The truth about Gas less laparoscopy and Dr. Kruschinski

The truth about Gas less laparoscopy and Dr. Kruschinski
Translation from German to English by Babelfish

“gasless” Laparoskopie

Gas lots Laparoskopie is (was) a special form of the Laparoskopie, with which one can operate without the expensive special instruments without body cut (could). The method requires (e) less exercise and fate than genuine endoscopic operating.

(The following text is co-ordinated with the president of the working group gynäkologische Endoskopie of the German society for Gynäkologie and birth assistance).

“Gas lots “Laparoskopie = spatial air Laparoskopie

This method finds in our region still isolates application. We are addressed on that occasionally by female patients.

The so-called “Lapro elevator” was developed at the beginning of the 90's of Jörg saucy stone (Austria, at that time upper physician at the University of Ulm). Saucy stone does not use the technology today any longer.

The manufacturer, the company STORZ in Tuttlingen, took the Lapro elevator in the year 2006 again from the market.

This concerns a simple variant of the Laparoskopie, which obtained attention for the first time in the 90's in Germany, however contrary to the standard Laparoskopie neither in the subject surgery nor in the subject Gynäkologie to become generally accepted could.

The name expresses that with this technology no medical CO2-Gas is introduced into the abdominal cavity around the abdominal cavity to unfold and place for the operational interference to create. Instead after opening of the abdominal cavity at the navel a handle is introduced and the abdominal wall is pulled up. It flows normal air with room temperature into the abdominal cavity. Air is definitv a gas. Thus the question arises whether the term is not unfortunately selected and/or misleading.

In the work community Gynäkologi Endoskopie of the German society for Gynäkologie and birth assistance (AGE) is therefore alternatively the term “spatial air Laparoskopie” common (Professor Leo De Wilde, Oldenburg, president of the AGE.)

If air arrives over open veins with an operation into the Blutkreislauf, it causes clearly more easily a lethal Embolie than CO2, which ent always as product of the respiration in low concentration in the blood and can over the lung be abgeatmet. Also from the abdominal cavity air is only very slowly eliminated by the organism, which is less important however.

Why thus at all “gas lots Laparoskopie”

Around to understand one must develop little conception gift as a layman: With the standard Laparoskopie must be worked against to escaping the Aufdehnungsmediums with valves, so that the development of the abdominal cavity remains keeping upright. With the gasless technology one can save this expenditure. The raising of the abdominal wall guarantees the hook elevator by course at the navel. One can make and leave as many as desired and of any size holes open into the abdominal wall. Simple rubber cases replace expensive valve cases. One knows logical way any instruments of the open belly surgery by these openings would bring in. A hospital can here evt. much money save, because this equipment is usually already present. With the standard Laparoskopie cannot be done that. Instruments must be exactly co-ordinated with the valve cases. One needs expensive special instruments and this depending upon OI spectrum evt. in large number. Because of the cost advantages the gasless Laparoskopie is naturally in poorer countries likes.

For an operating surgeon trained in conventional surgery the conversion is not more simply, there it the handling of the delicate, different Laparoskopie instruments to learn must. To that extent the gasless Laparoskopie makes endoscopically ungeübten surgeon possible a simplified entrance into the Laparoskopie.

Also from view of the Anästhesisten (Narkoseärzte) it gives to laproskopieren reasons “gasless”. The renouncement of CO2-Gas and the proportioned positive pressure in the abdominal cavity has advantages for certain risk female patients, essentially older humans. They can be endoscopically operated if necessary without body cut, although a standard Laparoskopie for them would not be possible.

Problems:

One wants the clearly rougher conventional instruments and staunching of bleeding methods (Tupfer!) uses, needs one clearly larger wounds in the abdominal wall. The cosmetic result is then accordingly more unfavorable. The wound in the navel region must offer place not only for the hook elevator mechanism but also for the optics system. The necessary Wunddurchmesser amounts to about 20 mm. (Standard Laparoskopie to the comparison 5 - 11 mm.)

The effectiveness of the belly development is more unfavorable, than with the CO2-Laparoskopie, since the rise takes place only at one point. The result is a conical figure with the highest point at the navel. The operating surgeon needs most place however within the basin range. That succeeds with the even Aufdehnung with exactly proportioned CO2-Gasdruck more effectively. This is for us a operation-technically important point. The punctual pressure is not favorable on the fabric by the hook construction with long operations. The rough elevator construction is natural the operating surgeon and the assistant when operating in the way.

The spatial air cannot be warmed up. It prevails during the “gasless” OI in the abdominal cavity a lower temperature than with the CO2-Laparoskopie with body-warm gas (for this special devices are available.) The sinking of the fabric temperature has some important unfavorable metabolic effects (see below).

Our result: The “gasless” spatial air Laparoskopie takes a central position between body cut and belly reflection for us. It has elements of both.

Naturally a OI team equipped well for the standard Laproskopie could use its fine instruments also by gasless spatial air Laparoskopie. Then at least the wounds would be in the abdominal wall alike. Also those captivatingly precise Microchirurgie with miniaturized equipment under strong picture enlargement would be realizable. Disadvantages remained the worse development of the abdominal cavity and the missing possibility of the heating up of the belly by the warm gas. Waste of the Körpertemperatur changed among other things the Pharmakokinetik, increases the Sauerstoffverbrauch by cooling trembling, strengthens subjective measurement feeling, worsens the immune defense, increases the muscle strain (and with it the pain feeling). The blood clotting is affected unfavorably. (Literature: Gabriele Depenbusch: Be called hints against cool cases - Perioperative heat measures for patients still more effectively used. Intensively 2002; 10:165 - 174 George Thieme publishing house)

We decided in the OPZ Hürth so far against the introduction of the spatial air Laparoskopie with the elevator technology. We would see the sense of the procedure only with completely special female patients, whom we cannot operate usually ambulatory, to e.g. older humans.


Wrong conceptions to the “gasless” spatial air Laparoskopie

The gasless Laparoskopie does not permit more precise operating.

The production of the entrance to the abdominal cavity effected with the gasless Laparoskopie on less dangerous art. one does not have to dot the abdominal cavity for the execution of a CO2-Laparoskopie not “blindly” with a Kanüle and not to also in-sting the Trokarhülsen “blindly”. One can use problem-free the “open” technology and manufacture the entrance under view. (Literature A. Maucher (1990), open Laparoskopie. gynäkol prax 14, 741-746, Hans Marseille publishing house Munich) S. also for this the chapter “open Laparoskopie” on this homepage. The entrance technology furthest common with distance is however the “Blindpunktion)
The OI times are not shorter. Patients do not recover faster. The pain after the interference is not smaller. The medicine need is not smaller.
The results of the operations are better in no aspect, than with the CO2-Laparoskopie. The resulting scars are not cosmetically more favorably but clearly larger.
„The gasless “Laparoskopie does not permit operational treatment, which one can realize not with the standard Laparoskopie. (Also the standard Laparoskopie permits surgical sewing, even with micro-surgical seam material under up to twenty-way picture enlargement).

The “gasless Laparoskopie” does not accompany with a lower total complication risk. The Embolie and Thromboserate are not lower. The Narkosetechnik differs not from the normal Laparoskopie.

http://www.opz-huerth.de/index.php?menue=m3_&sm=21  

Gaslose Laparoskopie ist (war) eine Sonderform der Laparoskopie, bei der man ohne die teueren Spezialinstrumente ohne Leibschnitt operieren kann (konnte). Die Methode erfordert (e) weniger Übung und Geschick als echtes endoskopisches Operieren.

(Der nachfolgende Text ist mit dem Präsidenten der Arbeitsgemeinschaft gynäkologische Endoskopie der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe abgestimmt).

"Gaslose“ Laparoskopie = Raumluft-Laparoskopie

Diese Methode findet in unserer Region noch vereinzelt Anwendung. Wir werden gelegentlich von Patientinnen hierauf angesprochen.

Entwickelt wurde der sog. "Lapro-Lift" zu Beginn der 90er Jahre von Jörg Keckstein (Österreich, seinerzeit Oberarzt an der Universität Ulm). Keckstein selbst verwendet die Technik heute nicht mehr.

Der Hersteller, die Firma STORZ in Tuttlingen, hat den Lapro-Lift im Jahre 2006 wieder vom Markt genommen.

Es handelt sich um eine einfache Variante der Laparoskopie, die in den 90er Jahren in Deutschland erstmals Aufmerksamkeit erzielte, sich aber im Gegensatz zur Standard-Laparoskopie weder im Fach Chirurgie noch im Fach Gynäkologie durchsetzen konnte.

Der Name bringt zum Ausdruck, dass bei dieser Technik kein medizinisches CO2-Gas in die Bauchhöhle eingeführt wird um die Bauchhöhle zu entfalten und Platz für den operativen Eingriff zu schaffen. Statt dessen wird nach Eröffnung der Bauchhöhle am Nabel ein Bügel eingeführt und die Bauchwand hochgezogen. Es strömt normale Luft mit Zimmertemperatur in den Bauchraum. Luft ist definitv ein Gas. Es stellt sich also die Frage, ob der Begriff nicht unglücklich gewählt bzw. irreführend ist.
In der Arbeitgemeinschaft Gynäkologische Endoskopie der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (AGE) ist deswegen alternativ der Begriff "Raumluft-Laparoskopie" gebräuchlich (Prof. Leo De Wilde, Oldenburg, Präsident der AGE.)

Wenn Luft über offene Adern bei einer Operation in den Blutkreislauf gelangt, verursacht sie deutlich leichter eine lebensgefährliche Embolie als CO2, das als Produkt der Atmung immer in niedriger Konzentration im Blut anwesend ist und über die Lunge abgeatmet werden kann. Auch aus dem Bauchraum wird Luft vom Organismus nur sehr langsam eliminiert, was aber weniger wichtig ist.

Warum also überhaupt "Gaslose Laparoskopie"

Um das zu verstehen muss man als Laie ein wenig Vorstellungsgabe entwickeln: Bei der Standard-Laparoskopie muss mit Ventilen einem Entweichen des Aufdehnungsmediums entgegengewirkt werden, damit die Entfaltung des Bauchraumes aufrecht erhalten bleibt. Bei der gaslosen Technik kann man sich diesen Aufwand ersparen. Das Anheben der Bauchdecke stellt der Haken-Lift durch Zug am Nabel sicher. Man kann beliebig viele und beliebig große Löcher in die Bauchdecke machen und offen lassen. Einfache Gummihülsen ersetzen teure Ventilhülsen. Logischerweise kann man jegliche Instrumente der offenen Bauch-Chirurgie durch diese Öffnungen einführen. Eine Klinik kann hier evt. viel Geld sparen, weil dieses Instrumentarium in der Regel bereits vorhanden ist. Bei der Standard-Laparoskopie geht das nicht. Instrumente müssen genau auf die Ventilhülsen abgestimmt sein. Man braucht teure Spezialinstrumente und dies je nach OP-Spektrum evt. in großer Zahl. Wegen der Kostenvorteile ist die gaslose Laparoskopie natürlich in ärmeren Ländern beliebt.

