Prof. Dr. Mike Ralf Langenbach

After many years as head physician of the surgical clinic and as medical director at the Helios St. Elisabeth Clinic in Oberhausen, Prof. Dr. med. Mike Ralf Langenbach took over as head physician of the Clinic for General Surgery, Visceral Surgery and Coloproctology at the Evangelical Hospital (EVK) Lippstadt – one of the largest acute hospitals in the region with around 18,000 inpatients per year – in the autumn of 2019. Besides his clinical work, Prof. Dr Langenbach is also active in research and teaching at the University of Witten/Herdecke.

The specialist in surgery, visceral surgery and special visceral surgery has an added qualification in proctology and an additional qualification in minimally invasive surgery. Thanks to his comprehensive training and many years of practical experience, the physician is familiar with the entire spectrum of surgical procedures for the abdominal cavity and digestive tract. At the EVK Lippstadt, he and his team were able to consistently expand the area of hernia and reflux surgery, among other things. Meanwhile, more than 200 operations involving hernias – such as inguinal or umbilical hernias – are performed in the hospital every year. As a member of the German Hernia Society (DHG), the clinic works to the highest quality standards. Prof. Langenbach also played a leading role in setting up the Reflux Centre at the EVK Lippstadt. Thanks to the "short distances" and the close, personal coordination of the various specialist departments "under one roof", affected patients receive comprehensive diagnostics and individually tailored therapy here in a timely manner.

Interdisciplinary approach – always for the benefit of the patients

For Prof. Langenbach, interdisciplinary cooperation with other departments of the clinic and close exchange with doctors in private practice are indispensable. Because even if the surgical intervention is at the centre of the treatment, for the physician, effective pain therapy, early mobilisation and the prevention of complications – during and after the operation – are just as important for the success of the therapy.

Close and personal exchange with patients and their relatives on an equal footing is also of central importance for the head physician in his work. This includes individual and easily understandable counselling about the chances and possible risks of an operation, as well as determining the patient's personal needs and expectations. Especially for a sick and needy person, it is important from the medical practitioner's point of view that he or she feels comfortable at all times, experiences human care and has complete trust in the professionalism of the practitioner. For Prof. Langenbach, his work does not therefore end in the operating theatre – after the operation, he and his team continue to closely monitor the patient's recovery process and are available as contact persons at all times.

It is possible that Prof. Langenbach's high level of commitment and empathy can be explained by the circumstances in which the now experienced specialist discovered his passion for medicine: As a young man, he completed his twenty-month civilian service in nursing – and after these experiences, it was soon clear that he wanted to become a doctor.

Hernia specialist: complex hernias

For hernias, Prof. Langenbach is familiar with all the modern procedures of today's surgery: The specialist's surgical palette ranges from classic inguinal hernias or umbilical hernias and incisional hernias to complex thigh hernias and abdominal wall hernias. In the case of inguinal hernias, the specialist and his team decide whether the hernia should be treated with a plastic mesh – this usually reducing the risk of recurrent hernias – or whether an operation without a plastic mesh is advisable. The decision as to whether an operation is minimally invasive or open, in other words conventional, is also made on an individual basis – also with the respective patient in a detailed explanatory discussion.

As a rule, the procedure is carried out using so-called keyhole surgery, i.e. minimally invasive. Prof. Langenbach mostly uses the TAPP technique – a very gentle and safe surgical procedure after which the patient recovers very quickly. He or she undergoes open surgery either according to Lichtenstein (with plastic mesh) – or according to Shouldice (in the latter case without mesh).

Abdominal wall hernias or incisional hernias are also usually treated by minimally invasive surgery. In the case of very large fractures or severe adhesions after previous operations, the choice tends to be open surgery. Here, too, Prof. Langenbach often uses plastic meshes – for example to tighten the abdominal wall. Since Prof. Langenbach creates an individual concept for each patient, even rather unusual combinations occur at first glance, which can then certainly lead to new standards of modern procedures.

Reflux: the widespread disease of heartburn

The second area in which Prof. Dr. med. Mike Ralf Langenbach has specialised with great dedication is the extensive subject area of reflux. The Reflux Centre, which was founded especially for this purpose at the EVK Lippstadt, is fully focused on the diagnosis and therapy of reflux disease. The disease – officially called reflux oesophagitis – describes the backflow of stomach acid into the oesophagus, a condition usually accompanied by agonising heartburn. In addition to pain and discomfort, sufferers also often suffer from sleep disturbances and lose their enjoyment of food and socialising. In addition to the high level of suffering, the disease carries further risks if it remains untreated for a long time: The acidic contents of the stomach can irritate the sensitive mucous membrane of the oesophagus and cause inflammation. In the long term, there may even be a risk of malignant tissue changes – so-called Barrett's oesophagus.

In order to clarify the cause of the diverse and often unspecific symptoms of the disease, various specialist departments work with interdisciplinary cooperation in the Reflux Centre headed by Prof. Langenbach. The team in the Department of Internal Medicine and Gastroenterology and the Department of Radiology conduct comprehensive diagnostics to determine the intensity and exact cause of the complaints. Based on the examination results, the patient receives a recommendation for lifestyle changes and/or drug therapy in the first step.

Reflux: particularly gentle interventions

If conservative therapy does not lead to the desired success in the long term or if there are already conspicuous changes in the mucosa, surgical therapy is often the only option. Once a detailed picture of the symptoms is available after extensive diagnostics, Prof. Langenbach agrees on the exact surgical method in a consultation. The specialist and his team have extensive experience in the surgical treatment of reflux disease: The procedure is always performed as gently as possible - usually minimally invasive. Prof. Langenbach can also rely on the innovative equipment of the EVK Lippstadt, which has a state-of-the-art surgical robot . With this Da Vinci® system, the surgeon can utilize high-precision control support, allowing him to use a console to control four robot arms with smallest instruments in real time . Particularly in complex operations, the robot offers great advantages and permits tissue-conserving and low-bleeding operations, which also results in a faster recovery of the patients.