Visceral surgeon Dr. Ulf Kessler has been at Hirslanden Clinique Cecil as an attending physician for more than a year, and has his practice at CMD Lausanne. With his extensive experience in visceral surgery, he is a competent partner for Swiss1Surgery with Dr. Jörg Zehetner, Professor (USC), in the special field of reflux surgery, as well as surgical intervention with the LINX Reflux Management System.
With the cooperation of Dr. Ulf Kessler and Swiss1Chirurgie, the range of services for the use of the LINX Reflux Management System can now also be offered in Lausanne. In this way, we are extending our radius of action to western Switzerland in the interests of our patients.
In March 2022, the collaboration between Dr. Jörg Zehetner and Dr. Ulf Kessler successfully treated a patient with the LINX Reflux Management System for the first time at the Hirslanden Clinique Cecil in Lausanne. The 45-minute operation was minimally invasive and the patient was discharged from the hospital after two days without any symptoms.
What’s new?
Dr. Zehetner has already performed 350 surgeries with the LINX Reflux Management System in Bern since 2015. This surgery is considered for all patients with typical reflux symptoms, small to moderate diaphragmatic hernia and with normal esophageal function. Now this surgical technique, which has been tried and tested worldwide for ten years, is also available to patients in French-speaking Switzerland.
With Dr. Ulf Kessler, an ideal partner for such interventions was found. Dr. Ulf Kessler was in training for a period of three years to specialize in visceral surgery at the Hirslanden Klinik Beau-Site in Bern, and has already worked with Dr. Jörg Zehetner – as the responsible tutor for Upper GI Surgery and Bariatric Surgery.
During this time, the results of the first 150 operations with the LINX system were also published in Bern. Dr. Kessler’s scientific collaboration was a key factor in the success of the project. In the Hirslanden Center for Digestive Diseases in Lausanne, an ideal partner was found for Western Switzerland, especially since important accompanying specialties such as endoscopy and gastroenterology/hepatology are also on site there.
Interested patients and affected relatives from Western Switzerland can contact Dr. Kessler directly in the future. With his team on site in Lausanne, Dr. Kessler will then perform the assessment and, in collaboration with Swiss1Surgery with Dr. Zehetner, perform any surgical procedures using the LINX Reflux Management System.
Through this collaboration, the good care during the clinic phase and also the follow-up by an experienced specialist can be guaranteed.
The cooperation between Swiss1Surgery and Dr. Ulf Kessler is groundbreaking for this field. This means that the expertise of Dr. Jörg Zehetner, who has the most experience with the LINX system in Switzerland to date, can also be made available to patients in French-speaking Switzerland.
For patients with special questions, the Swiss1Surgery practice in Bern and the GGP Gastroenterology Group Practice with its special functional diagnostics naturally remain a direct and good point of contact.
Johnson&Johnson called for a symposium and the gastro-esophageal reflux disease (GERD) specialists came. Also present was Professor Dr.med. Jörg Zehetner, who enjoys an exceptionally good reputation both in science and in the clinic as a globally recognised expert in minimally invasive surgical reflux methods.
Johnson&Johnson called for a symposium and the gastro-esophageal reflux disease (GERD) specialists came. Also present was Professor Dr.med. Jörg Zehetner, who enjoys an exceptionally good reputation both in science and in the clinic as a globally recognised expert in minimally invasive surgical reflux methods.
The symposium was all about gastro-oesophageal reflux disease, which often causes persistent or recurrent acid regurgitation, severe heartburn or unpleasant burning in the stomach in its chronic course and thus complicates patients’ everyday lives. A proven method for surgical intervention is the LINX Reflux System, which has now been used in the clinic for ten years. This is a small chain consisting mainly of titanium-coated magnets that is placed around the end of the oesophagus in a minimally invasive procedure. With this system, the regurgitation of gastric acid is prevented, while all other physiological functions such as food intake, regurgitation of air or even vomiting remain unhindered by the LINX system.
Dr. Jörg Zehetner is one of the top 5 reflux specialists in Europe and is one of the nine leading experts in the field at Johnson&Johnson. These alone were good reasons to invite Dr Zehetner to speak at the symposium in Hamburg. In front of more than 85 participants, the specialist explained the excellent possibilities of LINX in his lecture and continued these thoughts in the workshop “Complex cases and complication management in reflux surgery”.
For those who do not know what to make of the abbreviation EMEA, please note: EMEA stands for “Europe, Middle East, Africa” and thus summarises the regions in which Johnson&Johnson is particularly involved with its expertise and products such as the LINX Reflux System. Of course, the commitment also extends to the global arena and supports the scientific and practical efforts of the respective medical experts.
For Dr Jörg Zehetner as well as for the other participants at the 1st EMEA GERD Symposium in Hamburg, the occasion was a good reason to gather the best and latest experiences in reflux surgery and thus define further standards for the benefit of patients.
In the attached picture spread, we show the best moments of the intensive work at the EMEA GERD Symposium 2019 in Hamburg.
With a population of around 1.4 billion (as of 2018) and a size of approximately 9.6 million square kilometres, China is the most populous country in the world and approximately 233 times larger than Switzerland. These incredible figures alone show that this is a country with huge potential in all kinds of areas.
Among the less pleasant statistics is the fact that the People’s Republic of China alone accounts for more than half of all oesophageal cancer cases worldwide. In general, this disease is much more widespread in Asia than in Europe, for example.
The unusually high incidence of oesophageal cancer in China was one of the reasons for holding the 2019 OESO World Congress in Beijing for the first time ever, rather than in Europe or the USA. The OESO is a medical society made up of leading surgeons, gastroenterologists, pathologists, radiologists and other professionals in the field of oesophagus and stomach. Prof. Dr. Jörg Zehetner, who offers a specialised range of services for reflux diseases and bariatrics in Switzerland with the Swiss1Chirugie locations in Bern, Brig and Solothurn, is one of these specialists with high recognition worldwide.
