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Professor Peter R. Galle
Director of the Department of Internal Medicine, Mainz University Medical Centre
There have been remarkable technological advances in gastrointestinal endoscopy over recent years. Highly flexible, miniaturised endoscopes can now be gently manoeuvred around the stomach and intestines without causing pain, giving doctors a better idea of what is going on inside the body. This makes both diagnosis and treatment easier, safer and more efficient to carry out.
Until the late 18th century, it was not possible to inspect the gastrointestinal tract through the body’s natural openings. The development of the light guide by Philipp Bozzini (born in Mainz in 1773) paved the way for the first endoscopic examinations. Today, the Mainz University Medical Centre performs more than 12,000 endoscopic and sonographic examinations every year. Close cooperation with manufacturers of endoscopic devices enables new endoscopes to be developed and put into everyday use in the hospital within increasingly short periods of time.
Concept of university endoscopy
The aim of university endoscopy is to continually improve and enhance top-level patient care by applying new diagnostic and therapeutic approaches. This principle has led to new clinical concepts in endoscopy, described here using the example of two illnesses.
Heartburn is a widespread condition that is becoming particularly common in the western world. Heartburn – gastric reflux – is increasingly entering the spotlight as a result of changes in eating habits and the growing prevalence of obesity. The constant reflux of stomach acid inflames the oesophagus, which can lead to changes in the mucous membrane of the oesophagus. In approximately 10 per cent of patients, this causes Barrett’s oesophagus, which results in a greatly increased risk of developing oesophageal cancer.
It is recommended that patients with Barrett’s oesophagus undergo regular gastroscopy examinations, in which several biopsies are performed on the affected section of the oesophagus in order to diagnose any malignant changes at an early stage. The procedure has been improved by the introduction of endomicroscopy. This is when a miniaturised laser microscope is integrated with the endoscope so that the oesophagus can be examined under the microscope during the endoscopic examination. This makes the early detection of cancer considerably more effective and only a few samples have to be taken from the mucous membrane.
Colon cancer is one of the most common forms of cancer in humans and is widely feared. It can be prevented by an early colonoscopy (preventive care). Many people are scared of having a colonoscopy and are not aware that this examination can save their life. Modern colonoscopies do not cause any pain and are over very quickly.
We offer a very innovative procedure – a high-definition colonoscopy – that improves the diagnosis of precancerous stages of colon cancer, known as adenoma. The endoscopic image is also enhanced using an electronic filter or software, resulting in better recognition and characterisation of precancerous tissue. This procedure enables the precancerous tissue to be pinpointed and removed (polypectomy), thus preventing colon cancer from developing.
As an alternative for patients who are scared of undergoing a colonoscopy, we also offer capsule colonoscopy as a preventive measure. In this highly innovative procedure, the patient swallows a capsule containing a video camera on two sides that captures images of the mucous membrane of the colon. The capsule sends these images from the gastrointestinal tract to a data recorder that the patient carries around on a shoulder strap or belt throughout the day.