“Managing together, that is also my responsibility as a physician” – an interview with Dr. Kremser

In Greek and Roman antiquity (the Classical period), in the Middle Ages and in the modern era, predicting the future by reading “entrails” was absolutely conventional. Not only were dreams, the stars in the heavens or the flight of birds interpreted, but the answers to questions involving the future were also sought in the organs (of a sacrificial animal or human body).

Even Plato, the ancient Greek philosopher and disciple of Socrates around 400 BC, is supposed to have believed in the significance of the liver. Belief in prophesies, fortunetellers and clairvoyants persisted until the 17th and 18th century, until modern science made new ways of seeing man and his cosmos possible.

Today, that the liver and the other internal organs can reveal something about our state of health and about our well-being in general, in fact, is indisputable.

From a medical point of view, it is the visceral surgeons (lat. “viscera” = entrails, intestines), above all, who are particularly well-versed with our intestines.

If there is a serious condition, particularly in the region of the chest and the abdomen, the specialized expertise of medical experts such as Dr. Kremser is sought. Where there is inflammation, gallstones, an inguinal, incisional or umbilical hernia or a malignant condition, often every second counts.

Dr. Kremser is a Chief Resident and, as a specialist in visceral surgery, has specialized in complex abdominal surgery and in the treatment of tumors, inflammation and adhesions. The acting Chief Physician focuses on minimally invasive surgery, also called keyhole surgery. Using these methods, and in close collaboration with related disciplines such as gastroenterology and oncology, she has successfully treated serious conditions in the abdominal cavity and on the abdominal wall for many years.

We were very keen to become better acquainted with Dr. Kremser. She studied at the University of Heidelberg, has gained experience abroad in Montpellier (France) and in Wuhun (China) and has worked as a casualty physician in the emergency helicopter. She completed her training as a visceral surgeon at the Munich-Harlaching Hospital, before she was appointed to the position of Chief Resident.


Dr. Kremser, everything immediately in the abdominal region, that is, in the gastrointestinal tract, that develops a medical condition is within your specialist field. You are a Chief Physician and a specialist visceral surgeon. When did you decide to specialize in this and why?

Dr. Kremser: I was already convinced that I wanted to become a visceral surgeon during my study and my work in the surgical intensive care ward of the University of Heidelberg Surgical Hospital. I was fascinated by the complex clinical pictures, and the great surgeons were among my models.

“It is important for the patient to know that he can depend on his doctor.”

You treat the severe cases, in particular: malignant conditions, hernias, acute inflammations, chronic and complicated wounds, tumors, adhesions and emergency care. How do you deal with these personally?

Dr. Kremser: Thanks to 20 years of work as a casualty physician in the emergency helicopter Christoph 1, decisions and treatment under extreme time pressure are “normal” for me and do not cause me stress. Calm, swift and purposeful action is vital here, and this also applies to emergency surgery and unpredictable situations or problems in other surgery.

With malignant conditions, particular attention to the patient is required. Together with the required diagnostic investigation, in-depth conversations with the patients and the family are conducted beforehand. It is necessary to convey that we must manage the malignant condition together. It is important for the patient to know that he can depend on his physician.

Of course, we are also concerned with the patient’s future beyond the hospital, so disconnecting is simply unacceptable. We should also repeatedly critically scrutinize our actions, in spite of all our professionalism.

“I seek so-called ‘balance’ paragliding in the mountains.”

Certain severely damaged organs must sometimes be removed, for example, the stomach, appendix, endocrine organs or the gallbladder. Which organs can we “do without” (and survive without) and what do we then need to bear in mind?  

Dr. Kremser: If we adhere to the scientific consensus, the appendix and the gallbladder are “expendable” and you can continue to live completely normally without these organs.

It becomes somewhat more complex with other organs. Under the appropriate conditions, with the appropriate behavioral restraints and with the aid of medication, you can live e.g. without a thyroid gland, without a stomach, without a pancreas, with one kidney, without a spleen, with one third of the small intestine, without a large intestine and with ¼ of the liver.

These days, most surgery can be performed minimally invasively. The minimally invasive technique has multiple advantages: better visibility than the naked eye due to the magnification and high-definition image quality (4K, 3-D), small incisions, and hence, less postoperative pain, fewer wound healing dysfunctions, fewer surgical hernias, fewer postoperative adhesions, generally briefer hospital stay and a cosmetically better result.

I had already focused on the minimally invasive technique very early and so, here in the hospital, along with appendectomies, cholecystectomies, inguinal and surgical hernias, we can perform almost all colorectal resections (including for malignant conditions), and a number of procedures on the stomach, the liver and the pancreas minimally invasively.

“The enlightenment of the populace is still probably not always adequate.”

Advice from an expert! We really should not ignore this. Dr. Kremser, thank you for this interesting interview and we wish you continued success in your work as a visceral surgeon.

 


If you would like to find out more or contact Dr. Kremser directly, then visit her physician’s profile at Leading Medicine Guide.

This article is also available in German.

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