Für einen in konventioneller Chirurgie ausgebildeten Operateur ist die Umstellung einfacher, da er nicht die Handhabung der zierlichen, andersartigen Laparoskopie-Instrumente erlernen muss. Insofern ermöglicht die gaslose Laparoskopie endoskopisch ungeübten Chirurgen einen vereinfachten Einstieg in die Laparoskopie.

Auch aus Sicht der Anästhesisten (Narkoseärzte) gibt es Gründe "gaslos" zu laproskopieren. Der Verzicht auf CO2-Gas und den dosierten Überdruck im Bauchraum hat Vorteile für bestimmte Risiko-Patientinnen, im wesentlichen ältere Menschen. Sie können ggf. ohne Leibschnitt endoskopisch operiert werden, obwohl eine Standard-Laparoskopie für sie nicht möglich wäre.

Probleme:

Will man die deutlich gröberen konventionellen Instrumente und Blutstillungsmethoden (Tupfer!) einsetzen, benötigt man deutlich größere Wunden in der Bauchdecke. Das kosmetische Ergebnis ist dann entsprechend ungünstiger. Die Wunde in der Nabelregion muss Platz nicht nur für die Haken-Lift Einrichtung sondern auch für das Optiksystem bieten. Der erforderliche Wunddurchmesser beträgt etwa 20 mm. (Standard-Laparoskopie zum Vergleich 5 - 11 mm.)
Die Effektivität der Bauchentfaltung ist ungünstiger, als bei der CO2-Laparoskopie, da die Anhebung nur an einem Punkt erfolgt. Das Ergebnis ist eine kegelförmige Figur mit dem höchsten Punkt am Nabel. Der Operateur benötigt den meisten Platz aber im Beckenbereich. Das gelingt bei der gleichmäßigen Aufdehnung mit genau dosiertem CO2-Gasdruck effektiver. Dies ist für uns ein operationstechnisch wichtiger Punkt. Nicht günstig ist bei langen Operationen der punktuelle Druck auf das Gewebe durch die Hakenkonstruktion. Die grobe Lift-Konstruktion ist dem Operateur und den Assistenten natürlich bei Operieren im Weg.
Die Raumluft kann nicht angewärmt werden. Es herrscht während der "gaslosen" OP im Bauchraum eine niedrigere Temperatur als bei der CO2-Laparoskopie mit körperwarmem Gas (hierfür stehen spezielle Geräte zur Verfügung.) Die Absenkung der Gewebetemperatur hat einige wichtige nachteilige Stoffwechseleffekte (s. u. ).


Unser Fazit: Die "gaslose" Raumluft-Laparoskopie nimmt für uns eine Mittelstellung zwischen Leibschnitt und Bauchspiegelung ein. Sie hat Elemente von beiden.


Natürlich könnte ein für die Standard-Laproskopie gut ausgerüstetes OP-Team seine feinen Instrumente auch per gasloser Raumluft-Laparoskopie einsetzen. Dann wären zumindest die Wunden in der Bauchdecke gleich. Auch die bestechend präzise Microchirurgie mit miniaturisiertem Instrumentarium unter starker Bildvergrößerung wäre realisierbar. Nachteile blieben die schlechtere Entfaltung des Bauchraumes und die fehlende Möglichkeit der Erwärmung des Bauches durch das warme Gas. Abfall der Körpertemperatur verändert u. a. die Pharmakokinetik, erhöht den Sauerstoffverbrauch durch Kältezittern, verstärkt subjektives Missempfinden, verschlechtert die Immunabwehr, erhöht die Muskelanspannung (und damit das Schmerzempfinden). Die Blutgerinnung wird ungünstig beeinflusst. (Literatur: Gabriele Depenbusch: Heiße Tips gegen coole Fälle - Perioperative Wärmemassnahmen für Patienten noch effektiver eingesetzt. Intensiv 2002; 10: 165-174 Georg Thieme Verlag)

Wir haben uns im OPZ-Hürth bisher gegen die Einführung der Raumluft-Laparoskopie mit der Lift-Technik entschieden. Wir sähen den Sinn des Verfahrens nur bei ganz speziellen Patientinnen, die wir meist nicht ambulant operieren können, z. B. älteren Menschen.


Falsche Vorstellungen zur "gaslosen" Raumluft-Laparoskopie


Die gaslose Laparoskopie erlaubt kein präziseres Operieren. .
Die Herstellung des Zugangs zur Bauchhöhle erfolgt bei der gaslosen Laparoskopie nicht auf eine weniger gefährliche Art. Man muss zur Durchführung einer CO2-Laparoskopie nicht die Bauchhöhle "blind" mit einer Kanüle punktieren und die Trokarhülsen auch nicht "blind" einstechen. Man kann problemlos die "offene" Technik einsetzen und den Zugang unter Sicht herstellen. (Literatur A. Maucher (1990), Offene Laparoskopie. gynäkol prax 14, 741-746, Hans Marseille Verlag München)s. hierzu auch das Kapitel "offene Laparoskopie" auf dieser Homepage. Die mit Abstand am weitesten verbreitete Zugangstechnik ist allerdings die "Blindpunktion)
Die OP-Zeiten sind nicht kürzer. Patienten erholen sich nicht schneller. Die Schmerzen nach dem Eingriff sind nicht geringer. Der Medikamentenbedarf ist nicht geringer.
Die Ergebnisse der Operationen sind in keinem Aspekt besser, als bei der CO2-Laparoskopie . Die resultierenden Narben sind nicht kosmetisch günstiger sondern deutlich größer.
Die „gaslose“ Laparoskopie erlaubt keine operative Behandlung, die man nicht mit der Standard-Laparoskopie realisieren kann. (Auch die Standard-Laparoskopie erlaubt chirurgisches Nähen, sogar mit mikrochirurgischem Nahtmaterial unter bis zu 20-facher Bildvergrößerung).
Die "gaslose Laparoskopie" geht nicht einher mit einem niedrigeren Gesamt-Komplikationsrisiko. Die Embolie- und Thromboserate ist nicht niedriger. Die Narkosetechnik unterscheidet sich nicht von der normalen Laparoskopie.

If this really was the way to have an adhesiolysis then all the world would be clammoring at Kruschinskis door! All he has is "advertising" and no hard facts about his claims. The Endogyn "parrots", those endeared to Kruschinski are common lay people who will happily explain TO ANYONE WHO WILL LISTEN about the deletirious side effects of carbon dioxide and reel in another sucker to a very questionable surgery.
See the skeptisism in the forum below....first translated to English then in the originional German.

It is a far cry from what Karen Steward of Texas espouses!

Babelfish translation from German to English

Dr kurschinskie, EndyGyn = Risko growing together smaller
becci mouse
Mo, 07/06/2010 - 14:14hello it love,

since the contribution is already somewhat older, I open from there new post office and would like to ask, who already made thereby experiences, who there was in practice. with you actually fewer growing together, did you did develop have make again to let a OI? did someone use the possibility without full arcose to be operated???

since practice is far for many away, depending upon residence, I would know also gladly, how the contact came to conditions, how discussions ran, reliably by telephone/mail I take to? is one at all well advised and examined, if one only one day before the OI travels? can local physicians which with found at all begin or do have one to re-examinations again and again? for me some hundreds km, if I carry then however fewer growing together off and I have the chance, would be to be healed, take I gladly in purchase… from there completely urgently please to communicate to me many tips and experiences completely. sone fear of the OI has and is already correctly depressive, because I in the Internet horrogeschichten myself and risks read and see only black: (

and the latter asks: how did it run off with the assumption of the costs? I am private, but white not whether soetwas one takes over, if one drives etc. into another place.

are strained and wait longingly for answer, lg becci

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Hello becci, I has

DanH

Mo, 07/06/2010 - 18:59Hello becci,


I read not all your contributions, therefore I do not know your diagnosis/complaints.

Would like to mean you however (even if only volatile) impression of Dr. Kruschinski to describe. I had times at the telephone. It was before the diagnosis Endo, at that time a general physician the suspicion also growing together and possibly “which gynäkologisches”… and with to be googled is I evenly over it had tripped and have nen date made the telephone consulting hour. My impression was not the best one: We talked no 10 min, I to it completely scarcely my complaints and the suspicion let us describe and already had I nen OI date. I found that in such a way… naja. And the cash hätt's anyway not paid.

He works with this elevator method, as you writes without gas. And as growing together barrier it works with a kind spraying gel which I from otherwise no hospital knows (clearly, he has probably a patent drauf). (IHRT ~ Nah thats just what he wants you to think)

But is ob's good or bad.??? Does someone know relevant studies? I do not know so quite, but wenns the miracle drug against growing together would give nevertheless, then we would not have nevertheless all, or? That is only my completely personal opinion, and I white that female patients by him were operated on it to swear.

Love of greetings

Daniela


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Rear Becci, too doc

Erdbeere23

Mo, 07/06/2010 - 20:12Rear Becci,


too doc kruschinski gabs here already some discussions.

fact is: it is endometriosespezialist and still on NO advanced training or meeting about endometriose, also of endometrioseverband Germany, was seen none (to these meetings endometriosespezialisten, which train themselves further regularly, all go). alone to me would already signal to go there not.

besides it operates in a private hospital and describes on its homepage in my opinion fell so praising mark “which has I there again wonderful mad carried out” that I have the feeling, it goes over to be ego and, above all, around its money.

surely that sounds everything for someone, which hurts degrees has, in emergency feels, also psychologically possibly quite to ends is total (like most women, who look for nem endoarzt), like the rescue and super. BUT: on it the offer aims exactly, aims the way of the advertisement off! it is made, because in this way women, who are weak degrees, an alleged rescue anchor been enough and in addition properly into the bag reached. (IHRT ~ this really hits the nail on the head huh)

I würd there never probably go ...... to decide must that everyone. in a phase, where I was in emergency, I times contact there had, and even said, if I pay the OI and come, me as free achievement (further LOCK means) the preliminary investigation is given to me.

besides several said to me spezis the fact that my small endometrioseherde with the elevator method does not see and thus no comprehensive view can get (also different one spezis to work with elevator, but not at endo…). And: The complaints (muscular strain etc.) are also not better after that elevators than according to the method with gas.

I go rather to one endospezi, which is exactly specialized in endo, continues to form and to growing together one prevents also there.

LG


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I must agree you

DanH

Mo, 07/06/2010 - 20:16I must agree you strawberry.

Wenn's around Endometriose does not go is it already times at all the correct partner!!!! I thought it went around growing together.