Exchange of experience and knowledge every minute
What was particularly interesting about the organisation of the OESO World Congress in Beijing 2019 was that in the main part, technical presentations were each only five minutes long, each followed by a discussion that was also five minutes long. This gave the opportunity to exchange and discuss a lot of expertise within a short time.
This not only encourages the exchange of scientific expertise and opinions. Ideas for new studies are also conceived quite quickly and compactly in this way and can then be further refined later.
Dr Jörg Zehetner was a sought-after expert
In addition to the lectures and opinion pieces of his professional colleagues, Dr. Jörg Zehetner was also a sought-after subject matter expert. His experience from many years of work in the United States and his specialisation in upper GI diseases were just the right profile for a lively exchange with his colleagues.
Topics such as oesophageal cancer, stomach cancer, reflux diseases and diaphragmatic hernias also played an important role in the professional exchange with colleagues. The interactions and complementarities of bariatric and reflux surgery, especially in operations of the oesophagus, stomach and intestine, are a broad field that did not lack a great deal of attention at this year’s OESO Congress.
In a special lecture, Dr Zehetner addressed the topic of the size of the hiatal hernia and the choice of surgical procedure.
The focus was on selecting the most suitable surgical procedure for the individual. Dr Zehetner, who is the only surgeon in Switzerland who is versed in all currently known surgical procedures in this field, emphasised that decision-making must always take place together with the patient if long-term success is to be ensured. Conventional gastric sleeves, partial fundoplication, variants with partial removal of the stomach, LINX reflux management system (magnetic ring), electrical stimulation with Endostim or the new reflux stop system are a selection of methods that must always be chosen well-considered and based on the patient.
Dr. Jörg Zehetner is one of the world’s recognised experts in the field of diaphragmatic hernia and reflux surgery and has published several articles on the subject. Accordingly, the corresponding lecture was listened to with pleasure and followed attentively.
For Dr. Zehetner, it is important in every case to carefully weigh up every intervention and always make a decision in the best interests of the patient. Sometimes, drug treatment may take precedence, as not every patient is suitable for surgery per se. This decision can only be made in discussion with the expert. In the run-up to this, a good counselling interview, a targeted diagnosis and the prognosis for healing are important stages.
Swiss1Chirurgie, with its locations in Bern, Brig and Solothurn, offers such expertise for all patients undergoing bariatric surgery or therapy for reflux disease, abdominal hernias and similar complaints. You can also find out what Swiss1Chirurgie with Dr Jörg Zehetner can do at www.swiss1chirurgie.ch and, of course, always in personal contact with the medical specialists.
With the opening of the Swiss1Chirurgie clinic in Solothurn on 28 November 2019, the medical offering for the entire spectrum of abdominal surgery, but especially obesity surgery and reflux treatment in Switzerland has now taken another step towards improved patient care.
After the existing clinics in Brig and Bern, the Swiss1Chirurgie clinic in Solothurn is now the third location of the specialised medical practitioners. At the doctors’ aperitif on the occasion of the new opening of the Solothurn location, the head of Swiss1Chirurgie, Prof. Dr. med. Jörg Zehetner, emphasised that “in view of the increase in obesity problems and reflux disease, the needs of patients can thus be incorporated into medical practice much better than before”.
Swiss1Chirurgie Solothurn emerged from the visceral surgery clinic of Alejandro Metzger, MD. The expanded clinic in Solothurn and the additional location in Brig cover a large demand of an area that could not previously be served medically in this way.
The main focus of Swiss1Chirurgie at the Bern, Brig and Solothurn sites is on abdominal surgery as a whole, but especially on obesity surgery and the treatment of reflux diseases. While obesity surgery, after thorough individual diagnoses and consultations, often focuses on modern minimally invasive stomach operations in the sense of stomach reductions (tube stomach) or gastric bypass and the subsequent aftercare, reflux surgery deals primarily with the complaints associated with chronic heartburn, acid regurgitation and the subsequent impairment of quality of life. With the LINX Reflux Management System, Dr. Jörg Zehetner is one of the leading Swiss doctors in this field and also enjoys the highest recognition abroad, even in the USA and Saudi Arabia. Dr Alejandro Metzger is a proven specialist in visceral surgery and bariatric surgery.
The Swiss1Chirurgie team includes PD Dr. med. Rudolf Steffen, who as a specialist in visceral surgery covers the entire treatment spectrum of abdominal surgery at the Bern site.
At the opening of the Swiss1Chirurgie clinic in Solothurn, medical specialists and also practising general practitioners met at the doctors’ aperitif to find out in detail about the treatment methods and surgical techniques used by the specialists from Swiss1Chirurgie and the ZfbC (Centre for Bariatric Surgery in Bern). The lively exchange and the great interest show that with Swiss1Chirurgie a network of specialist medical services has been created that meets the needs of existing and potential patients. And it also offers general practitioners in the region a new point of contact, especially for patients with morbid obesity and reflux diseases.
For more information on Swiss1Chirurgie, the centre for bariatric surgery and the specialist doctors and treatment fields involved, please visit www.swiss1chirurgie.ch.
After Dr Jörg Zehetner was able to familiarise a total of five surgeons from Saudi Arabia with the LINX Reflux Management System, a special reflux surgical technique, in the summer of 2019, the next five medical professionals from Saudi Arabia now stood together with the Swiss specialist at the virtual operating table. In a special workshop on the LINX Reflux Management System, the Saudi surgeons were trained in the modern techniques of the procedures. While the summer was spent teaching and training in Saudi Arabia, the November workshop took place in Bern.
