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Le centre médical comprend également des services spécialisés dans le diabète (accrédités par l'Association allemande du diabète - DDG) et la chirurgie gastrique mini-invasive. Le St. Martinus-Krankenhaus a été élu Top Mediziner 2016 en chirurgie de l'obésité par le magazine Focus (l'un des prix médicaux les plus prestigieux d'Allemagne). La clinique dispose également d'une base de formation avancée pour les diététiciens de tout le pays.
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Mild pain is more common."},"contraindications":["Anticoagulant/antiplatelet therapy or bleeding disorder (relative; specialist assessment needed)","Thrombocytopenia or coagulopathy","Severe immunosuppression or neutropenia","Acute anorectal sepsis or thrombosed/strangulated external hemorrhoids","Grade IV (irreducible) hemorrhoids or large external component","Severe anal fissure or untreated anorectal IBD (relative)","Portal hypertension with rectal varices (relative)","Latex allergy if latex bands are used"],"days_in_clinic":{"min":0,"max":0,"unit":"nights","qualifier":"Performed as an office/clinic procedure with no overnight stay."},"diagnostic_duration_minutes":null,"diagnostic_preparation":null,"diagnostic_referral_needed":null,"diagnostic_result_time_hours":null,"exercise_resume_weeks":{"min":0.5,"max":1,"unit":"weeks","qualifier":"Strenuous exercise and heavy lifting usually avoided for several days to a week."},"final_result_months":{"min":1,"max":3,"unit":"months","qualifier":"After the course of banding sessions; symptom relief builds as banded tissue sloughs and fixes."},"fly_home_after_days":{"min":1,"max":2,"unit":"days","qualifier":"Short flights usually fine next day; delayed bleeding risk peaks days 5-14, so clinicians may advise waiting."},"follow_up_visits":[{"purpose":"assessment","requirement":"routine","after":{"min":14,"max":42,"unit":"days","qualifier":"Review of response and, if needed, next banding session."}},{"purpose":"other","requirement":"conditional","after":{"min":1,"max":14,"unit":"days","qualifier":"Urgent review for heavy bleeding, severe pain, fever or urinary retention."}}],"indications":["Symptomatic grade I–III internal hemorrhoids with bleeding or prolapse","Hemorrhoids not controlled by diet, fiber and medical measures"],"main_risks":["Pelvic or anal pain and rectal fullness/tenesmus","Bleeding, usually at band slough (days 5–14), occasionally significant","Urinary retention","Vasovagal reaction","Thrombosed external hemorrhoid","Rare pelvic sepsis: severe pain, fever, retention need urgent care"],"pain":"Usually mild to moderate: dull ache or pressure for 1–3 days, controlled with simple analgesics and sitz baths; severe pain is a warning sign.","preparation":["Anoscopy to confirm internal hemorrhoids and exclude other pathology","Colonoscopy considered per age/risk or bleeding evaluation","Review of bleeding risk and medications with the clinician","Often no bowel prep or an enema only","Avoid constipation; fiber and fluids"],"recovery_timeline":[{"phase":"Day 0–4","description":"Rectal pressure or mild ache; light activity possible.","restrictions":["Avoid straining","Avoid heavy lifting"]},{"phase":"Day 5–14","description":"Band falls off with a small amount of bleeding or spotting possible; report heavy bleeding or fever urgently.","restrictions":["Avoid heavy lifting until about day 7","Avoid constipation and prolonged straining"]},{"phase":"Weeks 2–6","description":"Healing of the ulcer at the banding site and symptom improvement.","restrictions":[]}],"rehabilitation_days":{"min":1,"max":3,"unit":"days","qualifier":"Return to ordinary function after a single banding session."},"result_longevity":"Symptom relief often lasts several years, but hemorrhoids can recur in roughly 10-30% of patients within 5 years. Constipation, straining and low fiber intake shorten results; repeat banding is possible.","revision_rate_pct":{"min":10,"max":30,"unit":"percent","qualifier":"Repeat banding or further treatment for recurrent symptoms within about 5 years."},"scars":"No external incisions or visible scars; a small mucosal ulcer heals internally.","sessions_or_stages":{"sessions":{"min":1,"max":3,"unit":"visits","qualifier":"Typical course of banding visits; often 1–2 hemorrhoids banded per session, depending on practice."},"stages":[{"code":"first_banding","label":"First banding session","after":{"min":0,"max":0,"unit":"days","qualifier":"Initial session."}},{"code":"repeat_banding","label":"Repeat banding if symptoms persist","after":{"min":14,"max":42,"unit":"days","qualifier":"Interval commonly 2–6 weeks after the first session."}}],"qualifier":"Number of sessions depends on the extent of disease and individual response."},"success":{"metric":"Symptom improvement (bleeding/prolapse control)","value":80,"unit":"percent of patients","horizon":"1-3 months after banding course","population":"Adults with symptomatic grade I–III internal hemorrhoids","evidence_status":"limited"},"techniques":[{"name":"Suction rubber band ligation via anoscope","suits_whom":"Adults with symptomatic grade I–III internal hemorrhoids.","recovery":"Same-day return home; mild discomfort for a few days."