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I do not know the physician,

EndotanteIV

Di, 08/06/2010 - 09:05
I do not know the physician, but I can only say, I am condemned glad, which was invented the full arcose! Never voluntarily I would like life received by this OP´s somewhat! Before the anaesthesias have I meanwhile no more fear… And I am gone until one year ago only under obligation to the blood removing…

LG Daniela



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hello daniela, with me goes

becci mouse

Di, 08/06/2010 - 14:49hello daniela,


with me it concerns the suspicion on endometriose. large fear has before intervened, first OI in full arcose and before the diagnosis, the risks of renewed growing together etc.

I found its homepage also not good in the first moment very and in my emergency know I, I whom was to believe, has already grant investigated, to each physician says something else, it gives those, which swear on the gasless and those, which gives preference to the classical method, gives it. report and opinions are only unfortunately always very on one side and each speaker make evenly only the contrary operation method totally bad, everything sound plausible and also widerum not.

me can someone help, has someone possibly well-founded studies or per/versus arguments for me? are already again drauf and to call off the OI: (

lg becci


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hello strawberry, you has completely

becci mouse

Di, 08/06/2010 - 15:00hello strawberry,

you have quite right with yours state: I despaired to degrees totally weakly, fearfully, panisch…: (

from where does one know that he was so far on no such studies and advanced training? how did you have contact to the hospital, by telephone?

relative this sprays: as it on the homepage is praised, is it the growing together means absolutely, in America is that course and give. I found that very logical everything, since the liquid, which is used with the classical OI method, remains clinging not on the wounds like this spray. there it, the scars meant were less with the gasless OI, belly cuts can be avoided. then is talks there about second look, thus a control OI, in the growing together, which grant themselves within 3 after the first OI form, to be solved can… and and… then with the regioanlanästhesie, has nevertheless such fear of a full arcose…

white further, today unfortunately a very short discussion by telephone with my COMPANY spoke, and this meant also that with the gasless OI less precise herd be found can, which is risks the same growing together also occur can… must one know that she transferred me to Dr. Ebert, therefore her surely not completely different physician then would particularly praise (to make we us anything forwards, ALL physicians do not want to earn, then unfortunately is that)

if jnd still more has information, opinions or experiences, please to write the text completely urgently here, are so down: (


lg


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Dr. Kruschinski

Schnecke83

Di, 08/06/2010 - 16:07Hello together,

only once I would like to say that everyone of the OI method must be convinced, it must let which be issued over itself!


If that is not the case, I would always call a OI off.


One must with itself in pure ones to be, because with the result, no matter how it goes out, one must to live be able.

Now to Dr. Kruschinski:

Is interesting, as much bad criticism it must put in and over it is written, although degrees those were never operated by it… (IHRT ~ Ummm I was)

I was operated one week ago by him! Head OI and some days after Second look.

Z.Zt. still am I in the hospital. After both interferences I knew immediately which thing am, have some pictures received, so that I knew exactly, what it there with me down “employed” have!

In a KH I would have gotten a belly cut, would have been said at that time me with the first BSP. I did not want to have these with nearly 27 years however, therefore I had decided against it. Now I lasted a breath of larger cuts as with normal EX. my considerations and research up to OI having a half year!

And why it to recruit must: It operates in a private hospital! There everyone can go without a transfer, says I now times so casually. And it must constantly fight for it and justify itself for its method. Is that fair? Or is it envy of the others? (IHRT ~ haw haw haw haw)

The SprayShield I got also, over experiences can I naturally only think I in some weeks for speaking and like it with the pain look!

I learned it to know now personally and from there can I now a judgement afford!

Which all patients say are: It seems to be always on the escape…

But: It is each day in the hospital, answers even at Easter and at night to my emails!!!

He says even it is its appointment and gives everything for it… from there suffers badly his family life under it. ( IHRT, This is the understatement of the century!)

Now, I know for me, if further OPs lines up, I will come always ago. My travel time: approx. 4 autohours

And I am not private, but the BKK health takes over the costs. Only the gel and the remainder of the stay one must pay.

To further questions simply announce



Love of greetings



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Hello becci, I became

DanH

Di, 08/06/2010 - 16:09Hello becci,


I would never go with a Endomoetrioseverdacht to him! Simply so from the feeling. In no technical periodical, on no congress of the Endovereinigung or hears one reads something of him in connection with Endo. With Endometriose you belong into the hands species! And Kruschinski is in my opinion only self-appointed which growing together bellies concerns.

Here times a beautiful text to the gasless Lap: http://www.opz-huerth.de/index.php?menue=m3_&sm=21

I had heard of it already, also of many disadvantages, and that I now found. How in the text by the way descriptive is developed by saucy stone - > and no more does not use! That says some nevertheless already…

LG

Daniela


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Left thank you

nela

So, 13/06/2010 - 16:42 Hello Daniela, thank you for the left and your open comment! I find it very courageous by you that you take here so openly position. I reacted it experienced as it to criticism. It feels asked already insulting if it for it we whether it at all a practice has. Also I go actually proving only to a physician to that me can in appropriate advanced training measures have participated, and/or in technical periodicals is represented. Which does not concern Schneck83 so would like I anybody too close to step however one could nearly believe that this is a kind advertisement. Which Doc omits itself already with a female patient over its family life. It should nevertheless the patient and not around the physician concern here. In addition which many bad criticisms? Criticism at it nevertheless nearly not only always exists these miracle stories. Endo is a hard fate and no place for physicians, who are already insulting if her are not praised.

LG Nela

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Hello Nela that with its

Schnecke83

So, 13/06/2010 - 18:24Hello Nela,



that with its family life does not have it me also told, I “snapped open” in the hospital only!



It changed with me no private word, everything had with me to do, thus for the patient.


Greetings

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Hello Schnecke83, are you

DanH

So, 13/06/2010 - 18:38Hello Schnecke83,


were you operated by Dr. Kruschinski because of Enometriose?

LG
Daniela

To write announcing or registering around comments

Hello Daniela, I has

Schnecke83

So, 13/06/2010 - 19:03Hello Daniela,


yes, I have Endo degree of 3 with strong growing together and an inclination to the Zystenbildung at the ovaries.

My was already again 8 cm large: - (

Between intestine and the Gebärmutter I have still Endo, which he has however for the time being leaves, there it a piece intestine to remove would have had and then get one an artificial intestine exit for 3 months, so that the two intestine ends can grow together.

Oh, always these OI `s, as good that one does not have white how often one still so in its life therefore under measurers.

LG

Origional German text

http://www.endometriose-liga.eu/node/26625

Dr kurschinskie, EndyGyn = Risko Verwachsungen geringer
becci-maus
Mo, 07/06/2010 - 14:14hallo ihr lieben,

habe soeben in einem älteren beitrag von dr kurschinski in braunschweig gelesen und bin total geschockt, aufgeregt und erfreut. habe mir sogleich dann seine homepage angeguckt und dort von seinen neuartigen op-techniken gelesen, die die risiken von verwachsungen eindämmen sollen, auch wird gaslos operiert, was insg auch weniger risiken birgt, außerdem gibt es dort auch die möglichkeit, ohne vollnarkose diesen eingriff vornehmen zu lassen, was mich total neugierg macht. denn ich habe schreckliche angst vor meinem op termin in berlin und würd am liebste absagen, wenn ich über die risiken lese und auch hier im forum wird deutlich, dass immer wieder verwachsungen über die jahre entstehen, die sicher nicht durch die endo, sondern durch BS / oder Bschnitte entstanden sind.

da der beitrag schon etwas älter ist, mache ich daher einen neuen post auf und möchte fragen, wer damit schon erfahrungen gemacht hat, wer dort war in der praxis. sind bei euch tatsächlich weniger verwachsungen entstanden, musstet ihr erneut eine op machen lassen? hat jemand die möglichkeit genutzt, ohne vollnarkose operiert zu werden???

da die praxis ja für viele weit weg ist, je nach wohnort, würde ich auch gerne wissen, wie der kontakt zu stande kam, wie besprechungen verliefen, sicher per telefon/mail nehme ich am? wird man überhaupt gut beraten und untersucht, wenn man erst einen tag vor der op anreist? können hiesige ärzte was mit den befunden überhaupt anfangen oder muss man zu nachuntersuchungen immer wieder hin? für mich wären das einige hunderte km, wenn ich dann aber weniger verwachsungen davontrage und ich die chance habe, geheilt zu werden, nehme ich das gerne in kauf...daher ganz dringend die bitte, mir ganz viele tips und erfahrungen mitzuteilen. habe sone angst vor der op und bin schon richtig depressiv, weil ich mir im internet horrogeschichten und risiken durchlese und nur noch schwarz sehe :(

und die letzte frage: wie lief es denn mit der kostenübernahme ab? ich bin privatversichert, aber weiß nicht, ob soetwas übernommen wird, wenn man in einen anderen ort fährt etc.

bin gespannt und warte sehnsüchtig auf antwort, lg becci



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Hallo becci, ich habe
DanH
Mo, 07/06/2010 - 18:59Hallo becci,

ich habe nicht alle deine Beiträge gelesen, also kenne ich deine Diagnose/Beschwerden nicht.

Möchte dir aber meinen (wenn auch nur flüchtigen) Eindruck von Dr. Kruschinski schildern. Ich hatte den mal am Telefon. Es war vor der Diagnose Endo, damals hatte ein Allgemeinmediziner den Verdacht auch Verwachsungen und evtl. "was gynäkologisches"...und beim googeln bin ich eben über ihn gestolpert und hab nen Termin zur Telefonsprechstunde gemacht. Mein Eindruck war nicht der Beste: Wir haben keine 10 min geredet, ich hab ihm ganz knapp meine Beschwerden und den Verdacht geschildert und schon hatte ich nen OP-Termin. Das fand ich so...naja. Und die Kasse hätt's ohnehin nicht gezahlt.

Er arbeitet ja mit dieser Lift-Methode, wie du schreibst ohne Gas. Und als Verwachsungsbarriere arbeitet er mit einer Art Sprühgel was ich aus sonst keiner Klinik kenne (klar, er hat wohl auch ein Patent drauf).

Aber ob's gut oder schlecht ist..??? Kennt jemand relevante Studien? Ich weiß nicht so recht, aber wenns doch DAS Wundermittel gegen Verwachsungen geben würde, dann hätten wir doch alle keine, oder? Das ist nur meine ganz persönliche Meinung, und ich weiß das Patientinnen die von ihm operiert wurden darauf schwören.