Johnson & Johnson had once again selected Dr Zehetner as an expert, who now conducted the workshop lasting several days directly in the Swiss1Chirurgie clinic at Schänzlihalde 1 in Bern. In addition to other special facilities, a meeting room with state-of-the-art presentation and video technology is also available there. In this way, it was possible to clearly and comprehensibly demonstrate and try out how the LINX Reflux Management System is to be applied to patients in need of treatment. Dr. Jörg Zehetner was supported by his colleague Dr. Karl Miller, with whom he has already worked as J&J Faculty at several clinics in Saudi Arabia.
After Dr Jörg Zehetner was able to familiarise a total of five surgeons from Saudi Arabia with the LINX Reflux Management System, a special reflux surgical technique, in the summer of 2019, the next five medical professionals from Saudi Arabia now stood together with the Swiss specialist at the virtual operating table. In a special workshop on the LINX Reflux Management System, the Saudi surgeons were trained in the modern techniques of the procedures. While the summer was spent teaching and training in Saudi Arabia, the November workshop took place in Bern.
Johnson & Johnson had once again selected Dr Zehetner as an expert, who now conducted the workshop lasting several days directly in the Swiss1Chirurgie clinic at Schänzlihalde 1 in Bern. In addition to other special facilities, a meeting room with state-of-the-art presentation and video technology is also available there. In this way, it was possible to clearly and comprehensibly demonstrate and try out how the LINX Reflux Management System is to be applied to patients in need of treatment. Dr. Jörg Zehetner was supported by his colleague Dr. Karl Miller, with whom he has already worked as J&J Faculty at several clinics in Saudi Arabia.
EMEA trainings bring regions together
EMEA is the grouping of Europe, the Middle East and the Americas that Johnson & Johnson has put together specifically to further develop treatments and surgical techniques for reflux disease. At the same time, these are the regions where reflux diseases requiring treatment are becoming more frequent.
As with the training sessions in the two German cities of Speyer and Wiesbaden, the focus of the training sessions was once again on the LINX magnetic ring, which brings decisive advantages for the new treatment technique.
Reflux diseases on the rise
The number of new cases of reflux disease continues to increase in the EMEA regions. Reasons for this include a changed lifestyle with sumptuous food and a corresponding increase in obesity. Even though this is a rather new form of affluent disease in the Middle East, it is still on the rise. Accordingly, it is important to already familiarise the appropriate medical professionals with the current expertise on the LINX Reflux Management System.
Typical signs of chronic reflux disease are frequent acid regurgitation, heartburn and burning in the stomach. The decisive factor here is not the occasional occurrence of such complaints, but a continuous and/or frequent observation of such symptoms with the corresponding sequelae, which can manifest themselves primarily in damage to the oesophagus due to constant contact with stomach acid. Subsequent changes in the mucous membrane of the oesophagus can be the first signs of oesophageal cancer. It is therefore advisable, especially for reflux patients over the age of 50, to have a preventive check-up, which should also be combined with a gastroscopy.
For 20 percent of the Swiss population, this is not an unknown disease, while in the countries of the Middle East, however, similar accumulations can already be predicted now. If you want to learn more about reflux disease, we recommend studying the relevant specialist articles on the Swiss1Chirurgie website or in the Swiss1Chirurgie APP.
More quality in reflux treatment through improved education and training
For Dr. Jörg Zehetner, a faculty member of Johnson & Johnson, it is clear that quality in reflux treatment is primarily a question of the appropriate surgical techniques. Continuing education is also seen as correspondingly important, always focusing on the latest and most successful methods in reflux treatment.
Dr. Jörg Zehetner is one of the most experienced surgeons in this field, both nationally and internationally. Accordingly, it is also the right decision to continue to promote the training and further education of colleagues in Germany, Austria and Switzerland, but also in the USA and in Saudi Arabia, for example, with this professionalism.
Together, J&J and Dr Zehetner are planning about two to three English-language EMEA workshops per year in Bern. In addition, there will be four to five further LINX workshops for German-speaking colleagues, also in Bern. This offer is completed by two to three further training series in Hamburg (at the J&J Institute Norderstedt, the J&J training and development centre) including a masterclass training series. This could at least meet the first major demand for specialised training series on the LINX Reflux Management System.
When the specialists at Swiss1Chirurgie look for the best ways to treat patients, it always has a lot to do with research, scientific work and the publication of the latest findings and methods.
The doctors at Swiss1Chirurgie under Prof. Dr. Jörg Zehetner specialise in obesity surgery as well as medical treatments under the umbrella term UpperGI. This includes, for example, interventions in the areas of reflux, diaphragmatic hernias, oesophageal and stomach cancer. Another field of work of Swiss1Chirurgie is visceral surgery, which is also colloquially referred to as abdominal surgery. In all these specialties, the medical professionals not only work on the patients themselves, but also, and above all, in parallel in the areas of research and further development of methods and techniques.
International prize goes to Swiss1Chirurgie
While Prof. Dr Jörg Zehetner was still attending the OESO Congress in Beijing, Swiss1Chirurgie received a special honour. At the ASMBS Meeting 2019 in November in Las Vegas, USA, Dr Catherine Tsai received the International Award for the best video presentation of a surgical procedure.
Dr Catherine Tsai
Dr Catherine Tsai has been working as a research assistant at Swiss1Chirurgie in Bern for the past two years, and her scientific research work significantly supports further development at the Swiss1Chirurgie sites in Switzerland.