},{"name":"Forceps-assisted rubber band ligation via anoscope","suits_whom":"Adults with grade II–III hemorrhoids that suction captures poorly.","recovery":"Same-day return home; mild discomfort for a few days."}],"treatment_conditions":["outpatient"],"treatment_duration_hours":{"min":0.1,"max":0.25,"unit":"hours","qualifier":"Per banding session, about 6–15 minutes."},"initial_assessment_documents":["Proctology or anoscopy exam report","Recent colonoscopy report","List of blood thinners","Recent hemoglobin blood test"],"travel_trips":{"min":1,"max":3,"one_trip_possible":true,"qualifier":"One session fits a 2-3 day trip; each repeat banding 2-6 weeks later needs another trip or extended stay."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Confirm the surgical team has reviewed your complete medical record","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Make sure the surgical team has received your full medical record and reviewed it","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Confirm arrangements for aftercare when you return home","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/going-abroad-for-medical-treatment/","host":"nhs.uk","quote":"You'll need to be aware of how your aftercare will be provided when you return home and understand the conditions under which you'll be treated abroad.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C3","text":"Confirm the surgeon is trained and experienced in the exact procedure you are considering, not just in surgery generally","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Verify that the surgeon is trained and experienced in performing the procedure you are considering.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C4","text":"Ask for certification information and the name of the body that certified the surgical setting","scope":"treatment_abroad","source":{"url":"https://www.isaps.org/discover/patients-home/considering-your-procedure-abroad/finding-a-surgeon-abroad/","host":"isaps.org","quote":"Ask for certification information and the name of the certifying body when assessing a surgical setting.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"C5","text":"Check that the surgeon who consults with you is the same person who will carry out the procedure","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Check that the surgeon you consult with, will be the same person carrying out the procedure.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"The clinic will not provide a full medical report for follow-up care","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"After your treatment, you should receive a full medical report in English to bring back to your UK doctor.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F2","text":"The clinic cannot explain how aftercare will be coordinated","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Ensure you're clear about how your aftercare will be coordinated.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F3","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise 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leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"Your hemorrhoids are large, external, or severely prolapsing","name":"Hemorrhoidectomy","source":{"url":"https://my.clevelandclinic.org/services/hemorrhoids-treatment","host":"my.clevelandclinic.org","quote":"If your provider determines that your hemorrhoids are more severe, they may choose to do a same-day surgery under anesthesia called hemorrhoidectomy to remove large external or severe prolapsing internal hemorrhoids.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200},"operation_id":310}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"technique_details":{"status":"ok","items":[{"id":"suction-rubber-band-ligation","name":"Suction rubber band ligation via anoscope","how_it_works":{"text":"Suction pulls the hemorrhoid into a cylinder for band placement","source":{"url":"https://my.clevelandclinic.org/health/procedures/hemorrhoid-banding","host":"my.clevelandclinic.org","quote":"Many providers use a suction device to “suck” the hemorrhoid into the cylinder.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":0,"max":0,"unit":"days","label":"Same day","source":{"url":"https://my.clevelandclinic.org/health/procedures/hemorrhoid-banding","host":"my.clevelandclinic.org","quote":"You can usually go back to your usual activities right after hemorrhoid banding.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}},{"id":"forceps-assisted-rubber-band-ligation","name":"Forceps-assisted rubber band ligation via anoscope","how_it_works":{"text":"Forceps grasp the hemorrhoid before the bands are pushed on","source":{"url":"https://my.clevelandclinic.org/health/procedures/hemorrhoid-banding","host":"my.clevelandclinic.org","quote":"A ligator has forceps (a scissor-like tool) on the end that allow your provider to grasp the hemorrhoid.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":0,"max":0,"unit":"days","label":"Same 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