Liebe Grüße

Daniela



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Hi Becci, zu doc
Erdbeere23
Mo, 07/06/2010 - 20:12Hi Becci,



zu doc kruschinski gabs hier schon einige diskussionen..

fakt ist: er ist kein endometriosespezialist und wurde noch auf KEINER fortbildung oder veranstaltung zum thema endometriose, auch vom endometrioseverband deutschland, gesehen (zu diesen veranstaltungen gehen endometriosespezialisten, die sich regelmäßig fortbilden, alle hin). das allein würde mir schon signalisieren, da nicht hin zu gehen.

zudem operiert er in einer privatklinik und schildert auf seine homepage meiner meinung nach die fälle so selbstlobend marke "was hab ich da wieder wundervolles tolles geleistet", dass ich das gefühl habe, es geht um sein ego und, vor allem, um sein geld.

sicherlich klingt das alles für jemanden, der grad schmerzen hat, sich in not fühlt, auch psychisch evtl ziemlich am ende ist (wie die meisten frauen, die nach nem endoarzt suchen), wie die rettung und total super. ABER: genau darauf zielt das angebot, zielt die art und weise der werbung ab! sie ist gemacht, weil auf diese weise frauen, die grad schwach sind, ein vermeintlicher rettungsanker gereicht wird- und dazu ordentlich in die tasche gegriffen.

ich würd da niemals hingehen......entscheiden muss das wohl jeder selber. in einer phase, wo ich in not war, hab ich da mal kontakt hin gehabt, und mir wurde sogar gesagt, wenn ich die op zahle und komme, wird mir als gratisleistung (weiteres lockmittel) die voruntersuchung geschenkt.

zudem haben mir mehrere spezis gesagt, dass mein kleine endometrioseherde mit der liftmethode NICHT sieht und somit keinen umfassenden einblick bekommen kann (auch andere spezis arbeiten mit lift, aber nicht bei endo...). Und: Die beschwerden (muskelkater usw) sind nach dem liften auch nicht besser als nach der methode mit gas..

ich geh lieber zu einem endospezi, der auf endo genau spezialisiert ist, sich weiter bildet und auch dort wird verwachsungen vorgebeugt..

LG



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Ich muss dir zustimmen
DanH
Mo, 07/06/2010 - 20:16Ich muss dir zustimmen Erdbeere.

Wenn's um Endometriose geht ist er schon mal gar nicht der richtige Ansprechpartner!!!! Ich dachte es ging um Verwachsungen.



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Ich kenne den Arzt nicht,
EndotanteIV
Di, 08/06/2010 - 09:05

Ich kenne den Arzt nicht, aber ich kann nur sagen, ich bin verdammt froh, das die Vollnarkose erfunden wurde! Niemals freiwillig möchte ich von diesen OP´s etwas life mitbekommen! Vor den Narkosen hab ich mittlerweile keine Angst mehr... Und ich bin bis vor einem Jahr nur unter Zwang zum Blutabnehmen gegangen...

LG Daniela

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hallo daniela, bei mir geht
becci-maus
Di, 08/06/2010 - 14:49hallo daniela,

bei mir geht es um den verdacht auf endometriose. habe ja große angst vor dem eingriff, erste op in vollnarkose und vor der diagnose, den risiken erneuter verwachsungen etc.

ich fand seine homepage im ersten moment sehr gut und in meiner not weiß ich auch nicht, wem ich glauben soll, habe bereits stunden recherchiert, jeder arzt sagt etwas anderes, es gibt die, die auf die gaslose schwören und es gibt die, die der klassischen methode den vorzug geben. nur leider sind die berichte und meinungen immer sehr einseitig und jeder sprecher macht eben nur die gegenteilige operationsmethode total schlecht, alles klingt einleuchtend und auch widerum nicht.

kann mir denn jemand weiterhelfen, hat jemand evtl fundierte studien oder pro/contra argumente für mich? bin schon wieder drauf und dran, die op abzusagen :(

lg becci



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hallo erdbeere, du hast ganz
becci-maus
Di, 08/06/2010 - 15:00hallo erdbeere,

du hast ganz recht mit deiner aussage: ich bin grad total schwach, ängstlich, verzweifelt, panisch...:(

woher weiß man denn, dass er bisher auf keinen solchen studien und fortbildungen war? wie hattest du denn kontakt zu der klinik, per telefon?

bezüglich diesen sprays: so wie es auf der homepage gepriesen wird, ist es DAS verwachsungenmittel schlechthin, in amerika sei das gang und gebe. ich fand das alles sehr logisch, da die flüssigkeit, die bei der klassischen op-methode verwendet wird, nicht auf den wunden haften bleibt wie dieses spray. dort hieß es, die narben seien mit der gaslosen op weniger, bauchschnitte können vermieden werden. dann ist da die rede von dem second look, also einer kontroll-op, in der verwachsungen, die sich ja innerhalb 3 stunden nach der ersten op bilden, gelöst werden können...und und und... dann das mit der regioanlanästhesie, hab doch solche angst vor einer vollnarkose...

weiß nicht weiter, habe heute mit meiner FA gesprochen, leider ein sehr kurzes gespräch per telefon, und diese meinte auch, dass mit der gaslosen op weniger präzise herde gefunden werden können, die risiken die gleichen sind, verwachsungen auch auftreten können...aberdazumuss man wissen, dass sie mich zu dr. ebert überwiesen hat, also würde sie sicher nicht einen ganz anderen arzt dann besonders loben (denn machen wir uns nichts vor, ALLE ärzte wollen verdienen, so ist das leider)

wenn jnd noch mehr infos, meinungen oder erfahrungen hat, bitte ganz dringend hier texten, bin so down :(

lg



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Dr. Kruschinski
Schnecke83
Di, 08/06/2010 - 16:07Hallo zusammen,

erst einmal möchte ich sagen, dass jeder von der OP Methode überzeugt sein muss, die er über sich ergehen lassen muss!

Wenn das nicht der Fall ist, würde ich eine OP immer absagen.

Man muss mit sich im Reinen sein, weil mit dem Ergebnis, egal wie es ausgeht, muss man leben können.



Nun zu Dr. Kruschinski:

Interessant ist, wie viel schlechte Kritik er einstecken muss und über ihn geschrieben wird, obwohl grade diejenigen nie von ihm operiert wurden...

Ich wurde vor einer Woche von ihm operiert! Haupt-OP und einige Tage danach Second look.

Z.Zt. befinde ich mich noch in der Klinik. Nach beiden Eingriffen wusste ich sofort Bescheid was Sache ist, habe etliche Bilder erhalten, so dass ich genau wusste, was er dort bei mir unten "angestellt" hat!

In einem KH hätte ich einen Bauchschnitt bekommen, wurde mir damals bei der ersten BSP gesagt. Diesen wollte ich mit fast 27 Jahren aber nicht haben, deshalb habe ich mich dagegen entschieden. Nun habe ich ein Hauch größerer Schnitte wie bei einer normalen BSP. Meine Überlegungen und Forschungen bis hin zu OP haben ein halbes Jahr gedauert!

Und warum er werben muss: Er operiert in einer Privatklinik! Dort kann jeder ohne eine Überweisung hin gehen, sage ich jetzt mal so salopp.. Und er muss ständig dafür kämpfen und sich für seine Methode rechtfertigen. Ist das fair? Oder ist es Neid von den Anderen?

Das SprayShield habe ich auch bekommen, über Erfahrungen kann ich natürlich erst denke ich in einigen Wochen sprechen und wie es mit den Schmerzen aussieht!

Ich habe ihn nun persönlich kennen gelernt und daher kann ich mir nun ein Urteil leisten!

Was alle Patienten sagen ist: Er scheint immer auf der Flucht zu sein...

Aber: Er ist jeden Tag in der Klinik, antwortet sogar an Ostern und nachts auf meine E-Mails!!!

Er sagt selbst es ist seine Berufung und gibt alles dafür...daher leidet arg sein Familienleben darunter.

Nun ja, ich für mich weiß, falls weitere OPs anstehen, werde ich immer her kommen. Meine Fahrzeit: ca. 4 Autostunden

Und ich bin nicht privatversichert, aber die BKK Gesundheit übernimmt die Kosten. Nur das Gel und den Rest des Aufenthaltes muss man selbst zahlen.

Bei weiteren Fragen einfach melden

Liebe Grüße



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Hallo becci, ich würde
DanH
Di, 08/06/2010 - 16:09Hallo becci,

ich würde mit einem Endomoetrioseverdacht niemals zu ihm gehen! Einfach so vom Gefühl her. In keiner Fachzeitschrift, auf keinem Kongress der Endovereinigung liest oder hört man etwas von ihm im Zusammenhang mit Endo. Mit Endometriose gehörst du in die Hände eines Spezies! Und Kruschinski ist meiner Meinung nach nur ein selbsternannter was Verwachsungsbäuche angeht.

Hier mal ein schöner Text zur gaslosen Lap: http://www.opz-huerth.de/index.php?menue=m3_&sm=21

Ich hatte davon schon gehört, auch von vielen Nachteilen, und das hab ich nun gefunden. Wie im Text übrigens beschrieben ist von Keckstein entwickelt -> und nicht mehr verwendet! Das sagt doch schon einiges...

LG

Daniela



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Link Vielen Dank
nela
So, 13/06/2010 - 16:42Hallo Daniela, vielen Dank für den Link und Deinen offenen Kommentar! Ich finde es sehr mutig von Dir, dass Du hier so offen Stellung beziehst. Ich habe es selbst erlebt wie er auf Kritik reagiert. Er fühlt sich schon beleidigt wenn er danach gefragt wir ob er überhaupt eine Praxis hat. Auch ich gehe nur zu einem Arzt der mir tatsächlich nachweisen kann an entsprechenden Fortbildungsmaßnahmen teilgenommen zu haben, bzw. in Fachzeitschriften vertreten ist. Was Schneck83 betrifft so möchte ich niemandem zu nahe treten aber man könnte fast glauben, dass dies eine Art Werbung ist. Welcher Doc lässt sich schon bei einer Patientin über sein Familienleben aus. Es sollte hier doch um den Kranken und nicht um den Arzt gehen. Außerdem welche viele schlechte Kritiken? Kritik an ihm existiert doch fast gar nicht bloß immer diese Wundergeschichten. Endo ist ein hartes Schicksal und kein Platz für Ärzte, die schon beleidigt sind wenn sie nicht gelobt werden.

LG Nela


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Hallo Nela, dass mit seinem
Schnecke83
So, 13/06/2010 - 18:24Hallo Nela,

dass mit seinem Familienleben hat er mir auch nicht erzählt, habe ich in der Klinik nur "aufgeschnappt"!

Er hat mit mir gar kein privates Wort gewechselt, alles hatte mit mir zu tun, also dem Patient.

Grüße



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Hallo Schnecke83, bist du
DanH
So, 13/06/2010 - 18:38Hallo Schnecke83,

bist du von Dr. Kruschinski wegen Enometriose operiert worden?

LG

Daniela



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Hallo Daniela, ja, ich habe
Schnecke83
So, 13/06/2010 - 19:03Hallo Daniela,

ja, ich habe Endo Grad 3 mit starken Verwachsungen und eine Neigung zur Zystenbildung an den Eierstöcken.

Meine war schon wieder 8 cm groß :-(

Zwischen Darm und der Gebärmutter habe ich noch Endo, die hat er aber vorerst belassen, da er ein Stück Darm hätte entfernen müssen und dann bekommt man einen künstlichen Darmausgang für 3 Monate, damit die zwei Darmenden zusammen wachsen können.