In the video presentation “Laparoscopic Conversion from Gastric Sleeve to RY Gastric Bypass with Remnant Gastrectomy using Fluorescent Angiography” by Dr Tsai, Dr Steffen and Dr Zehetner, you can see the laparoscopic conversion from a sleeve (tubular stomach) to a gastric bypass, whereby here the remaining stomach was completely resected for medical reasons. Fluorescent angiography was used to check the blood flow in the gastric pouch and duodenum, as shown in this video.
Swiss1Chirurgie continues its series of successes
The latest award ceremony for Swiss1Chirurgie and thus also for the Centre for Bariatric Surgery ZfBC continues a series of successes that have long since made the specialists Dr Jörg Zehetner, Dr Catherine Tsai, Dr Steffen and Dr Metzger real experts with an international reputation. We only need to refer to the numerous publications and prizes that were awarded to Swiss1Chirurgie last year.
The medical specialists are less concerned with fame and more with scientific, methodical and ultimately medical progress in the interest of the patients. Various studies are being carried out with the Inselspital Bern as well as in the Swiss1Chirurgie clinics and the Centre for Bariatric Surgery. The results of such studies primarily benefit the patients of Swiss1Chirurgie, underpin the outstanding international reputation of the specialists and, last but not least, form the basis for new developments in the specialist areas of Swiss1Chirurgie.
For the sake of completeness, we summarise here the most important publications, lectures and awards of Swiss1Chirurgie from the past years:
Swiss1Chirurgie accepts international award
When the specialists at Swiss1Chirurgie look for the best ways to treat patients, it always has a lot to do with research, scientific work and the publication of the latest findings and methods.
The doctors at Swiss1Chirurgie under Prof. Dr. Jörg Zehetner specialise in obesity surgery as well as medical treatments under the umbrella term UpperGI. This includes, for example, interventions in the areas of reflux, diaphragmatic hernias, oesophageal and stomach cancer. Another field of work of Swiss1Chirurgie is visceral surgery, which is also colloquially referred to as abdominal surgery. In all these specialties, the medical professionals not only work on the patients themselves, but also, and above all, in parallel in the areas of research and further development of methods and techniques.
International prize goes to Swiss1Chirurgie
While Prof. Dr Jörg Zehetner was still attending the OESO Congress in Beijing, Swiss1Chirurgie received a special honour. At the ASMBS Meeting 2019 in November in Las Vegas, USA, Dr Catherine Tsai received the International Award for the best video presentation of a surgical procedure.
Dr Catherine Tsai
Dr Catherine Tsai has been working as a research assistant at Swiss1Chirurgie in Bern for the past two years, and her scientific research work significantly supports further development at the Swiss1Chirurgie sites in Switzerland.
In the video presentation “Laparoscopic Conversion from Gastric Sleeve to RY Gastric Bypass with Remnant Gastrectomy using Fluorescent Angiography” by Dr Tsai, Dr Steffen and Dr Zehetner, you can see the laparoscopic conversion from a sleeve (tubular stomach) to a gastric bypass, whereby here the remaining stomach was completely resected for medical reasons. Fluorescent angiography was used to check the blood flow in the gastric pouch and duodenum, as shown in this video.
Swiss1Chirurgie continues its series of successes
The latest award ceremony for Swiss1Chirurgie and thus also for the Centre for Bariatric Surgery ZfBC continues a series of successes that have long since made the specialists Dr Jörg Zehetner, Dr Catherine Tsai, Dr Steffen and Dr Metzger real experts with an international reputation. We only need to refer to the numerous publications and prizes that were awarded to Swiss1Chirurgie last year.
The medical specialists are less concerned with fame and more with scientific, methodical and ultimately medical progress in the interest of the patients. Various studies are being carried out with the Inselspital Bern as well as in the Swiss1Chirurgie clinics and the Centre for Bariatric Surgery. The results of such studies primarily benefit the patients of Swiss1Chirurgie, underpin the outstanding international reputation of the specialists and, last but not least, form the basis for new developments in the specialist areas of Swiss1Chirurgie.
