Clarunis - Intestinal and Rectal Centre

Two highly specialised medical specialists who work hand in hand on all issues relating to the intestine and rectum and complement each other perfectly in their excellent expertise: Prof. Dr. med. Beat Müller and PD Dr med. Daniel Steinemann have together earned an amazing reputation in complex operations, especially on the last centimetres of the intestine. With their interdisciplinary approach and high expectations of themselves, the entire team and the equipment, they are in exactly the right place at the Clarunis University Abdominal Centre Basel.

At the Clarunis University Abdominal Centre Basel, patients can expect cutting-edge medical care at an internal level. This competence centre of the Claraspital and the University Hospital Basel was founded specifically to meet the increased demands for modern cutting-edge medical care on a permanent basis - for all diseases of the abdominal region.

In Basel, the development of high-class medical care is being promoted in a special way. The competence centre is based on a clear philosophy that stands for pioneering thought in health care: All activities are geared towards the patients - the entire organisation places patients’ wishes and needs at the centre of its actions. What is particularly important is that all operations are performed by only a few specialists, who in turn have an enormous wealth of experience. Because in Basel, everyone involved has internalised the fact that precision and the expertise of the surgeon play a decisive role in the success of the treatment, especially in surgical procedures.

For this reason, all departments are headed by several senior consultants, who are also responsible for the majority of interventions. In the case of the certified Intestinal and Rectal Centre, this responsibility lies in the hands of two internationally renowned specialists who have outstanding expertise in all matters concerning the rectum - namely Prof. Dr. med. Beast Müller and PD Dr med. Daniel Steinemann. Both have many years of experience and stand for particularly excellent quality of surgical procedures - and for the fact that the operations at the Basel institution have both an extremely low complication rate and better long-term results by international standards. This is confirmed not only by scientific studies, but also by the numerous feedbacks given by patients, especially in the sensitive area of rectal surgery. No wonder, then, that the Intestinal and Rectal Centre under the direction of the two specialists ranks among the top international addresses.

Therefore, anyone dealing with diseases concerning the anus and rectum is in exactly the right place at the Intestinal and Rectal Centre. It is important to make an exact and

comprehensive diagnosis - if only because of the large number of possible diseases. The specialists in Basel first do everything possible to avoid surgery, and in fact many conditions can be successfully treated with targeted medicines or local drugs - such as anal fissures or anal vein thrombosis. However, there are also many indications that make surgery unavoidable.

The rectum, also called the colon, is complex and performs very important tasks in our body. These are the last sixteen centimetres or so of the large intestine - this is where the stool is stored until it is emptied. Together with the anus, the rectum also has the role of retaining stool, i.e. ensuring continence.

Functional gastrointestinal diseases are common - and many of them also affect the rectum. Bloating, constipation, flatulence, irritable bowel syndrome or stool irregularities are usually associated with a high level of suffering in everyday life and obstruct normal processes in private and professional life. Since often no diseased organ is causally responsible, patients should rely on comprehensive diagnostics - and on specialists who, together with their teams, do impressive work with a lot of empathy in addition to high-class expertise. Discretion and caring empathy always play a special role at the Intestinal and Rectal Centre.

It is precisely because several factors often come together as causes for the complaints, such as altered motility or hypersensitivity of the gastrointestinal tract, that the wealth of experience of the specialists is so important in diagnosis. Is it an acute infection - or the effects of a past gastrointestinal infection? Is there a hereditary predisposition? Are there any undiscovered food intolerances? Changes in the intestinal flora are also a possibility, as are psychosocial factors or environmental influences. Therefore, every treatment at the renowned Basel centre is absolutely individual - and the spectrum between drug therapy and surgical interventions is broad: This includes dietary changes, physiotherapy and psychosomatic support, which is intended to strengthen the understanding of one's own illness. In helping people to help themselves, affected people ideally learn individual coping strategies.

However, surgical interventions are necessary for many diseases in the rectal area. This is the case with anal abscess, for example, a painful inflammation with pus accumulation, which is usually caused by blocked anal glands and is flushed out during an operation. The same is true of anal fistula, which often develops as a result of an anal abscess, and through which a secretion or stool can pass uncontrollably. And in the case of coccygeal fistula or major haemorrhoids, minor surgery is also often the best option.

One special area in which Prof. Müller and PD Dr Steinemann both have a great deal of experience is tumours and polyps of the rectum. If mucosal growths form in the anal canal or rectum, the specialists will already be convinced during diagnosis: If so-called pseudo polyps are present, which can be caused by chronic constipation or an anal fissure, for example, a small operation will completely eliminate the problem. But if real polyps develop, they can develop into rectal cancer. This shows not least how important screening is, especially for bowel cancer - because in the early stages, such polyps can be removed during a colonoscopy with an electric snare.

For larger polyps or findings in the anal canal, surgery is usually performed through the anus. For this, Prof. Müller and PD Dr Steinemann will often use a surgical microscope - or endoscopic procedures. Should an invasive tumour appear, the interdisciplinary approach that distinguishes the Clarunis University Centre for Abdominal Diseases in Basel will swing into action: The way forward will then be discussed in the hospital’s tumour centre.

