awkward for the person concerned. Although it is far more widespread than assumed, incontinence is largely a taboo subject.

Functional disorders

Common continence disorders include

Frequent urination during the day	Frequent urination at night
Sudden, frequent and intensified urge to urinate	Lack of sense of bladder filling and weak urge to urinate
Involuntary leakage of urine or urinary incontinence	Hampered and incomplete emptying of the bladder
Incomplete emptying of the bladder	Weak, interrupted urinary stream
Problems starting or initiating urination	Painful bladder filling and emptying

Neuropelveology

The Hirslanden Continence Centre is part of the Hirslanden Group, Switzerland's largest private healthcare group. It is situated adjacent to and cooperates closely with Klinik Hirslanden, the principal hospital in the Hirslanden Group.

Specialists in the fields of neurourology, neuropelviology, urology and gynaecology collaborate closely to achieve the best possible outcome.

What makes the Hirslanden Continence Centre unique? The Centre is uniquely placed to benefit from the new and exciting area of neuropelveology. This was pioneered by Prof Marc Possover, who heads the Neuropelveology Centre next door.

Therapy and treatment

Neuropelveology concentrates on three different surgical approaches

Maximum preservation of the pelvic nerves in the case of radical surgery of the small pelvis. The objective is to preserve all sexual, vesical and intestinal functions in interventions such as surgical treatment of endometriosis, myoma hysterectomy or resection of malignant tumours (oncological surgery)

Minimally invasive pelvic nerve laparoscopy to determine the aetiology of pain in the abdomen and pelvic cavity and optimal treatment, including neurosurgical procedures

Electrode implantation on pelvic nerves. This laparoscopic method, which consists in implanting a neuroprothesis, is also called the LION procedure. It is used in the following cases:

•  As a means to control pain in the small pelvis subsequent e.g. to surgical damage of a pelvic nerve or in the case of pudendal nerve pain (pudendal neuralgia), nerve disease (polyneuropathy) in the lower limbs associated with conditions such as diabetes, or phantom pain following amputation.
•  As a means to control and restore vesical, intestinal and sexual functions
•  As a means to restore mobility in paralysed patients (paraplegia, Spina bifida, multiple sclerosis, etc.).

Because open surgery does not provide adequate access to the pelvic nerves, all these different treatments only became possible with the advent of laparoscopy in general and pelvic nerve electrostimulation (LANN) in particular. This latter technique makes it possible to identify the function of a nerve during the course of surgery.

Neuropelveology is a specialised medical domain that focuses on neurological diseases and functional disturbances of the small pelvis.

Its diagnostic and therapeutic spectrum is very large and includes conditions such as endometriosis, tumours of the small pelvis and postoperative scars and adhesions that may affect the small pelvis nerves and cause pain.

Neuropelveology also studies direct damage to pelvic nerves that occurs, for example, in multiple sclerosis and spina bifida, as well as traumatic spinal cord lesions and nerve wounds caused by extensive surgery.

The diagnosis and targeted therapy of pelvic pain and functional disturbances of the small pelvis require specific medical knowledge in gynaecology, urology, neurology and neurosurgery.

Aside from the brain and the spinal cord, no other part of the human body contains such a large number of important nerves as the small pelvis. Not only do pelvic nerves control key motion processes such as standing up, walking and maintaining balance but they also direct vesical and intestinal functions (filling and emptying) and sexual functions.

The Small Pelvis

 

 

 

 

 

 

 

 

 

 

Signals from the brain to the pelvic nerves travel through the spinal cord and return signals, such as perceptions of pain, are sent back to the brain through the same route.

The same applies to so-called phantom pain that is produced by the brain when incoming signals are wrongly interpreted as pain emanating from an amputated limb.

The nerves, which form a tight nerve bundle within the spinal cord, separate at the level of the small pelvis and innervate different organs, such as the bladder, the intestines and the sexual organs.

The small pelvis is also the only region traversed by the two main nerves of the lower limbs, the sciatic nerve and the femoral nerve, the latter being located at a depth of only a few centimetres.