Ach ja, immer diese OP`s, wie gut, dass man nicht weiß wie oft man noch so in seinem Leben deswegen unters Messer muss..

LG

If you need friends bad enough to hang with the likes of Dr Daniel Kruschisnki and Karen Steward than we pray God keep you safe through your ordeal. Wouldnt facebook be a safer bet?

Dr Kruschinski and Unsafe medical practices ~ IHRT blast from the past

Thursday, July 20, 2006
Dr. Daniel Kruschinski: The Dangerous Medical Issues
Let's focus on the most important issues, the medical issues regarding Dr. Daniel Kruschinski.

1. That he was dismissed from 5-10 surgical facilities before he opened his practice at the Emma Klinik.

2. That he did not request that his patients from the U.S. obtain (and FAX to him) standard pre-op testing before they left home, including EKG, routine blood work, Urinalysis, BP. Unsafe medical practice.

3. That he operated on some very ill and/or elderly patients, for lengthy surgeries, with no ICU at the Emma Klinik. The closest ICU to the Emma Klinik is in Frankfurt. Unsafe medical practice.

4. That he did not ask patients if they were taking pain meds, dosage, etc. Unsafe medical practice.

5. That he himself is very likely impaired by alcohol abuse/addiction, lack of emotional control, or both. He certainly revealed that he was impaired in some way in some of his e-mails and message board posts. Unsafe medical practice.

6. That he violated "Dr.-Patient Confidentiality" by sharing personal information about several of his patients, even posting some of that information on his message board, using their complete name. Unethical Medical Practice.

7. That he shared his personal problems with some patients and asked them for their assistance to bring him more patients. Unethical Medical Practice.

8. He's a gynocologist but works on men. Unsafe medical practice.

Posted by IHRT at 10:29 PM 5 comments:

Anonymous said...
Thank you for your summary of the MEDICAL issues regarding Dr. Daniel Kruschinski.

I agree with you.
His personal life is just that--- personal.

There are other issues, however, that are also important- those dealing with the BUSINESS aspect of his practice:

1. That he demanded that patients wire their money directly into his bank account.

2. That he intercepted e-mails written from prospective patients to other surgeons, and responded to them himself, attempting to set up a surgery to be done by him alone, although the pt. had requested a different surgeon. (Example: the pt. from Hawaii).

3. That he set up surgery dates, and demanded payment, for some patients before he had even seen their medical histories.
(this would be both a medical and a business issue).

July 20, 2006 11:28 PM
IHRT said...
Malignant narcissisim

1. THE PATHOLOGICAL LIAR is skillfully deceptive and very convincing. Avoids accountability by diverting topics, dodging questions, and making up new lies, bluffs or threats when questioned. His memory is self serving as he denies past statements. Constant chaos and diverting from reality is their chosen environment.
Defense Strategy: Verify his words. Do not reveal anything about yourself - he'll use it against you. Head for the door when things don't add up. Don't ask him questions - you'll only be inviting more lies.

2. THE CONTRACT BREAKER agrees to anything then turns around and does the opposite. Marriage, Legal, Custody agreements, normal social/personal protocol are meaningless. This con artist will accuse you of being the contract breaker. Enjoys orchestrating legal action and playing the role of the 'poor me' victim.
Defense Strategy: Expect him to disregard any agreement. Have Plan B in place. Protect yourself financially and emotionally.

3. THE HIGH ROLLER Successfully plows and backstabs his way to the top. His family a disposable prop in his success facade. Is charismatic, eloquent and intelligent in his field, but often fakes abilities and credentials. Needs to have iron-fisted control, relying on his manipulation skills. Will ruthlessly support, exploit or target others in pursuit of his ever-changing agenda. Mercilessly abuses the power of his position. Uses treachery or terrorism to rule or govern. Potential problem or failure situations are delegated to others. A vindictive bully in the office with no social or personal conscience. Often suspicious and paranoid. Others may support him to further their own Mephistophelian objectives, but this wheeler-dealer leaves them holding the bag. Disappears quickly when consequences loom.
Defense Strategy: Keep your references and resume up to date. Don't get involved in anything illegal. Document thoroughly to protect yourself. Thwarting them may backlash with a cascade of retaliation. Be on the lookout and spot them running for office and vote them out. Educate yourself about corporate bullies

4. THE SEXUAL NARCISSIST is often hypersexual (male or female). Pornography, masturbation, incest are reported by his targets. Anything, anyone, young, old, male/female, are there for his gratification. This predator takes what is available. Can have a preference for 'sado-maso' sexuality. Often easily bored, he demands increasingly deviant stimulation. However, another behaviour exists, the one who withholds sex or emotional support.
Defense Strategy: Expect this type to try to degrade you. Get away from him. Expect him to tell lies about your sexuality to evade exposure of his own.

5. THE BLAME-GAME NARCISSIST never accepts responsibility. Blames others for his failures and circumstances. A master at projection.
Defense Strategy: Learn about projection. Don't take the bait when he blames you. He made the mess let him clean it up.

6. THE VIOLENT NARCISSIST is a wife-Beater, Murderer, Serial Killer, Stalker, Terrorist. Has a 'chip-on-his-shoulder' attitude. He lashes out and destroys or uses others (particularly women and children) as scapegoats for his aggression or revenge. He has poor impulse control. Fearless and guiltless, he shows bad judgement. He anticipates betrayal, humiliation or punishment, imagines rejection and will reject first to 'get it over with'. He will harass and push to make you pay attention to him and get a reaction. He will try to make you look out of control. Can become dangerous and unpredictable. Has no remorse or regard for the rights of others.
Defense Strategy: Don't antagonize or tip your hand you're leaving. Ask for help from the police and shelters.

7. THE CONTROLLER/MANIPULATOR pits people against each other. Keeps his allies and targets separated. Is verbally skillful at twisting words and actions. Is charismatic and usually gets his way. Often undermines our support network and discourages us from seeing our family and friends. Money is often his objective. Other people's money is even better. He is ruthless, demanding and cruel. This control-freak bully wants you pregnant, isolated and financially dependent on him. Appears pitiful, confused and in need of help. We rush in to help him with our finances, assets, and talents. We may be used as his proxy interacting with others on his behalf as he sets us up to take the fall or enjoys the performance he is directing.
Defense Strategy: Know the 'nature of the beast'. Facing his failure and consequences will be his best lesson. Be suspicious of his motives, and avoid involvement. Don't bail him out.

8. THE SUBSTANCE ABUSER Alcohol, drugs, you name it, this N does it. We see his over-indulgence in food, exercise or sex and his need for instant gratification. Will want you to do likewise.
Defense Strategy: Don't sink to his level. Say No.

9. OUR "SOUL MATE" is cunning and knows who to select and who to avoid. He will come on strong, sweep us off our feet. He seems to have the same values, interests, goals, philosophies, tastes, habits. He admires our intellect, ambition, honesty and sincerity. He wants to marry us quickly. He fakes integrity, appears helpful, comforting, generous in his 'idealization' of us phase. It never lasts. Eventually Jekyll turns into Hyde. His discarded victims suffer emotional and financial devastation. He will very much enjoy the double-dipping attention he gets by cheating. We end the relationship and salvage what we can, or we are discarded quickly as he attaches to a "new perfect soul mate". He is an opportunistic parasite. Our "Knight in Shining Armor" has become our nightmare. Our healing is lengthy.
Defense Strategy: Seek therapy. Learn about this disorder. Know the red flags of their behaviour, and "If he seems too good to be true..." Hide the hurt you feel. Never let him see it. Be watchful for the internet predator.

10. THE QUIET NARCISSIST is socially withdrawn, often dirty, unkempt. Odd thinking is observed. Used as a disguise to appear pitiful to obtain whatever he can,

11. THE SADIST is now the fully-unmasked malignant narcissist. His objective is watching us dangle as he inflicts emotional, financial, physical and verbal cruelty. His enjoyment is all too obvious. He'll be back for more. His pleasure is in getting away with taking other people's assets. His target: women, children, the elderly, anyone vulnerabie.
Defense Strategy: Accept the Jekyll/Hyde reality. Make a "No Contact' rule. Avoid him altogether. End any avenue of vulnerability. Don't allow thoughts of his past 'good guy' image to lessen the reality of his disorder.

12. THE RAGER flies off the handle for little or no provocation. Has a severely disproportionate overreaction. Childish tantrums. His rage can be intimidating. He wants control, attention and compliance. In our hurt and confusion we struggle to make things right. Any reaction is his payoff. He seeks both good or bad attention. Even our fear, crying, yelling, screaming, name calling, hatred are his objectives. If he can get attention by cruelty he will do so.
Defense Strategy: Manage your responses. Be fully independent. Don't take the bait of his verbal abuse. Expect emotional hurt. Volence is possible.

13. THE BRAINWASHER is very charismatic. He is able to manipulate others to obtain status, control, compliance, money, attention. Often found in religion and politics. He masterfully targets the naive, vulnerable, uneducated or mentally weak.
Defense Strategy. Learn about brainwashing techniques. Listen to your gut instinct. Avoid them.

14. THE RISK-TAKING THRILL-SEEKER never learns from his past follies and bad judgment. Poor impulse control is a hallmark.
Defense Strategy: Don't get involved. Use your own good judgement. Say No.

15. THE PARANOID NARCISSIST is suspicious of everything usually for no reason. Terrified of exposure and may be dangerous if threatened. Suddenly ends relationships if he anticipates exposure or abandonment.
Defense Strategy: Give him no reason to be suspicious of you. Let some things slide. Protect yourself if you anticipate violence.

16. THE IMAGE MAKER will flaunt his 'toys', his children, his wife, his credentials and accomplishments. Admiration, attention, even glances from others, our envy or our fear are his objective. He is never satisfied. We see his arrogance and haughty strut as he demands center stage. He will alter his mask at will to appear pitiful, inept, solicitous, concerned, or haughty and superior. Appears the the perfect father, husband, friend - to those outside his home.
Defense Strategy: Ignore his childlike behaviours. Know his payoff is getting attention, deceiving or abusing others. Provide him with 'supply' to avert problems.

17. THE EMOTIONAL VACUUM is the cruellest blow of all. We learn his lack of empathy. He has deceived us by his cunning ability to mimic human emotions. We are left numbed by the realization. It is incomprehensible and painful. We now remember times we saw his cold vacant eyes and when he showed odd reactions. Those closest to him become objectified and expendable.
Defense Strategy: Face the reality. They can deceive trained professionals.

18. THE SAINTLY NARCISSIST proclaims high moral standing. Accuses others of immorality. "Hang 'em high" he says about the murderer on the 6:00 news. This hypocrite lies, cheats, schemes, corrupts, abuses, deceives, controls, manipulates and torments while portraying himself of high morals.
Defense Strategy: Learn the red flags of behaviour. Be suspicious of people claiming high morals. Can be spotted at a church near you.