For the sake of completeness, we summarise here the most important publications, lectures and awards of Swiss1Chirurgie from the past years:
Swiss1Chirurgie Research Fellowship (2017-2019)
Conferences (number of presentations)
International Federation for the Surgery of Obesity and Metabolic Disorders-European Chapter (IFSO-EC), Athens, Greece, May 2018 (3)
European Association of Endoscopic Surgery (EAES), London, UK,May 2018 (2)
Digestive Disease Week – Society for Surgery of the Alimentary Tract (DDW – SSAT),Washington DC, June 2018 (3)
IFSO, Dubai, UAESeptember 2018, (4)
American College of Surgeons (ACS), Boston, MA, October 2018 (2)
SAGES, April 2019, Baltimore, MD (2)
World Congress on Interventional Therapies for Type 2 Diabetes (WCITD), April 2019, New York, NY (1)
DDW, May 2019, San Diego, CA (1)
Swiss Surgical Society, May 2019, Bern, Switzerland (6)
ASMBS Obesity Week, November 2019, Las Vegas, Nevada (2)
Publications (4)
Tsai C, Steffen R, Kessler U, Merki H, Zehetner J, “Short-term outcomes of endoscopic gastro-jejunal revisions for treatment of dumping syndrome after Roux-En-Y gastric bypass,” Surgical Endoscopy, September 2019
Tsai C, Zeheter J, Beel J, Steffen R, “Long-term outcomes and frequency of revisional bariatric surgeries beyond 15 years after gastric banding: A high band failure rate with safe revisions,” SOARD, February 2019
Tsai C, Kessler U, Steffen R, Merki H, Zehetner J, “Endoscopic Gastrojejunal Revisions Following Gastric Bypass: Lessons Learned In More Than 100 Consecutive Patients,” Journal of Gastrointestinal Surgery, September 2018
Tsai C, Kessler U, Steffen R, Merki H, Zehetner J, “Endoscopic Closure of Gastro-gastric Fistula After Gastric Bypass: a Technically Feasible Procedure but Associated with Low Success Rate,” Obesity Surgery, September 2018
Oral Presentations (16)
Tsai C, Steffen R, Zehetner J, “Magnetic Sphincter Augmentation for Treatment of Gastroesophageal Reflux Disease after Roux-En-Y Gastric Bypass” (Video) ASMBS November 5, 2019
Tsai C, Zehetner J, Steffen R, “Laparoscopic Conversion from Gastric Sleeve to Roux-en-Y Gastric Bypass with Remnant Gastrectomy using Fluorescent Angiography” (Video) ASMBS November 6, 2019
Tsai C, Zehetner J, Bally L, Steffen R, “Impact of roux-en-y gastric bypass alimentary limb length on long-term weight loss, diabetes, and dumping syndrome outcomes,” Swiss Surgical Society Congress, Bern, Switzerland May 17, 2019
Tsai C, Zehetner J, Beel J, Steffen R, “Long-term outcomes and frequency of revisional bariatric surgeries 15 years and beyond after gastric banding: A high band failure rate with safe revisions,” Swiss Surgical Society Congress, Bern, Switzerland May 16, 2019
Tsai C, Steffen R, Kessler U, Lipham J, Zehetner J, “Post-operative dysphagia following magnetic sphincter augmentation for gastroesophageal reflux disease,” Swiss Surgical Society Congress, Bern, Switzerland, May 15, 2019
Tsai C, Steffen R, Kessler U, Zehetner J, “Endoscopic gastro-jejunal revisions for treatment of dumping syndrome after Roux-en-Y gastric bypass,” SAGES, Baltimore, MA April 4, 2019
Tsai C, Zeheter J, “Laparoscopic Hiatal Hernia Repair with Posterior Cruroplasty and Magnetic Sphincter Augmentation in a Patient with GERD and Large Type III Hiatal Hernia,” ACS, Boston, Massachusetts, October 24, 2018 (video)
Tsai C, Kessler U, Merki H, Steffen R, Zehetner J, “Laparoscopic Magnetic Sphincter Augmentation with routine Posterior Cruroplasty: Postoperative Dysphagia and Hiatal Hernia Recurrence,” ACS, Boston, Massachusetts, October 25, 2018 (quickshot)
Tsai C, Zehetner J, Kessler U, Steffen R, “Long-term results of pancreatectomy for post-gastric bypass hypoglycemia,” IFSO, Dubai, UAE, September 27, 2018
Tsai C, Zehetner J, “Conversion of gastric banding to laparoscopic sleeve gastrectomy with perfusion assessment using laser-assisted fluorescence angiography,” IFSO, Dubai, UAE, September 27, 2018 (video)
Tsai C, Zehetner J, “Laparoscopic sleeve gastrectomy with perfusion assessment using laser-assisted fluorescence angiography,” IFSO Dubai, UAE, September 28, 2018 (video)
Tsai C, Kessler U, Merki H, Steffen R, Zehetner J, “Endoscopic gastrojejunal revisions following gastric bypass: lessons learned in more than 100 consecutive procedures,” Digestive Disease Week (SSAT sessions), Washington DC, June 5, 2018
Tsai C, Kessler U, Merki H, Steffen R, Zehetner J, “Endoscopic closure of gastro-gastric fistula after gastric bypass: a technically feasible procedure but associated with low success-rate,” Digestive Disease Week (SSAT sessions), Washington DC, June 4, 2018
Tsai C, Kessler U, Merki H, Steffen R, Zehetner J, “Dumping syndrome after gastric bypass: endoluminal revision of the dilated gastrojejunostomy is a safe and highly effective treatment option,” presented as oral presentation as part of Best Abstracts session at International Federation for the Surgery of Obesity and Metabolic Disorders, European Chapter (IFSO-EC), Athens, Greece, May 19, 2018
Tsai C, Zehetner J, Kessler U, Steffen R, “Outcomes 15 years and beyond following adjustable gastric banding for morbid obesity: high band failure rate with safe revisions,” IFSO-EC, Athens, Greece, May 17, 2018
Tsai C, Steffen R, “Re-sleeve with silastic ring and crurorhaphy in a rare case of severe hyperinsulimic hypoglycemia after sleeve gastrectomy,” IFSO-EC, Athens, Greece, May 18, 2018 (video)
Poster Presentations (10)
Tsai C, Zehetner J, Bally L, Steffen R, “Long-term weight loss, diabetes, and dumping syndrome outcomes after short versus long alimentary limb roux-en-y gastric bypass,” DDW (SSAT sessions), San Diego, CA May 21, 2019
Tsai C, Steffen R, Zehetner J, “Perfusion assessment using laser-assisted fluorescence angiography during conversion of gastric band to laparoscopic sleeve gastrectomy,” Swiss Surgical Society Congress, Bern, Switzerland May 15-17, 2019
Tsai C, Steffen R, Zehetner J, “Laparoscopic hiatal hernia repair with posterior cruroplasty and magnetic sphincter augmentation in patient with refux and large type III hiatal hernia,” Swiss Surgical Society Congress, Bern, Switzerland, May 15-17, 2019
Tsai C, Steffen R, Kessler U, Zehetner J, “Gastroesophageal reflux disease after bariatric surgery: Magnetic sphincter augmentation in patients with normal esophageal motility,” Swiss Surgical Society Congress, Bern, Switzerland, May 15-17, 2019