Stress incontinence

An involuntary leakage of urine that occurs when sneezing, coughing, lifting heavy objects or during physical exertion, but which is not accompanied by the urge to urinate, indicates a weakness in the bladder closure mechanism. Under exertion, the bladder pressure exceeds the closure pressure of the urethral sphincter, resulting in an involuntary leakage of urine.

This is attributable to a weak urethral sphincter. The risk of stress incontinence increases with age and is far greater among women than men. In women, a weakness of the bladder sphincter and stress incontinence can be due to a lowering of the bladder and uterus, or a paralysis of the urethral sphincter. In men, a prostate operation is the most frequent cause of stress incontinence.

Urge incontinence

The bladder is intended to store urine without leakage over several hours. This is expelled by a contracting of the bladder wall, normally after the brain has sent a conscious start signal. If, however, the bladder acts independently of the brain's control, it automatically contracts when a certain capacity level is reached and attempts to expel the urine.

This malfunction of the bladder can lead to incontinence if a toilet cannot be reached within a couple of minutes of this moment. Since the leakage of urine occurred with an urge to urinate, this form of involuntary leakage is called urge incontinence. An overactive bladder is generally the cause if the urge incontinence coincides with frequent urination during the day and at night.

Mixed incontinence

If an involuntary leakage of urine occurs with both an urge to urinate and during physical exertion, this is known as mixed incontinence. Women aged 50 and over in particular are susceptible by this condition. One cause of mixed incontinence is overactivity of the bladder triggered by physical exertion.

Affected women typically describe a strong urge to urinate arising immediately after coughing or sneezing, when doing sport or even after laughing, which is hard to suppress and requires an immediate visit to the toilet. It is already too late in many cases, and a not inconsiderable quantity of urine is expelled.

Other trigger and causal factors

A wide variety of medical conditions and events can lead to problems of incontinence. These include stroke, Parkinson's disease, multiple sclerosis, dementia, neurological disease, traumatic brain injury, interstitial cystitis, prostate surgery, pelvic surgery and diabetes.

Continence Treatments

A number of treatments are available, depending upon your individual circumstances. These include the following

Medication treatment

Bladder problems and involuntary leakage of urine can be treated effectively with medication. The correct selection and dosage of the agents together with an assessment of their risks and limits for each individual concerned are the prerequisite for successful, treatment without side-effects. This requires neurourological experience.

Instillation treatment of the urinary bladder

This involves the administration of liquid medicines into the bladder. A catheter is placed temporarily in the bladder, either by the patients themselves or someone assisting them or a catheter permanently positioned in the bladder is also suitable.

Using the catheter the bladder is first emptied and then filled with the liquid containing the medicine, bringing it into contact with the internal wall (mucosa) of the bladder. This is generally pain-free; the patient feels merely a brief sensation of coldness. Bladder instillation is employed primarily in cases of overactive and painful bladder syndrome (interstitial cystitis).

Injection treatment with botulinum toxin (Botox)

Botulinum toxin has been used to treat bladder dysfunctions, including overactive bladder, for around 10 years.

First, the internal wall of the bladder is desensitised using a local anaesthetic. During a cystoscopy, the toxin is then injected into the bladder wall from inside. The agent takes effect after five to seven days, stabilising the overactive bladder muscle for up to twelve months. The injection may be repeated if the symptoms recur.

Pelvic floor therapy

Training the pelvic floor muscles is a highly effective way of countering urinary incontinence without side-effects and biofeedback and electrical stimulation are seen as a complement to this.

The simplest method is visualisation of the urethra in an ultrasound scan, showing the proper way to contract the muscles and how to correct this. Devices for biofeedback training use a probe in the vagina or the intestine to measure the activity of the pelvic floor muscles and show this on a chart. Some devices can also deliver electrical impulses that train the pelvic floor muscles by stimulating the vagina.