19. THE CALLING-CARD NARCISSIST forewarns his targets. Early in the relationship he may 'slip up' revealing his nature saying "You need to protect yourself around me" or "Watch out, you never know what I'm up to." We laugh along with him and misinterpret his words. Years later, coping with the devastation left behind, his victims recall the chilling warning.
Defense Strategy: Know the red flags and be suspicious of the intentions of others.

20. THE PENITENT NARCISSIST says "I've behaved horribly, I'll change, I love you, I'll go for therapy." Appears to 'come clean' admitting past abuse and asking forgiveness. Claims we are at fault and need to change too. The sincerity of his words and actions appear convincing. We learn his words are verbal hooks. He knows our vulnerabilities and what buttons to push. We question our judgement about his disorder. We can disregard "Fool me once..." We hope for change and minimize past abuse. With a successful retargeting attempt, this N will enjoy his second reign of terror even more if we allow him back in our lives.
Defense Strategy: Expect this. Self-impose a "No Contact" rule. Focus on the reality of his disorder. Journal past abusive behavior to remind yourself. Join a support group

Enjoy life free of the Narcissist!!
The male gender is used. Your abuser may well be female.

July 21, 2006 8:15 AM
Anonymous said...
Brief Summary of the UNETHICAL BEHAVIOR of some of Kru's former PATIENTS:

1. That they did not update their "pt. stories", to add that they had to go back for one or two or three more surgeries. Their "pt. stories" as posted are deceptive, because they indicate that the person was "given a new lease on life and made pain-free after the first trip to Germany.
(See Pt Stories on Adhesions.de)


2. That they gave incomplete information to people who called or e-mailed them, using the "patient contact" list on endogyn.de. In many cases, they did not tell the caller that they were not well, or that they had to go back for more surgery, or that they were planning to go back for more surgery.

3. That they neglected to tell prospective patients that they still had to take pain meds on a continuous basis, despite the fact that they were "adhesion-free and/or pain-free".

3. That they continued to support Kru with their messages on the message board, even when they directly observed (and told others) that he smelled of alcohol and displayed erratic behavior while he was seeing pts. in his office, next to the apts.

July 22, 2006 8:30 PM
IHRT said...
Flip the five bucks and call Emma Klinik and ask for yourself.
I am sure you can find the link on "Dan the Man's" website.
Isn't it a brief call to germany to see if this dismassal from there is true?
You can keep your head in the sand if you prefer. It's monday and he is stating that he can go to Emma Klinik anytime,,,ha.
If what we say then is true, would you not consider that a whopper of a tale to tell, especially to his devoted fans?

The price of one phone call..........

Dawn

July 24, 2006 5:25 PM
IHRT said...
Oh and I nominate Karen for the annual
"Maudlin Insipid Poetry Award"
She's a strong candidate and I think she can win!!!!
(Karen, go back to raving, it's what you do best)
DR

Robotic surgery gains popularity

Patients appreciate faster recovery; surgeons report ability to see better

By Rhiannon Meyers

Corpus Christi Caller Times

Posted July 23, 2011 CORPUS CHRISTI — As the patient lay motionless on the table, her belly exposed and marked for a hysterectomy, Dr. Laura Shelton prepped for surgery.Shelton removed her plastic face shield and pulled off her sanitized surgeon's gown. She sank into a rolling chair, pushed up her long sleeves to the elbows and kicked off her tennis shoes.

For the next hour, Shelton performed the hysterectomy in a pair of pink and gray ankle socks sitting at a console 6 feetfrom the patient.

A live video feed from within the woman's abdomen illuminated Shelton's pale blue eyes as she worked a set of joysticks guiding robotic arms that cut, cauterized and sutured.

This, Shelton said, is the future of surgery.

The growing popularity of this pricey equipment — which can cost more than $2 million, according to some estimates — has sparked a debate on the merits and risks of robotic surgery.

Both local hospital systems now have surgical robots in an effort, hospital officials say, to provide minimally invasive surgery that shortens patients' hospital stays. Christus Spohn Health System bought one last year and Corpus Christi Medical Center added one in January.

Surgeons who use the robots say the technology allows patients to recover quicker because they lose less blood — less than a tablespoon, in some cases — and the incisions are smaller, sometimes less than half an inch.

"We can have them back on their feet in a week instead of six weeks," said Dr. Stan Shoemaker, an obstetrician/gynecologist who operates at Corpus Christi Medical Center. "It's a much more attractive alternative."

Advocates also say robotic surgery causes less physical strain on the surgeon and could lengthen a doctor's career in the operating room. Shoemaker said the robot also allows him to perform more challenging surgeries in a minimally invasive way.

"I'm not nearly as frightened about a tough case," Shoemaker said.

But others argue that the benefits are overstated and driven by marketing, at times by the robot's manufacturer, Intuitive Surgical Inc., which earned $1.4 billion in its last fiscal year.

One recent study suggested there was no solid scientific evidence to back claims that robotic surgery is more precise and results in less pain. The study, released in May by Johns Hopkins University School of Medicine researchers, also argued that hospitals often use Intuitive Surgical's promotional materials and fail to talk about robotic surgery risks, including claims that such surgeries can take more time, causing patients to remain under anesthesia longer, and that they are more costly.

There remains a healthy debate about the merits of traditional surgery versus the robotic procedure, said Dr. Benjamin Lowentritt, a urologist in Baltimore who solely offers robotic surgery.

"I don't think it does anyone any good to declare it as a cure-all and the perfect treatment," he said. "I would not advocate (open surgery) in my practice, but at the same time, I don't fault anyone for making that choice."

Still, Lowentritt said, it's difficult for any hospital to opt against offering robotic surgery because of the strong patient demand.

"I wouldn't want to go to a hospital that didn't have it for my prostate care," he said. "To be a center that provides the full complement of care to your patients, I think it is something that you should have."

Plus, he said, robotic surgery acts as a good recruiting tool for new surgeons.

"As time goes on, hospitals and communities that don't have them will more and more have difficulty attracting newer and recently trained physicians," he said.n n nFor the past 1½ years, Debra Cantu, 34, struggled with near-constant pelvic pain and an overactive bladder. She popped pain relievers at least three times a week and ran to the bathroom once an hour. She woke frequently at night to use the restroom.

Shelton diagnosed her with uterine fibroids, which are noncancerous tumors, and possibly endometriosis, a painful condition where tissue typically lining the uterus grows outside the uterus, becomes inflamed and eventually develops scar tissue and adhesions, which bind organs together and causes pelvic pain, according to the Mayo Clinic.

Shelton recommended giving Cantu a partial hysterectomy using Christus Spohn Health System's da Vinci robot.

The robots are controlled solely by the surgeon, who sits at a nearby console and views the surgery through a viewfinder, where the images are magnified 10 times and appear in 3D.

Robotic instruments, which look like miniature forceps, are inserted through tubes in the patient's body. The surgeon uses joysticks to direct them to pinch, cut and sew.

Using a pedal that looks like a car accelerator, the surgeon can move around a small, lighted camera, usually inserted through a tube in the patient's belly button, to peek around organs and zoom in on blood vessels. The surgeon uses another pedal to deliver bursts of electricity that cauterize, or burn, tissue and blood vessels to seal them and stop the bleeding.

As Shelton worked at the console Wednesday – shoeless, she said, so she could better feel the pedals – she navigated the instruments past organs and blood vessels that filled the flat-screen televisions on each side of the operating room.

Shelton pointed to scar tissue and adhesions that marred the inside of Cantu's pelvis and decided she had to do a complete hysterectomy. It was the only option, she said, that could relieve Cantu of her pain, even though it would force the mother of two into early menopause.

It was an option they had discussed in a pre-operative appointment, but once Shelton saw in excruciating detail the extent of the scarring from Cantu's endometriosis, she said she realized the problem was worse than expected. Cantu's ovaries had adhered to her abdominal wall and scar tissue was tucked underneath her uterus, a typically hard-to-reach area for a surgeon.

Shelton said she wouldn't have been able to see such detail with traditional surgery, which likely would have been more challenging.

"The visualization is key," she said. "I could see exactly where the adhesions were, exactly where to cut."

Lowentritt, who said he was skeptical at first of what he thought would be a gimmicky new technology, said the visualization provided by robotic surgery changed his mind.

"I feel like it has made me a much better surgeon because I could see for the first time in ways I couldn't with open surgery," he said.n n nWhile hospitals nationwide offer robotic surgery for a variety of procedures, from heart surgery to gastric bypass, the local hospitals so far only offer it for gynecological and urologic surgeries, such as hysterectomies and prostate removals.

All surgeons working with the robot must be trained.

Christus Spohn Health System bought its robot for urologists at Spohn Hospital Shoreline, but officials moved the robot in March to Spohn Hospital South so it could get more use, spokeswoman Katy Kiser said.

The hospital system has used it 115 times, and five gynecologist surgeons now operate on it, da Vinci representative Michael Isaac said. Kiser said the hospital system has plans to train more surgeons on the robot and expand its surgical offerings, but no plans to buy additional robots.

Corpus Christi Medical Center bought a newer version of the robot in January and surgeons there since have performed 150 gynecologic and urologic procedures, hospital spokeswoman Lisa Robertson said. Twelve hospital system surgeons are trained on the robot, she said.

Dr. Joseph Wagner, director of robotic surgery at Hartford Hospital in Connecticut, said he considers a robot thoroughly used at 500 cases a year.

He suggests hospitals consider expansion if their robots hit 350 to 400 annual operations, well above the usage level at Corpus Christi hospitals.

Kris Muller, spokeswoman for Corpus Christi Medical Center's parent company HCA, said robotic surgery does not cost patients more than traditional surgery. Some insurance policies cover the full cost, others do not, Shelton said.

n n n

While the debate continues about the cost of the technology and long-term benefits for patients, there seems to be little argument that robotic surgery is better for the surgeon.

Surgeons say robotic surgery leaves them less fatigued, allows them to see better within the body and gives them the ability more easily to suture, or sew tissue, than they could with traditional laparoscopic surgery, a type of minimally invasive surgery in which surgeons work at the bedside using long, slender, chopstick-like instruments inserted through small incisions in a patient's body.

Dr. Alan Nesbit, a urologist who operates at Corpus Christi Medical Center, said the robot is easier on his body than traditional laparoscopic procedures, which left him exhausted.

His knees, hips and back ached after standing for five or six hours at a patient's bedside, his arms positioned in an awkward manner over the patient's body.

"No matter how strong you are, it's a very physical surgery," he said.

Shoemaker said, without the robot, his persistent back pain and arthritis likely would have forced him to take a break from surgery. Robotic surgery allows him to rest his back by sitting in a cushy chair at a console, instead of standing for hours at a patient's bedside.

"It's extended my surgical career by 10 years," he said.

At Cantu's hysterectomy on Wednesday, Shelton chatted easily while she performed complicated maneuvers within Cantu's pelvis. As she flicked her wrists at the joysticks, the robotic instruments pushed a tiny, thin needle with barbed-wire-like thread in and out of the tissue. Shelton said she was operating within a space the size of a pingpong ball.