Tsai C, Herzig D, Zehetner J, Kosinski C, Kunezli C, Stauffer TP, Nett P, Steffen R, Stettler C, Bally L, “Incretin response in patients with postprandial hyperinsulinemic hypoglycemia following gastric bypass surgery with or without extended distal pancreatectomy,” World Congress on Interventional Therapies for Type 2 Diabetes (WCITD), New York, NY, April 8-10, 2019
Tsai C, Steffen R, Kessler U, Lipham J, Zehetner J, “Post-operative Dysphagia Following Magnetic Sphincter Augmentation for Gastroesophageal Reflux Disease,” SAGES, Baltimore, April 3 – 6 2019
Tsai C, Steffen R, Kessler U, Zehetner J, “Gastroesophageal reflux disease after bariatric surgery: magnetic sphincter augmentation in patients with normal esophageal motility,” IFSO, Dubai, UAE, September 26-29, 2018
Tsai C, Kessler U, Merki H, Steffen R, Zehetner J, “Dumping syndrome after gastric bypass: endoluminal revision of the dilated gastrojejunostomy is a safe and highly effective treatment option,” DDW (SSAT sessions), Washington DC on June 5, 2018
Tsai C, Kessler U, Merki H, Steffen R, Zehetner J, “Endoscopic gastrojejunal revisions following gastric bypass: lessons learned in more than 100 consecutive procedures,” European Association of Endoscopic Surgeons (EAES) in London, United Kingdom May 31-June 1 2018
Tsai C, Kessler U, Merki H, Steffen R, Zehetner J, “Endoscopic closure of gastro-gastric fistula after gastric bypass: a technically feasible procedure but associated with low success-rate,” EAES, London, United Kingdom May 31-June 1 2018
Awards
Best Video Presentation International Award, ASMBS Obesity Week, 2019
SSAT Resident and Fellowship session honoree, Digestive Disease Week, 2018
The new year is now a few days old and for many people everyday life has already returned. Yet 2020 began with many good intentions. Less kilos, more sport and active exercise are the most frequently mentioned good intentions for the new year, along with giving up cigarettes and spending more time with the family.
It is becoming clear that more and more people are taking a more conscious look at their own health and are focusing their plans on fitness, resilience and having more fun with active exercise. Especially when overweight, digestive complaints, stomach problems or reflux are daily companions in life, active exercise or regular sport is the way out of the vicious circle for many Swiss people.
We at Swiss1Chirurgie know that especially in cases of morbid obesity, sporting activity is often difficult to implement and ambition quickly wanes if the pounds do not fall off so clearly and quickly. One quickly falls back into old habits or tries to find other excuses for the supposed failure. In many such cases, bariatric surgery may be the best long-term solution. And even after such an operation, physical activity is one of the most important rules if the excess weight is to be permanently reduced and a healthier lifestyle maintained.
Snowshoeing is a clear recommendation
Especially in the cold season, the choice for recreational sports is somewhat limited. Cycling, classic hiking, jogging or water sports are often ruled out due to the weather. For some, the only option seems to be to go to the gym or the swimming pool. But many overweight people also fail to do this, mainly for psychological reasons. The shame of showing one’s own body openly, the fear of hidden smiles up to open hostility and certainly also fears of failure make the way into the dumbbell gyms and swimming pools even more difficult. Classic winter sports such as cross-country skiing, skiing, snowboarding or ice skating are also rarely possible.
The good variant of relaxed but active hiking in winter is snowshoeing. Even the old mountain farmers at high altitudes in Switzerland used snowshoes to get around in winter when the snow was heavy. Today, that is actually no longer necessary. But snowshoeing has become a popular leisure activity in winter, which is definitely a good choice of means for overweight people and also reflux patients.
The somewhat more difficult running requires, in addition to a certain degree of discipline, above all endurance and attention to one’s own body. Since snowshoeing is also only possible outdoors, it also contributes to a better supply of fresh air for the organism. Another nice thing about snowshoeing is that it can be done alone or in a group. In addition, there are specially prepared and signposted routes for snowshoe hiking, especially in the winter sports regions of Switzerland. Perfect for all those for whom skiing and tobogganing are rather unsuitable and who nevertheless do not want to do without sporting activity even in snowy winters.
We have the right equipment
For those who are now more intensively interested in snowshoeing, we offer an excellent possibility to get the sports equipment for snowshoeing quickly, easily and without additional costs. Together with Suzuki Switzerland, Swiss1Chirurgie is giving away a total of 50 snowshoe sets, each with a pair of snowshoes and matching poles.
However, you have to be quick here. Because only the first 50 entrants can enjoy new snowshoes for free and then start their snowshoeing experience with Suzuki snowshoes.
Click here to go to the competition
But also for everyone else, snowshoeing is a clear recommendation for more activity in winter. This applies to normal weight people as well as to overweight people or those with certain complaints.
Of course, we will be happy to advise you in the Swiss1Chirurgie clinics in Brig, Solothurn and Bern about your very individual options for an active life. This way, you may be able to keep your good resolutions for 2020 a little better and achieve the first results soon. Maybe even with a snowshoe set from Swiss1Chirurgie and Suzuki Switzerland. Have fun and above all wish you a healthy new year Jörg Zehetner and the entire Swiss1Chirurgie team.
With its first magazine, Swiss1Chirurgie addresses all patients and those hungry for information who want to learn more about the topics of morbid obesity or about reflux disease.
We work our way forward in interesting articles on these topics and also provide interesting information about our clinics and the Centre for Bariatric Surgery (ZfbC).
You can find out more about the magazine itself and the contents in detail in the detailed article.
