When a specialist focuses passionately on a medical discipline and has developed and expanded his expertise over many years, this is good news for patients in particular. For Prof. Markus von Flüe, MD, who as head of visceral surgery at the Clarunis University Abdominal Centre in Basel is a master of the entire range of gastrointestinal and rectal surgery at the university level, the oesophagus is a particular focus of his work. This is partly because this tube, called the oesophagus, plays the central role in transporting food from the mouth to the stomach - but also because operations on this muscular tube are often particularly complex. At the Basel-based institution, Prof. von Flüe is therefore exactly right: Here, innovative high-performance medicine, which aims to create trend-setting maxims, is offered at two locations at once. The certified oesophageal centre headed by Prof. von Flüe provides outstanding proof of this.
A very special specialist in a very special place: In Prof. Markus von Flüe, MD, the Clarunis University Abdominal Centre Basel has a renowned chief physician who is a perfect match for this pioneer of modern high-performance medicine. Because in this competence centre of the Claraspital and the Basel University Hospital, patients are offered treatment for the entire abdominal area that is based on the latest findings and that goes far beyond classic basic care: At Clarunis, specialists in gastroenterology, hepatology and visceral surgery work closely together on an interdisciplinary basis and have an international reputation for their expertise and scientific knowledge.
So anyone who turns to the Clarunis competence centre with problems of the oesophagus can be certain: High-class care is guaranteed in the certified oesophageal centre, and this is provided by a proven specialist. Whether it is a matter of heartburn, outpouchings or functional disorders - Prof. von Flüe has an extremely high level of expertise in all areas.
Oesophagus: Diagnostics as the basis for medical success
It all starts with comprehensive diagnostics, which play an important role especially in examinations of the gastrointestinal tract and the upper digestive tract. The visceral abdominal centre uses gentle gastroscopy procedures to properly clarify symptoms. Sometimes only a biopsy can provide definitive information, because a tissue sample is considered to be the most informative diagnostic method, especially when it comes to oesophageal cancer. The most modern endoscopic procedures are used here, whereby tissue samples are taken almost painlessly. Of course, X-ray examinations are also part of the diagnostics - as well as functional clarifications in case of movement disorders, which are carried out by manometry, i.e. by measuring pressure.
Prof. von Flüe's gastro team uses another diagnostic method, especially for reflux - this is pH metry. Those who suffer from heartburn, like almost twenty percent of all people in Central Europe, thus learn why stomach acid often flows back into the oesophagus and how long it remains there. To do this, a tiny probe that measures the pH level is placed in the oesophagus for a whole day. In addition, an impedance measurement provides information about what non-acidic fluids show up in the oesophagus.
Common disease reflux: High-class individual treatments
With a widespread disease like reflux, a high-class diagnosis is very important - this disease is not to be trifled with. Initially, excruciating heartburn causes unpleasant pain, especially when lying down, and thus often leads to sleep disturbances - but reflux carries further enormous risks if left untreated: When acidic stomach contents irritate the mucous membrane of the oesophagus, inflammation often results - which in turn can cause malignant tissue changes: Barrett's oesophagus.
At the Clarunis University Abdominal Centre Basel, the many symptoms of the disease are clarified, which can often vary greatly and therefore also require interdisciplinary expertise. Is it enough for patients to change their lifestyle habits? Is drug therapy the right thing to do - or surgery?
The fact that Prof. von Flüe is familiar with the latest surgical methods for reflux fits in with the overall picture of the competence centre, which, with the Claraspital and the University Hospital, belongs to two cornerstones of regional care - and whose reputation has spread beyond the country's borders to Germany and France. Thus, he primarily proceeds with minimally invasive and thus particularly gentle interventions (robot-assisted Da Vinci technique), which are precisely tailored to the individual complaints.
Wide range of services: Diverticula in the oesophagus
Less common, but also very unpleasant, are outpouchings in the oesophagus - oesophageal diverticula. If these diverticula lead to swallowing difficulties or cause chunks of food to be regurgitated even without nausea, you should definitely see a specialist. The best known of these are the protrusions of the mucous membrane called Zenker’s diverticula: These are usually due to a weakness in the throat muscles, which Prof. von Flüe treats with a so-called stacker device - an endoscopic threshold cleft.
