We, who post messages at the International Adhesions Society Message Board, first heard of Dr. Korell through the messages which Joanne Butman ( Chuckbcpa@email.msn.com ) posted here - before and after her trip to Germany for her surgery in March 2000.
Why did Joanne, who is from California, travel so far for her adhesiolysis ( surgery for adhesions )? A friend of hers, who lives in Germany, told her that she had heard great things about this wonderful surgeon, Dr. Korell.
Another deciding factor for Joanne was the fact that surgeons in Europe, including Dr. Korell, have been using the gel adhesion barrier, Intergel, in their surgical procedures since 1998!! As many of you already know, the FDA in the United States did NOT give their approval to Intergel, a gel adhesion barrier, in January 2000; and it is uncertain as to when Lifecore Biomedical, makers of Intergel, will again seek the approval of the FDA.
I have combined all of Joanne's messages since February 2000 so that her experience - before and after - can be easily accessed at one site. You will find her messages at:
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Here is Beverly's second letter to Dr. Korell:
Dear Dr. Korell,
If an American patient would send their current medical records - as well as diagnostic evaluations - along with their most current operative reports and pathology/cytology reports, would you be able to determine if this patient would qualify to have an adhesiolysis procedure done by you in Germany?
Can any or all pre-operative workups be done prior to going to Germany? Examples: Blood draw, EKG, Chest X-ray, urinalysis. If all of this were done, let's say within five to seven days prior to a scheduled adhesiolysis procedure, can this be completed in the United States prior to going to Germany?
Do you have any statistics - in writing - as to the longest length of time an Adhesion Related Disease ( ARD ) patient - who underwent your adhesiolysis - remained pain free? Have you tracked second look surgeries in any form of a report? Do you have your adhesiolysis procedure in writing?
You did not mention wether you used "clot " evacuation during your procedure, do you do that? What is your theory on adhesion formation - as to the etiology of adhesions? Are you of the opinion that adhesions, which are attached to the peritoneum, are the problematic ( painful ) adhesions?
Dr. Korell, I assist many people throughout the world who suffer with ARD ( Adhesion Related Disease ) in finding surgical intervention for their adhesions. It is very important that I find out as much as I can about a particular surgeon - who appears to be skilled in dealing with adhesions - since they are few and far between throughout the world!! I would also be interested in knowing how long does a prospective patient have to wait at this time for an adhesiolysis procedure?
I am sure you can agree with this and also can understand that it is of the utmost importance that, when I make a referral to a surgeon, I must have facts and statistics available for them. When I do make a referral, I must feel comfortable that I am referring them to the highest quality of medical care available to them today!
I appreciate very much your taking the time to discuss these issues and look forward to hearing from you again soon.
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>----- Original Message -----
From: M.Korell <M.Korell@t-online.de>
Sent: Tuesday, May 30, 2000 5:39 AM
Subject: Re: adhesions
Dear Beverly Doucette,
I understand your questions and I will try to answer:
I work in the field of adhesions since now 20 years both - experimental and clinically. Enclosed you find some abstracts and publications regarding my work in adhesions. If you need any further informations or papers - please let me know.
Regarding the adhesiolysis we try to induce peritoneal defects as less as possible. Intensive rinsing and clot evacuation is standard during the whole procedure. We prefer the endoscopic approach because it leads to less recurrences. But, sometimes the adhesions are so severe that one must do a laparotomy first. Here, an early second look laparoscopy can be helpful in further reducing the adhesions.
Specially the Intergel seems to increase the chance for adhesion-free healing. As you see in the abstract we have experience and controls in myomectomy patients with good results. I have seen many patients with severe intraabdominal adhesions in the last years with a long follow up. If one can reach an adhesion-free abdominal cavity the chance for no pain is good.
Depending on the extent of adhesions there is a risk of recurrence, which leads to pain again - typically 6 weeks up to some months after a pain-free interval. Otherwise the patients have no problems for years. While the induction of adhesions by peritoneal defects is understood, the pathomechanism of pain is not so clear. I suppose that especially the fixation of bowel to the abdominal wall can cause pain. The adhesions from bowel to bowel seems to be less severe. The typical adhesions from the omentum to the peritoneum causes normally no problem.
To decide whether a patient may profit from an adhesiolysis, we need the medical records of the previous interventions and a description of type and location of the pain. After that we can discuss the individual case with the patient whether there is a chance for an improvement.
The costs for surgery in Germany depends on the length of the hospital stay ( every day about 750 DM )...and the type of surgery and special medical treatment ( about 2-3000 DM ). There is at the moment no special waiting list. We have dates about 6 weeks in advance.
I hope I could help with my answer. If there are any further questions don`t hesitate to contact me again.
Dr. Matthias Korell
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On May 10th Bev commented to me about Dr. Korell's response to her letter:
"Take a look at this surgeon's theory on the pain from adhesions!!!! It is what I have been saying all along!! I am thrilled!! I put it in bold for you!!"