You can pick up a printed copy of the magazine in the Swiss1Chirurgie clinics. Those who can no longer get a copy or prefer to read online can obtain the magazine via the following link: https://v.calameo.com/?bkcode=006115199635078f16024&mode=mini&clickto=embed&autoflip=4
We hope you enjoy reading and look forward to your feedback or meeting you in person at one of our locations in Brig, Bern or Solothurn.
Your Swiss1Chirurgie
Dr. Jörg Zehetner
The first edition of the Swiss1Chirurgie magazine is out. The magazine is now available as a printed copy in our clinics in Brig, Bern and Solothurn. For those who prefer to read the first Swiss1Chirurgie magazine online, it is also available for download via the Swiss1Chirurgie app or on the Swiss1Chirurgie website.
To the contents
We are happy to inform you now, more or less in advance, about the thematic focal points of the magazine in the March 2020 edition.
Morbid obesity, a widespread affliction
A major focus is morbid obesity. From stigmatisation to treatment options, you will learn a lot in the magazine that is worth knowing, new, interesting and particularly informative for those affected. In this way, we do not simply want to disseminate scientific findings, but above all to show the individual path to change. In an easily understandable yet correct form.
To this end, we have approached this still very difficult topic in the magazine with various articles, statements, reports and testimonials. We hope that this will pave a new way for overweight people in particular to get informed and ultimately take the right steps to treat their morbid obesity.
At this point, the reports by and about Sina Gossweiler, also known as Sina Lark in the music scene, should be of particular interest. The young woman is not only known from the show “Deutschland sucht den Superstar” (DSDS), but has also been fighting against morbid obesity for a long time. Obviously with success.
Reflux – When acid regurgitation becomes a torment
Another main topic in the first Swiss1Chirurgie magazine is reflux disease. Persistent, chronic acid regurgitation is not only unpleasant and annoying, it can also have real medical significance. Especially when the oesophagus is attacked by the constant confrontation with stomach acid. Consequential symptoms can extend to oesophageal cancer.
Here we also take the opportunity to present different medical and surgical procedures for the treatment of reflux disease in a little more detail.
Portrait of our locations
The first issue of the Swiss1Chirurgie magazine also gives us the opportunity to present our locations in Brig, Solothurn and Berne in more detail. You will not only learn interesting facts about the clinics themselves, but also about the doctors who are there for you every day.
We will also focus on the Centre for Bariatric Surgery Bern (ZfbC) and show you how the scientific work is being further developed there. A number of different specialist papers and support for bariatric surgery worldwide shows the expertise with which this centre is equipped.
New app makes access to specialist medical services more tangible
We would also be pleased to introduce you to the new Swiss1Chirurgie app. Many people already know them and may also use them to read this article. Anyone who is not yet familiar with the new Swiss1Chirurgie app is expressly invited here to download and use it free of charge.
A wealth of information, a direct line to the medical specialist and support before, during and after treatment are just some of the many benefits that you can enjoy with the Swiss1Chirurgie app.
Take advantage of this opportunity and simply pick up your print copy of the Swiss1Chirurgie magazine in the clinic or download the online version to your device.
People are more interested in their health and use different sources to inform themselves about healthy lifestyles but also about diseases and their symptoms as well as treatment options. Especially widespread diseases such as obesity (morbid overweight) or reflux diseases (for example chronic acid reflux) are moving further into the focus of public interest and thus also opening the doors to media such as radio or television.
Swiss1 Surgery, led by Prof. Jörg Zehetner, has long been committed to professional public relations and welcomes all measures and ways to promote social awareness of such diseases. Jörg Zehetner sees the stigmatisation of affected women and men as a problem that prevents many patients from undergoing appropriate medical examinations. Ultimately, this leads to a vicious circle, which is associated with a long path of suffering and rarely leads to an improvement in the lives of those affected, usually not at all. Old but also new widespread diseases are not only a problem for those affected themselves. The economy and society as a whole are also affected when rising case numbers lead to more incapacity to work, occupational disability, disability to work and, ultimately, rising health insurance costs.
With a lot of commitment, Jörg Zehetner has therefore now spoken out on the radio as part of his efforts to be heard more in public. On 17 August 2020, as part of the podcast series “Medical Knowledge”, the topic of oesophagectomy (resection of the oesophagus) was a focal point on which the specialist physician at the Hirslanden Klinik Beau Site positioned himself. When and why an oesophagectomy may be indicated was explained very clearly by Jörg Zehetner in just two minutes.
The very next day, 18 August 2020, Jörg Zehetner could be heard again on Radio Bern1. This time on the topic of obesity, which is becoming more and more important as a disease in Switzerland and all other highly developed industrialised countries in the world. Here, too, Jörg Zehetner took a clear position on those affected and, with his many years of experience as a visceral surgeon, spoke about the classic methods of treating morbid obesity.
Here too, Jörg Zehetner impresses with his ability to present the essential treatment options in just two minutes.
Listen to the two podcast contributions from Radio Bern1 in full length here:
It should be noted that these short podcasts cannot replace a comprehensive and thorough diagnosis and counselling. If you think you are confronted with one of these two problems, contact one of the Swiss1Chirurgie clinics. A visit to the website www.swiss1chirurgie.ch can also be helpful. Extensive content on the subject areas is offered here. In addition, all contact details for Prof. Jörg Zehetner and the Swiss1Chirurgie clinics can be found there.
If we analyse the cases of oesophageal cancer in Switzerland, we find that around 600 people suffer from this serious disease every year. The main risk for the development of oesophageal cancer are reflux diseases, which clearly favour the development of cancer in the oesophagus due to the pathological acid regurgitation. About three quarters of those affected are men. One of the promising therapies for oesophageal cancer is oesophagectomy, which will be explained in more detail in this article.