The most important topic in the certified Clarunis Oesophageal Centre is oesophageal cancer - which is a particularly rare tumour disease. However, anyone who falls ill with it should get themselves directly into the hands of an experienced specialist: To treat oesophageal cancer effectively, very complex surgical procedures are required. No wonder, then, that in the eyes of Swiss health care this type of cancer also belongs to the field of highly specialised medicine, or more precisely: highly specialised visceral surgery. As part of the Visceral Oncology Centre, which is also certified, the oesophageal centre under the direction of Prof. von Flüe is one of the selected institutions that have a corresponding performance mandate according to the Swiss decision-making body - and for six years, no less. Because here, all performance-specific requirements are not only met, but far exceeded: In terms of case numbers, structural and process quality and all other relevant points - and of course with regard to the activities with which the head physician repeatedly underpins the reputation of the centre in teaching, further training and research.
Special expertise: Oesophageal cancer
Patients who turn to the Clarunis University Abdominal Centre Basel because of a tumour in the oesophagus can therefore be fully confident that they will receive top-class treatment here, carried out according to international standards down to the smallest detail. But this high recognition was not enough for the interdisciplinary team led by Prof. Markus von Flüe, MD: In autumn 2020, the oesophageal cancer centre was additionally certified by the German Cancer Society (DKG): For three whole days, the DKG assessors were particularly impressed by the interdisciplinary and interprofessional cooperation that all those involved in the oesophageal cancer centre bring to life. The resulting certificate is intended to give people, who have often had the rug pulled out from under them due to the diagnosis of oesophageal cancer, additional confidence in their choice of hospital: At the Clarunis oesophageal cancer centre, they can expect highly specialised medicine - and a proven team of experts with excellent expertise in the field of oesophageal cancer, from diagnostics to innovative robot-assisted surgical techniques and aftercare.
The importance of diagnostics in oesophageal cancer is evident in the fact that it often only becomes apparent at a late stage. And there are novel examination techniques that enable individual treatment concepts. Here, too, Clarunis’ interdisciplinary approach comes into play, because four times a week, the tumour board decides together which approach is best in each case - for example, whether radiation or chemotherapy should be carried out before the operation. If the cancer is already in an advanced stage, the gastro team sometimes inserts metal stents to at least allow normal food intake.
Innovative keyhole surgery
Operations at the certified oesophageal centre in Basel are mostly carried out using so-called keyhole surgery (laparoscopic or robot-assisted). Surgical intervention is still the only guaranteed cure - and operations on the oesophagus are challenging. There are two reasons for this: The complex procedure is often performed through the abdomen and chest, and close cooperation with anaesthesia and intensive care specialists is also required. With Clarunis, all this is a given: In Prof. von Flüe, a renowned specialist is available who can be relied upon at all times to provide a high standard of treatment in all areas.
Usually, part of the oesophagus is removed during the operation, along with the surrounding lymph nodes. If the cancer is already in an advanced stage, the gastro team sometimes inserts metal stents to at least allow normal food intake. To restore the passage of food, a part of the stomach and intestine are joined together if necessary - not an easy operation, but simply because this operation is performed frequently here, the competence centre has an extremely low complication rate.
Connected to the city and region
Prof. Markus von Flüe, MD, has a long history with the Claraspital and the University of Basel. He studied in Bern, gained his first experiences as a specialty registrar in Lucerne - and in this position first came to the beautiful metropolis on the Rhine in 1989. He was also granted his habilitation at the university there - and received his titular professorship there as well in 2001, after a short stay in Hanover and Dortmund in Germany, among other places. He returned to the Claraspital in 2003 - as head of the surgical clinic and head of visceral surgery.
In order to be able to offer his patients the highest standards of treatment in all areas at all times, Prof. Markus von Flüe, MD, is also involved in teaching and research in addition to his clinical work. in 2019, he was granted the structural professorship for visceral surgery at the University of Basel. He gives lectures - for example on innovations in laparoscopic surgery - and is involved in prestigious professional societies. For example, he was a board member of the Working Group for Coloproctology, is part of the professional body for national planning of highly specialised medicine and is active in the International Society for Surgery. His many publications also draw considerable attention.
However, Prof. Markus von Flüe, MD sees his main task in the care of his patients, who are allowed to have the highest standards of medical and nursing conditions in all areas at the Clarunis University Abdominal Centre Basel. Because here, no one is satisfied only with what has been achieved, so quality is constantly optimised from diagnosis to aftercare. One reason why Prof. von Flüe, as head of visceral surgery, feels he is in the right place at Clarunis is that all areas here are staffed with a high level of competence - from the specialists to the specialised nursing staff who cover all patient needs, to the people who ensure a smooth process with short waiting times in the administration: At Clarunis, the two traditional parent institutions - the Claraspital and the Basel University Hospital - stand for visceral surgical and gastroenterological primary care that meets the highest international standards.