Urinary incontinence surgery

If the makeup of the bladder and/or urethral sphincter mechanism is damaged, or conservative, or medication-based measures do not result in the desired success, surgery may be an effective option.

Neuromodulation and neurostimulation

Neuromodulation involves applying electrical impulses to stimulate fine nerve tracts in the sacral nerves, as this is where the nerve tracts and reflexes of the urinary tract come together. Fine electrodes are placed on the sacral nerves in the small pelvis either through the skin or laparoscopically and connected to a battery-powered stimulator. Stimulation is then applied in a test phase lasting a number of days and the success ascertained.

Since stimulation has a modulating effect on the reflex pathways, it can be used to treat a series of different functional disorders of the bladder. Thus, the procedure is of equal help to patients with overactive and underactive bladders. If the patient benefits from the stimulation, a stimulation system can be fully implanted just like a pacemaker.

Incontinence advice and continence aids

Unfortunately it is not possible to successfully treat incontinence and functional disorder of the urinary tract in every case, but most sufferers can control incontinence using suitable aids. The ability to maintain normal outward appearance helps to maintain a person's quality of life and self-confidence. The choice of aids stretches from urine flasks and incontinence pads through to various models of catheter, based on individual circumstances and needs.

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CyberKnife® Treatments

The CyberKnife® Robotic Radiosurgery System is a non-invasive alternative to surgery for the treatment of both cancerous and CyberKnife Suitenon-cancerous tumors anywhere in the body, including the prostate, lung, brain, spine, liver, pancreas and kidney. The treatment – which delivers beams of high dose radiation to tumors with extreme accuracy – offers new hope to patients worldwide.

Though its name may conjure images of scalpels and surgery, the CyberKnife treatment involves no cutting. In fact, the CyberKnife System is the world’s first and only robotic radiosurgery system designed to treat tumors throughout the body non-invasively. It provides a pain-free, non-surgical option for patients who have inoperable or surgically complex tumors, or who may be looking for an alternative to surgery.

 

 

 

 

 

 

 

 

CyberKnife radiosurgery is a precise, painless, non-invasive radiation treatment that can be an alternative to open surgery or conventional radiotherapy in certain cases. It uses very fine, high power radiation beams instead of a scalpel, so there is no incision, no blood and no pain.

It is used for certain forms of cancer and conditions such as acoustic neuroma, trigeminal neuralgia and AVMs (arteriovenous malformations) where high precision is required to avoid damage to adjacent nerves and blood vessels.

CyberKnife uses a miniature linear accelerator mounted upon a highly flexible, robotically controlled arm to deliver fine beams of radiation. These are fired from many different angles so as to focus precisely on the tumour, AVM or other target.

Each individual beam is insufficient to cause harm, but the convergence of all the beams means that the target receives a very high dose of radiation whilst sparing nearby normal tissue much more effectively than radiotherapy can.

CyberKnife radiosurgery is so precise that radiation beams can be sculpted to small, complex-shaped tumours near critical structures, such as hearing and vision nerves, where surgeons will not conduct open surgery.

Whilst it is a major breakthrough for a wide range of conditions, media headlines of 'miracle cures' of celebrities can over-simplify and raise unreaslistic hopes. In fact CyberKnife is not a single fixed procedure but an operational tool. Each surgeon brings his own unique experience to it so different centres have their own approaches and CyberKnife may form only part of a wider treatment.

Radiosurgery v Radiotherapy

Radiosurgery differs from conventional radiotherapy in several important respects.

Radiotherapy depends primarily on tumour cells having greater sensitivity to radiation than normal tissue. To protect normal tissue as far as possible the treatment is fractionated over many sessions, usually over a period of several weeks.

In stereotactic radiosurgery (SRS), a high power radiation beam is projected onto the target with much greater accuracy. By cross-firing from many different angles the exposure of adjacent healthy tissue is minimised and the number of treatments can be greatly reduced.

Radiosurgery does not remove the tumour but destroys tumour cells or stops growth of active tissue. The main forms of radiosurgery available today are Linac (linear accelerator), GammaKnife® and CyberKnife, of which CyberKnife is the most recent and the most flexible.