This is the kind of technique that, if done in a traditional laparoscopic way, would have been more difficult and physically draining, Shelton said.

"I feel like I'm going to go exercise now and I wouldn't have wanted to go exercise had I done it laparoscopically," she said after the surgery. "I would've been too sore. I would've said, 'I've done my exercise for the day.'"

n n n

Experts say robotic surgery is likely to expand in coming years, particularly as the technology improves. Surgeons say they expect the devices will get smaller and eventually provide tactile feedback, giving surgeons back the sense of feel that they traded for the magnified, high-definition vision that came with robotic surgery.

Click to read more

Meet the real Karen Steward

Nostrils flairing....mouth a roaring...this is Karen in her truest form.....exhibiting what appears to be more transference of very bad behaviors onto others.
Ever innocent, Karen always seems to be backing the wrong horse.
Meet her internet buddy Mayor Bob Habick :


Now here is the link to her newest crusade...another Kruschinski ilked bad boy she has taken to.
Former patients to endogyn may not want to read this as they might find the info she released about them very painful and callous. It would make anyone think twice before confiding in her we believe.
Marinette City Hall Mayham: Dear Donna, Meet Karen Steward, your husbands internet gal pal

Hey Carl, what about Dr. Demco?

Dr. Larry Demco, MD, FRCS, Alberta, Canada
Email: Larry.Demco@obgyn.net

Office Address: 271A 1600 90 Ave S.W. 
Calgary Alberta Canada T2V 5A8 
Phone:403 253 0709 
Fax403 253 0709

PRESENT APPOINTMENTS

Associate Clinical Professor Obstetrics & Gynecology 

University of Calgary Alberta Canada
Teaching Appointment 
Cedar Mount Sinai

Adhesion Related Disorders

Kruschinski goes Communist then crazy? Castro Loving Fool!

Doc_Kru
Master advanced



Gender: Male
Location:
Registered: Jul 2003
Status: Offline
Posts: 469



Posted Thursday, March 3, 2011 @ 05:22 PM

Das Portal SEOIncentives.de hat einen virtuellen Wettkampf der besonderen Gattung angefangen. Derjenige KubaSeoTräume Internetdesigner oder Blogbesitzer, der am 14.04.2011 mithilfe dem Keyword KubaSeoTräume an erster Location der Ergebnisse bei Google steht, gewinnt eine zweiwöchige Ausflug hinauf die Sonneninsel Perle der Karibik. Sämtliche Suchmaschinenoptimierer und Web-Zocker sind gebeten, ihre teilnehmende Internetpräsenz derart auf KubaSeoTräume zu besser machen, dass die große Suchmaschine diese solcherart weit wie auch erdenklich in die oberen Plätze bringt. Schnuppe ob Kenner oder Hobbyoptimierer, jeder sind aufgefordert, ihr Bestes zu zuteilen.
SEO Contests (alias SEO Wettbewerbe genannt) werde im WWW fortlaufend nochmals ausgerichtet. Zumeist werden diese Aktionen von Agenturen oder Organisationen aus dem Gebiet SEO (Search Engine Optimizing, zu deutsch: Suchmaschinenoptimierung) gestartet. Neben dieser Eigenwerbung des Ausrichters, steht dasjenige Erringen von Erkenntnissen über den Bewertungsprozess dieser Suchmaschinen und die daraus abgeleitete Erfahrungen sowie Techniken für SEO-Agenturen im Vordergrund. Benachbart ist natürlich dieser olympische Gedanke "Dabei sein ist alles" und der Nacheiferung der einzelnen Mitglieder eine erhebliche Inzentiv bei der Teilhabe an diesen Wettbewerben.
Der aktuelle SEO Contest von Seiten SEOIncentives hat als Keyword das Fantasiewort KubaSeoTräume ausgesucht. Die Präferenz eines geeigneten keyworts ist in keiner Weise ganz simpel, denn es muss für die Suche ein jungfräuliches Satzpartikel darstellen. Das heißt, es dürfen bis heute keine Suchresultate vorliegen, damit Gleichstellung vorliegen ist. Um auch den Hauptsponsor des Wettbewerbs einen Tick ins Rampenlicht zu rücken, sollte dies Keyword gleichwohl auf den Hauptpreis hindeuten. Und da Suchmaschinenoptimierer (SEO's) sicherlich auch einmal von Freizeit auf Zuckerinsel phantasieren, ist dies Keyword KubaSeoTräume auch ergötzlich auserwählt, da ja der enthaltene Umlaut das Besser machen der entsprechenden Seite unbedingt komplizierter macht. Es ist folglich ein spannender Wettkampf zu erwarten, bei dessen Ende ein glücklicher Gewinner mit Zigarre und Rum an dem weißen Stränden Kubas tingeln darf.

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http://kubaseotraeume.org
http://ferien-und-lastminute.de
http://kubaseotraeume.net
http://sportartikelversand.com
http://hundepensionen.org
http://katzenhotels.info
http://kubaseo.org


http://www.endogynserver.com/cgi-bin/210/cutecast.pl?session=2YOHnTFFLvJxJXGDREaDuiEaM2&forum=33&thread=20911



gucci1
Board Owner


Gender: Male
Location:
Registered: Jan 2005
Status: Offline
Posts: 51

Posted Wednesday, March 2, 2011 @ 04:11 AM

Cuba is a fascinating country, and not just because of its revolutionary history. Indeed, there are several interesting tidbits that few people know about - here are my 5 favourite interesting facts about Cuba - I'm confident there will be at least a couple of surprises in here! If you're planning on taking a Cuban holiday, a little research into the country can prove an eye opening experience?




Posted Wednesday, March 2, 2011 @ 04:11 AM

Castro's speeches are longer than most feature-length films

Much has been written and said about Cuba 's former president Fidel Castro, but few can argue that he's an incredible man. The 81 year old has lived through an estimated 600+ assassination attempts, the Cold War and 9 US presidents. He also is known for his long speeches - indeed, he holds a place in the Guinness book of records for his 1960 speech to the United Nations which lasted 4 hours and 29 minutes. Amazingly, this pales in comparison to his best within Cuba - a jaw dropping 7 hours and 10 minutes at the 1986 Communist Party Conference in Havana . Now he's retired from the role, there's no risk of being stuck listening to one on a Cuba holiday!





Posted Wednesday, March 2, 2011 @ 04:12 AM

Cuba has a national bird, tree and flower

Here's some interesting information on Cuba : it has a national bird, tree and flower. Each has its own special meanings: The flower is the Butterfly Jasmine, and represents purity, rebelliousness and independence. The national tree is the Royal Palm for its strength - it can survive storm force winds and hurricanes. Finally, the national bird is the Tocoroco, which shares the colours of the Cuban flag - red, white and blue. Nature lovers should be able to find all of these on holiday in Cuba .





Che Guevara Wasn't the First Celebrated Revolutionary

Although you can't get very far in Cuba without seeing the iconic image of Che Guevara, he and Castro weren't the first Cuban revolutionary heroes to be celebrated. Jose Marti was a revolutionary who died in 1895 in battle fighting for independence from Spain - the war ended 3 years later. He spent his time in and out of prison, writing papers and fighting for the cause - it's no wonder he's still revered to this day as a hero.

His legacy is still felt in the island - many streets bear his name and you'd be hard pressed to miss the Jose Marti Memorial in the Plaza de la Revolucion! Indeed, when you take your Cuba holiday, you may well touch down in Jose Marti airport! There's no shortage of stories and information in Cuba about the man.

There are many more interesting facts about Cuba which will surprise and intrigue, just through reading through the island's action packed history. Certainly a little research into its history means that you'll get a lot more from your luxury Cuban holiday.

Emma Lelliott is the general manager of Captivating Cuba, an independent Cuba holiday specialist. With offices in Havana and the UK , Captivating Cuba can help you tailor-make the perfect Cuban holiday experience.

--------------------
http://kubaseotraeume.net
http://ferien-und-lastminute.de
http://kubaseotraeume.org
http://sportartikelversand.com
http://hundepensionen.org
http://katzenhotels.info
http://kubaseo.org



medical
Just starting


Gender: Unspecified
Location:
Registered: Oct 2010
Status: Offline
Posts: 1

Posted Thursday, October 21, 2010 @ 03:01 AM

MedicalDomains.co

MedizinDomains.co

DomainJongleur.co

DomainJuggler.co

en.The1st.co

de.The1st.co

phlebologie.co

plastischer-chirurg.co

venenzentrum.co

venenchirurgie.co

KubaSEOTräume for 1.000.000 euros auctioneers?

What the heck is this?
It really would not be a surprise to IHRT that the likes of Kruschinski, Katzer and Libyan dictator Muammar Gaddafi would somehow keep company.
Read below and your guess is as good as ours.......perhaps there will be new infrastructure built from word of this bid but as usual...a con is a can and since assests are frozen once again Daniel and Michi are in the poor house and schemeing to get out by means other than hard work!

SEO auctioned for 1,000,000 €?



(http://www.schaepp.de/allgemein/kubaseotraeume-ein-neuer-lifestyle/) are now auctioned off final. Nach einem langen Rechtsstreit hat man sich auf eine öffentliche Versteigerung der KubaSEOTräume (http://www.my4web.de/business/kubaseotraeume-seo-contest-news-2337.html) einigen können. After a long legal battle it has been able to agree on a public auction of the SEO (http://www.my4web.de/business/kubaseotraeume-seo-contest-news-2337.html).




Der Höchstbieter hat eben den Zuschlag für KubaSEOTräume (http://www.pr4press.de/freizeit-unterhaltung/kubaseotraeume-seo-contest-news-2379.html) bei einem Gebot von 1.000.000 Euro erhalten. The successful bidder has just received the contract for SEO (http://www.pr4press.de/freizeit-unterhaltung/kubaseotraeume-seo-contest-news-2379.html) with a bid of 1,000,000 euros. Wie wir aus zuverlässigen Quellen erfahren haben, soll es sich beim Bieter um Gaddafi handeln. As we learned from reliable sources, it should be, the tenderer is Gaddafi.



Nach Beendigung der Versteigerung lis die amerikanische Regierung verlauten, das man bereits alle Konten Gaddafis eingefroren hätte und es nun eine neuer Versteigerung geben müsse. Announced after the end of the auction, lis, the U.S. government, which would have been already frozen all accounts Gaddafi and now it must be a new auction. KubaSEOTräume (http://www.endogyn-wiki.de/kubaseotraeume/kubaseotraume-und-der-stand-in-kuba/) werden also nun erneut versteigert. SEO (http://www.endogyn-wiki.de/kubaseotraeume/kubaseotraume-und-der-stand-in-kuba/) will therefore now be auctioned again. Gaddafi lies daraufhin verlauten, das er auf seinen Doktor Titel verzichten werde und wir uns alle an ihm ein Beispiel nehmen sollen.Digital-Institut.de - Online-Ratgeberportale & WebserviceDigital-Institut.de Read Gaddafi announced then that he would forgo his PhD and we all take sollen.Digital-Institut.de an example of him - Online Guides & Portals webservice digital Institut.de

Oliver Schmid Oliver Schmid

Gotthardstr. Gotthardstr. 45 45



80686 München 80686 Munich

Deutschland Germany



E-Mail: info@digital-institut.de E-mail: info@digital-institut.de

Homepage: http://www.digital-institut.de Homepage: http://www.digital-institut.de

Telefon: (030) 231883266 Phone: (030) 231 883 266

It sure made headlines!