More information and interesting insights directly from Prof. Dr. med. Jörg Zehetner can be experienced in a Zoom Online lecture. Date: 10 March 2021, 6:30 pm to 7:30 pm.
Let’s start by explaining the technical terms that are important for this topic
The medical term reflux refers to the backflow of gastric acid from the stomach into the oesophagus. In layman’s terms, this is described as acid reflux. The cause of the backflow of stomach acid into the oesophagus is a weakening of the muscle at the end of the oesophagus (cardia). In addition to the actual acid regurgitation, patients describe such things as frequent heartburn, burning in the chest area or also stomach burning.
The oesophagus is called the oesophagus in medical vocabulary. Functionally, the oesophagus is a kind of muscular tube that transports food into the stomach through contractions. In the stomach, stomach acid, among other things, is responsible for breaking down the food as part of the digestion process. To protect the oesophagus from the constant acid attack, there is a muscle at the bottom of the oesophagus that closes it when it is functioning normally. If the function of this muscle is impaired, the reflux described above occurs.
In medicine, resection is the surgical removal of an organ or part of an organ. With reference to our topic, oesophagectomy is accordingly the surgical removal of the largest part of the oesophagus.
The risk factors for the development of oesophageal cancer
Over the years, the main risk factors for developing oesophageal cancer have changed somewhat. Whereas in the past it was smoking and excessive alcohol consumption, today it is persistent (pathological) acid regurgitation and obesity that significantly increase the risk of oesophageal cancer. If you follow the relevant advice books, acid blockers and diets are often recommended to get the problem of reflux under control. However, this only addresses the individually noticeable phenomena, but not the cause. Therefore, the risk of developing oesophageal cancer remains in the medium and long term unless the causes of acid regurgitation are consistently addressed. What remains is the no longer correctly functioning “valve” at the end of the oesophagus, i.e. the muscle that prevents the stomach acid from rising into the oesophagus. If no improvement can be achieved here, then the constant acid attack on the oesophagus ultimately threatens oesophageal cancer. Surgery on the reflux muscle at the right time can significantly reduce the risk.
From complaints to diagnosis
One of the most common complaints that bring patients to the doctor is difficulty swallowing. After anamnesis and a more detailed description of the symptoms, a gastroscopy is often performed. If malignant tissue is discovered or suspected in the oesophagus or at the transition to the stomach, it can be removed under a short anaesthetic using a type of mini forceps. A laboratory examination will confirm whether or not this is malignant tissue. In the former case, it must then be assumed that there is oesophageal cancer, which must be treated surgically as a matter of urgency. Once the diagnosis of oesophageal cancer has been made, the decision for a suitable therapy must be made.
Recommendation: Combined therapy
Before therapeutic steps are taken, the severity of the disease and the spatial spread of the oesophageal cancer must first be examined more closely and determined in detail. Computer tomography (CT) of the chest and abdomen is the method of choice for this. In this way, it is also possible to assess whether there are deposits in the lungs and liver. An ultrasound scan of the oesophagus can also assess deposits in the lymph glands.
A common feature of the work of the medical specialists at Swiss1Chirurgie and at the Beau-Site Clinic is an interdisciplinary tumour board, where specialists from all the disciplines involved carry out a precise assessment of the symptoms, risks and treatment options. In addition to recommending therapeutic measures, this also includes timely clarification of follow-up treatment.
In most of the cases, a combined therapy is considered by the tumour board. This combination consists of an upstream chemotherapy, which is to be understood as a preparation for the actual surgical intervention within the scope of the oesophageal resection. If necessary, radiotherapy can also be part of the treatment. The surgical intervention takes place a few weeks after the start of chemotherapy or radiotherapy.
The esophagectomy procedure
Thanks to modern surgical techniques, the removal of the oesophagus (oesophagectomy) can be performed as a minimally invasive procedure (also called keyhole surgery). The operation itself takes about three to four hours and is performed under anaesthesia. Through small incisions in the abdominal wall, the connections of the oesophagus to the stomach and at the diaphragm are loosened. The lymph glands in the abdomen are then removed, followed by removal of the oesophagus itself either through the abdomen or through the chest. The adjacent tissue, which may also be affected by tumour cells, is also removed.
In a further step, the stomach is formed into a tube. This stomach tube is finally connected to the upper remaining end of the oesophagus in the neck area. Afterwards, the success of the surgical procedure is checked using a method specially developed by Dr. Jörg Zehetner. For this purpose, a fluorescent substance is injected into the patient’s bloodstream. Within five to ten seconds, a laser camera can be used to determine whether the result of the operation is satisfactory.
Rapid mobilisation and recovery of patients
A clear advantage of modern surgical techniques in the context of oesophageal resection is the short time patients spend in hospital. With independent breathing, the operated patients wake up from the anaesthesia and remain in the intensive care unit for one to two days, depending on their condition, to monitor their bodily functions. In the normal ward, a swallowing X-ray is taken as early as five days after the operation to check whether the connection between the stomach tube and the beginning of the oesophagus has healed well. If this can be confirmed, the diet can be slowly built up.
Depending on the individual development, the clinic stay itself lasts about one week to ten days. This is followed by a two-week rehabilitation measure, which helps the patient to heal quickly. After just three months, the patient experiences his or her original quality of life, now without oesophageal cancer and the unpleasant accompanying symptoms. In principle, everything can now be eaten again, perhaps in smaller portions, but spread over several meals a day.
More information and interesting insights directly from Prof. Dr. med. Jörg Zehetner can be experienced in a Zoom Online lecture. Date: 10 March 2021, 6:30 pm to 7:30 pm.