 

The list below shows a very brief summary of treatments offered, however it must be stressed that not all cases are suitable for CyberKnife radiosurgery and some centres do not offer all treatments. The list is based on current information but is subject to revision from time to time.

Brain
Acoustic neuroma (vestibular schwannoma), meningeoma, haemangioblastoma, jugular foramens tumour, other neuromas, metastases, AVM (ateriovenous malformation), trigeminal neuralgia

Eye
Uveal melanoma

Spine
Metastases, neuromas, meningeomas, haemangioblastomas, MPNST (malignant peripheral nerve sheath tumour).

Body
Certain tumours to the lung, liver, pancreas and prostate. Note that some of these treatments require a multi-modal approach and that CyberKnife® alone may not be sufficient.

 

 

Body tumours are treated using the Sychrony® software (left) which allows the CyberKnife to track soft tissue tumors, compensating for natural movement due to breathing and which has extended the range of treatments that can be offered.

Small metal markers are implanted near the tumour and must be allowed to settle for a few days before treatment. They are not required for brain and spine treatments however where CyberKnife Centres use the 'X-Sight'® software, which allows the CyberKnife to use the patient's own bone structure to provide the necessary markers.

 

 

 

 

The latest treatment protocols are announced on the manufacturer‘s websites www.cyberknife.com and www.accuray.com. Please note that MHL is not responsible for any content on those web sites.

For details on treatments offered at the centres which you apply to through MHL visit our dedicated website MHL CyberKnife Service www.cyberknifeservice.com. You will also find helpful information on how cases are assessed for treatment. Research references may be found by following this link to Research.

How does CyberKnife® work?

CyberKnife is a revolutionary new way of performing stereotactic radiosurgery and combines three advanced technologies.

Precision robotics
The robotic arm, which is also used in the automobile industry, provides unparalleled access to tumours anywhere in the body. It moves in six planes to reach areas of the body that are untreatable with other radiosurgery systems and allowing more flexible delivery of radiation for optimum treatment.

Out of a possible 1,400 beam directions about 150 beams are selected for a complete treatment cycle, though he actual number in any specific case varies with the size, location and complexity of the tumour. Treatments typically last between 45 and 90 minutes.

Radiation device
This is a particularly lightweight and compact 6MV linear accelerator using a dose rate of 6Gy/min and which is mounted on the robotic arm. Multiple beams of high-energy radiation are delivered from multiple points and converge precisely at the tumour or lesion inside the body.

Each individual beam is insufficient to cause harm, but the convergence of all the beams at the tumour results in the lesion receiving a very high dose of radiation. The high energy photon beams cause significant damage to the DNA of the tumour cells, leading to subsequent cell death without harming the adjacent healthy tissue.

Image guidance system
With the computer assisted image guidance system the CyberKnife can target the tumour throughout the treatment and compensate for smaller patient movements throughout the treatment.

CyberKnife tracks the tumour between doses, so allowing radiation to be delivered without the use of a stereotactic frame. In most cases there is also no need for anaesthesia as the treatment is painless.

The patient lies free on the treatment couch whilst the CyberKnife moves from one position to the next and there is no tunnel to cause feelings of claustrophobia.

Visit the manufacturer's video archive

Advantages of CyberKnife®

100% Frameless

The ability to correct for patient movement during treatment avoids the pain and inconvenience of a conventional head frame, that must be fixed to the skull with screws.

Published studies have shown that frameless CyberKnife radiosurgery is as accurate – if not more so – as frame-based radiosurgery.

Full body capability & staged treatment

CyberKnife is able to deliver precise, high-dose radiation not just to lesions in the brain but to the spine and to other organs throughout the body.

Because no frame is required it can also perform “hypo-fractionated” or staged radiosurgery, where the total radiation dose is divided into 3-5 smaller doses.

This is especially beneficial for treating lesions near sensitive structures and larger tumours because it better protects surrounding healthy tissue.