A particularly sensitive and still taboo subject in which Prof. Dr. med. Beat Müller and PD Dr med. Daniel Steinemann also have an international reputation is faecal incontinence. According to studies, up to twelve percent of people in Switzerland are affected by it - and suffer severe restrictions in their social life and quality of life. The fact that women are affected more often is due to the fact that faecal incontinence can also be the result of childbirth. Other causes are sometimes long-standing sphincter injuries, diabetes or neurological diseases.

Because the causes also play a decisive role in determining the therapy, the quality of the proctological examination also becomes immensely important. At the Intestinal and Rectal Centre, innovative and informative 3D ultrasound examinations and MRI checks are part of the programme. This will also show whether a colonoscopy is indicated for further clarification.

In many cases, a change in diet will already bring some relief - or an improvement in incontinence can be achieved through medication to regulate stool or to slow down the passage of stool. Good results can also be achieved with urogenital rehabilitation measures in Basel, whereby specialised physiotherapists take patients through pelvic floor training. Biofeedback therapy can also be done, which uses a pressure measurement to control the activation of the pelvic floor. And if conservative and physiotherapeutic measures are unsuccessful, an efficient therapy option is available that most especially uses sacral nerve modulation, a procedure through which fine electrodes stimulate the sacral nerves and thus the pelvic floor.

In more difficult cases of uncontrolled stool loss, a sacral pacemaker is used, which has an impressive success rate of over eighty percent at the Basel Intestinal and Rectal Centre. The pacemaker sits in the buttocks region under the skin and is only implanted definitively after an extensive evaluation.

Therefore all relevant diseases are treated to an international level at the Clarunis Intestinal and Rectal Centre. Both specialists stand for the quality of the centre:

Prof. Dr. med. Beat Müller, MD, FEBS, MBA has been Chief of Visceral Surgery at Clarunis – University Center for Gastrointestinal and Liver Diseases since 2022. With his specialties, which include oncological and metabolic surgery as well as the entire gastrointestinal tract and colorectal surgery, the experienced specialist is considered an internationally recognized representative of modern high-performance medicine – and the perfect choice to head the Visceral Oncology Center. He has a high level of expertise in the field of diseases of the intestines and rectum – especially in robot-assisted surgery. Prof. Müller is a certified robotic surgeon for the rectum. Especially in the case of challenging tumors of the rectum, this experience is of great benefit to the patients. Prof. Müller is a Fellow of the European Board of Surgery in Surgical Oncology (FEBS Surgical Oncology) and of the European Board of Surgery MIS (FEBS/MIS). In 2021, he was inducted into the Upper GI International Association (UGIRA). He is a member of the International Society for Diseases of the Esophagus (ISDE), and he is a board member of the Surgical Association for Minimally Invasive Surgery (Chirurgische Arbeitsgemeinschaft Minimal Invasive Chirurgie (CAMIC)), the German Society for Computer and Robotic Assisted Surgery (Deutsche Gesellschaft für Computer- und Roboterassistierte Chirurgie (CURAC)), and, the Surgical Association of the Upper Gastrointestinal Tract (Chirurgischen Arbeitsgemeinschaft Oberer Gastrointestinaltrakt (CAOGI)).

Prof. Beat Müller studied at the University of Zurich and completed his residency in surgery in Aarberg and St. Gallen. He then went to Heidelberg, Germany, where he habilitated and completed his extensive clinical training with a residency in visceral surgery and special visceral surgery. His scientific focus is on translational and clinical research of surgical methods and technologies and their further development. As a member of the Executive Board of Clarunis, he is one of the leading people in the innovative institution, where his knowledge of healthcare management and controlling, which he possesses as a Master of Business Administration (MBA), also comes into play.

As head of visceral surgery, PD Dr. med. Daniel Steinemann not only specialises in intestines and rectum, he also heads the pelvic floor centre and is considered a specialist in the surgery of inguinal hernias. As a specialist in surgery (FMH), special visceral surgery and coloproctology (EBSQ), he is a perfect fit for Clarunis' high standards - also because of his certified knowledge of keyhole surgery. He was a scholarship holder of the Swiss National Science Foundation and worked as a senior physician at various important clinics - in Zurich and in Heidelberg. His numerous publications, for example on innovations in endoscopic and laparoscopic surgery, have made him well-known in international professional societies - and may also be regarded as proof that PD Dr. med. Daniel Steinemann is in exactly the right place at Clarunis.

So anyone who turns to the two rectal specialists in Basel can be sure that these are two internationally recognised experts at work, that they work closely together in an interdisciplinary manner and in close cooperation with other specialists from the fields of gastroenterology, hepatology and visceral surgery, and that they are at the cutting edge of science, given their expertise in all matters surrounding the rectum. The high quality of medical treatment is complemented by the comprehensively trained special nursing staff, who have outstanding competence especially in sensitive areas.