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Krushcinski new partner in crime and her reviews

Birds of a feather truely do flock together so it was no suprise to find this Doctors name on the unused Endogyn message board....google the name and boom....nothing but trouble....

Name: PRS


Date: 2009-03-24

BEWARE of Dr.Jayam Kannan if you are planning your infertility treatment.



Dr.Jayam Kannan is the worst doctor in Chennai.



She is so moneyminded that she does not care about the patients and what they are going through in their lives.Her Only motive is to extract money from innocent patients who follow her with the hope that they will be able to conceive.



Dr.Jayam kannan will behave very gently in the beginning and slowly as he extracts money from you, you will see her true colours.After extracting money,she will dump you without any explanation.



Such doctors should start someother business to make money rather than playing with the sentiments of childless couples.




Name: NK

Subject: DONT EVER GO TO JAYAM KANNAN

Date: 2010-07-23

She is money sucking animal. She levies unnecessary tests and delays time. She performas laproscopy unnecessarily. If you ask any questions about the treatment. She abruptly says to follow advice. Then you end up in spending money alone there will not be any improvement.



She has a doctor Arunagiri he is an Ortho doctor. But he performs male screening. And he asked me to undergo circumcision. It will help us to get pregnant. While other urologist doctor i consulted laughed at theory of Mr.Arunagiri.

They have less supporting staff. And they bark at us.

Myself and my wife sufferred a mental trauma because of her. Please dont ever go to them and waste the time and money.
http://gowww.indiaparenting.com/boards/showmessage.cgi?messageid=3217&table_name=dis_infersolutions

FDA Safety Notification: Risk of Air or Gas Embolism When Using Air- or Gas- Pressurized Spray Devices

Ummm do you mean like Sprayshield too???????Does Kruschinski know about this...another way to maim his poor patients. Is Carl aware of this too? I'm betting he does not!

FDA Safety Notification: Risk of Air or Gas Embolism When Using Air- or Gas- Pressurized Spray Devices
Date Issued: July 9, 2010


Audience: Surgeons, Operating Room Nurses, and other support personnel in the Operating Room


Products:
Air- or gas-pressurized sprayers are dual syringe products that simultaneously mix and apply two non-homogeneous liquids within a single spray head that is connected to a pressure regulator and a source of compressed air or gas. Air- or gas-pressurized sprayers can be used to mix and apply hemostatic drug or biological products (products that help control bleeding from blood vessels during surgery) including fibrin and non-fibrin sealants.


They include devices such as:


EasySpray and spray set used with Duploject system(Baxter Healthcare Corporation)
Tissomat and spray set used with Duploject system (Baxter Healthcare Corporation)
Evicel application device (Omrix Medical)
FibriJet Aerosol Applicator (MicroMedics)
HemaMyst Surgical Applicator System (Heamacuare Corporation)
MicroMyst Applicator and Air Pump Models 20-5000 and AP-A-6063 (Confluent Surgical)
Vitagel Hemostat Spray Set (Orthovita, Inc.)
Summary of Problem and Scope:
FDA has received reports of air or gas embolisms occurring during or immediately after application of hemostatic drug or biological products using air- or gas- pressurized sprayers. Although rare, the reports describe air embolisms that are life threatening and include one fatality.


These adverse events appear to be related to use of spray devices inconsistent with the approved product labeling and instructions for use. In some reports the device was used at higher than recommended pressure or at a distance too close to the surface of the bleeding site.


Recommendations/Actions:
Given the life-threatening consequences of an air or gas embolism, FDA is recommending that clinicians using air- or gas- pressurized spray devices for application of hemostatic drug or biological products:


Use the applicator, spray set, and pressure control device or regulator as recommended in the labeling or Information For Use (IFU) of the hemostatic agent.
Use an air or gas pressure setting within the range recommended by the manufacturer of the sprayer.
Ensure that distance between the spray head and the tissue surface is not less than the minimum recommended by the manufacturer of the sprayer.
Monitor blood pressure, pulse, oxygen saturation and end tidal CO 2 for signs of an air or gas embolism.
Make sure the regulators are maintained properly and checked for safe performance regularly.
FDA Activities:
In cooperation with the FDA, Baxter Healthcare Corporation and Omrix Pharmaceuticals, the manufacturers of all fibrin sealants licensed in the U.S., have updated the Warning and Precautions sections of the labels of EVICEL, T isseel and ARTISS to emphasize the risk of air embolism and the need to use the recommended ranges of pressure and distance.


The labeling of the spray devices and non-fibrin hemostatic drug or biological products also includes information on recommended pressures and distances.


Report Problems to FDA:
Prompt reporting of adverse events can help FDA identify and better understand the risks associated with medical products. If you suspect problems with the use of fibrin sealants and/or air or gas pressurized fibrin sprayers, we encourage you to file a voluntary report through MedWatch, the FDA Safety Information and Adverse Event Reporting program1. Healthcare personnel employed by facilities that are subject to FDA's device user facility reporting requirements2 should follow the reporting procedures established by their facilities.


Contact Information:
If you have questions about this communication, please contact the Division of Small Manufacturers, International and Consumer Assistance (DSMICA) at DSMICA@FDA.HHS.GOV or 800-638-2041.
http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/ucm218523.htm

SprayShield EU Post Market Study Terminated

Um Kru....this is more bad news for you but another reason for people not to seek you out.
Spay Gel was halted in clinical trials too remember....but that didn't stop you from blasting in excessive amounts on unsuspecting patients....then oops an appendix blow on the plane while leaving you...couple of gallbladders.....a dangerous supermarket. Somehow folks just kept on having their adhesions recur....like they always have!

SprayShield EU Post Market Study

This study has been terminated.

http://clinicaltrials.gov/ct2/show/NCT01002287

First Received on October 26, 2009. Last Updated on May 4, 2010 History of Changes

Sponsor: Confluent Surgical

Information provided by: Confluent Surgical

ClinicalTrials.gov Identifier: NCT01002287



Purpose

This will be a prospective, multi-center, randomized, single blind study to collect and evaluate post-market clinical data on the SprayShield Adhesion Barrier System as an adjuvant to good surgical technique for the reduction of postoperative adhesion formation following major open abdominal surgery.



Condition Intervention Phase

Ulcerative Colitis

Familial Polyposis

Device: SprayShield Adhesion Barrier System

Procedure: Good Surgical Technique Alone

Phase IV


Study Type: Interventional

Study Design: Allocation: Randomized

Intervention Model: Parallel Assignment

Masking: Single Blind (Subject)

Primary Purpose: Prevention

Official Title: An Evaluation of the SprayShield Adhesion Barrier System in Reducing Post-Operative Adhesion Formation Following Major Open Abdominal Surgery




Resource links provided by NLM:


Genetics Home Reference related topics: Crohn disease familial adenomatous polyposis Help Me Understand Genetics

MedlinePlus related topics: Adhesions Ulcerative Colitis

U.S. FDA Resources




Further study details as provided by Confluent Surgical:




Primary Outcome Measures:

•To evaluate the incidence of adhesions, defined as the proportion of subjects presenting at the follow-up surgery (10-12 weeks) with one or more adhesions to the midline incision, regardless of extent and/or severity. [ Time Frame: 10-12 Weeks post Initial Surgery for J-Pouch ] [ Designated as safety issue: No ]




Estimated Enrollment: 30

Study Start Date: October 2009

Estimated Study Completion Date: May 2011

Estimated Primary Completion Date: October 2010 (Final data collection date for primary outcome measure)

Arms Assigned Interventions

SprayShield Adhesion Barrier: Experimental

SprayShield Adhesion Barrier + Good Surgical Technique

Intervention: Device: SprayShield Adhesion Barrier System Device: SprayShield Adhesion Barrier System

Adhesion Barrier Device Plus Good Surgical Technique

Control: No Intervention

Good Surgical Technique Alone

Intervention: Procedure: Good Surgical Technique Alone Procedure: Good Surgical Technique Alone

Good Surgical Technique Alone





Eligibility



Ages Eligible for Study: 18 Years and older

Genders Eligible for Study: Both

Accepts Healthy Volunteers: No



Criteria

Inclusion Criteria:



•Diagnosis of ulcerative colitis or familial polyposis and require two-stage surgery for treatment of either of these disorders will be eligible

Contacts and Locations



Please refer to this study by its ClinicalTrials.gov identifier: NCT01002287



Locations

United States, Massachusetts

Confluent Surgical

Waltham, Massachusetts, United States, 02451

Sponsors and Collaborators

Confluent Surgical

More Information



No publications provided



Responsible Party: Confluent Surgical ( Jennifer Doyle/Director, Clinical Affairs )

ClinicalTrials.gov Identifier: NCT01002287 History of Changes

Other Study ID Numbers: ABD-08-001

Study First Received: October 26, 2009

Last Updated: May 4, 2010

Health Authority: Czech Republic: Ethics Committee; Poland: Ministry of Health



Additional relevant MeSH terms:

Colitis

Colitis, Ulcerative

Adenomatous Polyposis Coli

Ulcer

Gastroenteritis

Gastrointestinal Diseases

Digestive System Diseases

Colonic Diseases

Intestinal Diseases

Inflammatory Bowel Diseases

Adenomatous Polyps

Adenoma

Neoplasms, Glandular and Epithelial

Neoplasms by Histologic Type

Neoplasms

Colorectal Neoplasms

Intestinal Neoplasms

Gastrointestinal Neoplasms

Digestive System Neoplasms

Neoplasms by Site

Colonic Neoplasms

Neoplastic Syndromes, Hereditary

Intestinal Polyposis

Genetic Diseases, Inborn

Pathologic Processes



ClinicalTrials.gov processed this record on May 12, 2011



Pity

Kruschinski Family Trickery Endogyn Adhesions

Search engine optimization is a family affiar for the Kruschinski's.
Holy moley!
Cast a wide net and see what is snagged.
Not an ethical way to get patients to a surgical intervention but a way........

try as you might you can't make a silk purse from a sows ear and those who see this internet saturation of websites that lead right to his hook hanging self.....beware.....


David Kruschinski



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ARDvark Blog Journal of Adhesion Related Disorder: Intraperitoneal adhesions-an ongoing challenge between biomedical engineering and the life sciences.

ARDvark Blog Journal of Adhesion Related Disorder: Intraperitoneal adhesions-an ongoing challenge between biomedical engineering and the life sciences.