Painless and better quality of life

Treatment is painless so there is no need for anaesthesia in most cases*. There is no surgical incision so no risk of infections and reduced risk of complications compared to traditional open surgery. After treatment there is no recovery time so the patient simply resumes normal activities.

* Uveal melanoma is a rare exception as this requires local retrobulbar anaesthesia behind the eye.

Video Redefining Radiosurgery

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Da Vinci® 'Robotic' Surgery

The da Vinci® 'robotic' surgical system provides surgeons with powerful assistance in performing minimally invasive operations with great accuracy. As with any new technology, the system takes some time to learn but a skilled and experienced surgeon can perform operations more quickly and accurately than by hand. It is not suitable in all cases and the surgeon will decide on a case by case basis which patients will benefit from this method and which to operate upon unaided.

The word 'robotic' is commonly used but 'telemanipulation' is a more accurate term. The system relays the surgeon's hand movements to the instruments, that have been inserted through small incisions in the abdomen.

The surgeon then controls the movements via a three-dimensional view with a one to ten times magnification. A tremor filter suppresses the trembling of the human hand and together these provide a high degree of precision.

Robotic surgery systems are expensive and in many countries public health care authorities weigh the cost of such equipment against benefits to patients of spending the money in other areas. For this reason da Vinci is largely found in a number of top private hospitals around the world, but take-up is incerasing

Robotic assistance is suitable for complex laparoscopic surgery, requiring precise work and challenging reconstruction.

The advantages are less pain, quicker mobility, shorter rehabilitation and minimal scar formation.

Note: MHL has no commercial or contractual relationship with Intuitive Surgical Inc., the manufacturers of the da Vinci® surgical system.

 

 

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Eye Cancer

A new treatment for uveal malanoma has recently been developed in Munich, which can save removal of the eye (enucleation). This is often required in order to gain access to the tumour, but the European CyberKnife Centre is now providing radiosurgical treatments which avoid this necessity for some patients.

MHL currently features the following centre for radiosurgical treatment of uveal melanomas

The European CyberKnife Centre (ECZM)

ECZM is a modern, purpose built private medical facility based in Munich, Germany and treatment is provided on an outpatient basis. The Centre opened in 2005 and is one of the busiest CyberKnife® centres in the world, especially for brain and spinal tumours.

Demand for this prestigeous centre is now very high but international patients can access treatment through our enquiry service.

Uveal melanoma New treatment can avoid removal of the eye

Uveal melanoma is cancer of the eye which involves the iris, ciliary body, choroid or a combination of these. A variety of treatments is available but in severe cases complete removal of the eye can be required.

Now a new procedure has been developed at the European CyberKnife Centre in Munich (ECZM) which avoids the need for this drastic step. It involves a single-session treatment where retrobulbar anesthesia, CT scanning, planning and treatment by CyberKnife® radiosurgery are all performed within a time frame of about two hours.

The first local patients have already been treated and Medilux Healthcare is now able to introduce patients from around the world.

Read our Press Release on the Vision2020 web site.

VISION 2020 UK is an umbrella organisation which facilitates greater collaboration and co-operation between organisations within the UK, which focus on vision impairment and operate on a national, regional or international basis. Vision 2020 is a supporting member of the Vision 2020 Global Initiative

VISION 2020 UKs objectives are:

• To prevent avoidable blindness
• To improve the quality of services to visually impaired people
• To improve the training available to professionals providing advice and services
• To improve communication between organisations within the VI Sector
• To improve the availability of information to visually impaired people
• To ensure that the voices of the visually impaired are heard when planning services and their opinions sought on key issues affecting their lives
• To raise public awareness of the issues and problems relating to sight loss
  
  
  To enquire for treatment please visit our dedicated website at www.cyberknifeservice.com

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University Medical Centre, Hamburg, Germany
Universitätsklinikum Hamburg-Eppendorf (UKE)

Voice Clinic

Dr Markus Hess is Professor and Director of the Department of Voice, Speech and Hearing Disorders at the UKE Hamburg. He is a dedicated otolaryngologist and phoniatrician (a combination of speech-language pathologist and physician in one person), subspecializing in laryngology and disorders of professional voice users.

