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L.OE.H.D.E.-PROCEDURE

First of all, for your information: l.oe.h.d.e. is the abbreviation for the surgical procedure I developed according to the international medical nomenclature:

" laparoscopic oesophago-hiatal DeltaMesh enhancement".

 

The key to this procedure lies in our research results. We have found that the esophagus of reflux patients is completely healthy. Tissue examinations show that there is no muscle sphincter at all, as is always said, and that the muscles in this area are only 1.5mm thick, i.e. extremely thin. In addition, the lower esophagus consists of so-called smooth muscles. By nature, these can only close and open in slow motion. This means that we would have to wait around 30 seconds for every sip of water until the so-called lower esophageal sphincter has finally opened. If we were to drink or eat just a little too early, everything would flow into our windpipe immediately while we coughed and spit, because the esophagus only holds about half a glass of water! So we can be happy that we don't have a sphincter!

 

But how does the system work? Further research led to the discovery of the so-called core-engine (knowledge and details) deep within the body: a complex, interlocking system of organs in which the heart and diaphragm play a central role. Reflux is not a problem of a disease of the esophagus, but rather solely a problem of its displacement within this system! As a result of this discovery, a completely new surgical treatment approach was created: the l.oe.h.d.e.-procedure.

Today, after over 2000 operations with exclusive anatomical reconstruction of this core engine and without any wrapping, without a single stitch on the esophagus or stomach, we know: With this reconstruction, all functions return and the system works as it did before! The reflux is also over.

 

The other key to the procedure is to achieve permanent stability in the diaphragm. Otherwise the system will fall apart again. Achieving this permanent stability in the diaphragm is extremely difficult because the diaphragm is so delicate and is subjected to considerable forces every day. We have developed the innovative, 3-dimensional DeltaMesh as a patented mesh structure approved in Germany and the EU specifically for these high requirements.

It differs fundamentally in shape, structure and stability from all conventional meshes used in surgery.

 

The l.oe.h.d.e.-procedure requires extensive surgical training and cannot be learned in weekend courses. It may only be performed by certified surgeons. This certification is carried out by Dr. Löhde.

Image 1: The aim is to return the displaced esophagus to the organ system.

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Figure 2: The correct position of the esophagus and stomach is reconstructed in different axes

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Image 3: For safety, the diaphragm muscles are reinforced by a fine mesh structure. The esophagus is embedded in its correct position.

The reflux has stopped.

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OVERVIEW OF THE L.OE.HDE PROCESS

Indications
All disruptions in the "organ mechanism" (see also symptoms)
Barrett’s esophagus changes
Failed surgeries after Nissen, Toupet, etc.

Principles
Anatomically correct arrangement of all organs
No stitches or staples on the esophagus and stomach
No constriction or wrapping
No detachment of the stomach from the spleen and diaphragm for wrapping


No risk of gas-bloating syndrome*
(*Feared complication: Constriction of the esophagus by the wrap in fundoplcation may prevent belching, causing the stomach painful to inflate like a balloon)


No risk of slippage of the wrap**
(**Feared complication: The wrap in fundoplication, along with the stomach and sutured esophagus, painfully slides through the diaphragm into the chest cavity)

Surgical Procedure
Admission on Monday, surgery on Tuesday, discharge on Friday.

Rest for 2 weeks, sports after 4 weeks.
Later:
No restrictions on competitive sports
No restrictions on pregnancy
No restrictions on belching or vomiting

Care
Diagnosis, indication, and risk analysis personally by Dr. Löhde
Surgery planning, reservation, formalities, instructions, and preparation by the Löhde team
Surgery discussion between Dr. Löhde and Dr. Thomas
Surgery and inpatient care by Dr. Thomas
Post-operative care again by Dr. Löhde until recovery
Later, contact with Dr. Löhde is possible at any time

WHY CAN'T EVERYONE DO THIS?

"Everyone" will certainly never master the l.oe.h.d.e.-procedure. But there are undoubtedly very good and talented surgeons who would be suitable for this procedure.

However, the certification process is not yet complete. This is because knowledge about 3-dimensional organ functions, anatomically precise diaphragm reconstruction and DeltaMesh implantation must be conveyed not only theoretically in a quick weekend course but also practically directly at the operating table for weeks or even months.

Dr. Thomas is currently the only surgeon I certified for this operation.

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©2022 Privatdozent Dr. med. Eckhard Löhde

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