Treatments for singers, actors, public speaker and performing artist
For diagnostics and treatment of 'professional voice disorders', the voice team in Hamburg includes logopedists, trainers for classical singers and for contemporary commercial music, with a principal focus on musical theatre, acting voice therapists, singing voice therapists, psychologists, engineers, and healthcare professionals as required by the individual patient's needs.

Dr Makus M Hess - professional profile

Dr Hess is a recognized expert on care of the professional voice and is active in the regional, national and international field of voice diagnostics and treatment, including his speciality of phonosurgery.

With his dedicated team and multidisciplinary approach, he has helped many top-level international singers, actors, public speakers and other performing artists.

The Department of Voice, Speech and Hearing disorders at UKE Hamburg has created a centre of excellence, including laryngeal microsurgery with cutting-edge, minimally invasive techniques.

A major feature of the Hamburg clinic is voice surgery in an office-based setting, i.e., so-called indirect surgery without general anesthesia.
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He has pioneered techniques to improve visualisation of vocal fold vibration, facilitate office-based laryngeal morphometry, establish objective voice assessment tools and intraoperative measurement of visco-elastic properties of the vocal folds.

He has also designed and developed phonosurgical instruments with a major medical instrument company.

Specialities

Phonosurgery (all techniques including thyroplasty and arytenoid adduction).	High speed imaging
Office-based phonosurgery	Electroglottography
Digital videostroboscopy	Voice range profile
Computer-aided voice analysis	Electromyography
Spectrography	Botulinum toxin injections
	Laser technology (CO2, KTP)

Enquiries

Please e-mail: uke-hamburg@mhlhealth.com and UKE Hamburg will contact you directly. MHL is not authorised to discuss individual cases.

UKE is the largest hospital in Northern Germany, with 80 clinics and institutes. As a teaching hospital, it carries out medical research and many doctors, scientists and students visit to work in its clinics and laboratories.

The Centre has approximately 1,400 hospital beds and each year it treats around 50,000 in-patients. It also treats about 250,000 out-patients as well as 50,000 emergency patients.

UKE offers a complete range of treatment options, applying new ideas in research and new approaches for the diagnosis and therapy of disease. Medical care extends from diagnostics to highly specialised and complex treatments necessary for rare diseases.

Centres of excellence

Centres of Excellence at UKE include Spine, Oncology, Heart, Urology and Prostate, the Transplantation Centre and the Children's and Women's Centres

UKE's record of clinical trials and publications proves that the professors and doctors are part of leading scientific discussion. Treatment, research and science are surrounded by a well-defined process of medical quality in a warm, comfortable and caring environment.

International patients

UKE has a long tradition in medical treatment of international patients, who come from all over the world for treatment by famous specialists, professors and doctors. Many come back on a regular basis, for instance after an organ transplant.

The International Office coordinates all aspects of international patients' medical care, paying special attention to their personal, cultural and travel-related needs. Doctors, nurses and administrative staff try to do everything in order to make the patient’s stay as comfortable as possible.

UKE has a special ward, especially epquipped for patients from abroad, with ethnic food, international TV and newspapers, internet access and more. The centre can also provide interpreters, arrange airport transfers, hotel shuttles, limousines and even personal shopping guides.

Treatment Enquiries

Please e-mail: uke-hamburg@mhlhealth.com and UKE Hamburg will contact you directly. MHL is not authorised to discuss individual cases

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National and regional web sites

As an internet-based company MHL has a comprehensive network of web sites for different subjects, countries or regions. All sites include a summary of products and services promoted by MHL together with any additional information available for patients and customers in these countries. Follow the country links below to our national websites.

MHL (Medilux Healthcare Limited) has a dedicated web prescence in 28 countries world wide.

Europe

Middle East and Africa

Asia and Australasia

North and South America

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