On Saturday there is an open day at the Klinikum Großhadern – Munich

One foot in, then the other. Can you move your feet? No. Good! Then you can begin. A large iron ring is loosened by a woman in a hospital gown and gently pushed. The author of this text then floats forwards in a self-experiment. Then pushed backwards by her own physical strength. The device that makes this possible is called the Spacecurl, and it was actually used in the past in astronaut training at the US space agency NASA.

Now, most patients can feel the tingling feeling of weightlessness that it creates. The Spacecurl, which is currently rotating faster and faster, now in all three levels of the room at the same time – just thinking about it makes your head spin again – is in the vertigo and balance center of the LMU hospital in Grosshadern. Next Saturday, anyone who is interested can try it out. That’s when it’s open day in Grosshadern, and all disciplines and subjects invite you to get to know them and explore them.

Feel like an astronaut for once: At the LMU Hospital in Grosshadern, the “Spacecurl” device is used to diagnose dizziness symptoms. (Photo: Stephan Rumpf)

The day celebrates the 50th anniversary of the medical center. There is an extensive program with various hands-on activities, a simulation of a pediatric heart operation, a walk-in lung model, tours of all the major centers, a children’s program, and numerous expert lectures in three lecture halls. It promises the opportunity to take a look inside a hospital without being a patient.

So there you are in the Spacecurl and briefly reflect on the solidity beneath your feet and the feeling of losing it. Then Andreas Zwergal, neurologist and director of the dizziness center, explains: Most of the time, doctors use the device for diagnostics. Someone comes in with a feeling of dizziness – and can get the “feeling of verticality” reflected back. In the best case, you get a little more understanding of where the dizziness might be coming from. Because “dizziness is a symptom of all kinds of illnesses,” says Zwergal. Here in the center, the largest of its kind in Europe, they try to get to the bottom of the specific illness with all kinds of tests.

Which instruments are used in the dizziness and balance center

Sometimes the dizziness is so hard for those affected to bear that around half of them have to reduce their work hours or give up completely, says Zwergal. Patients sometimes come to their outpatient clinic after a years-long odyssey through the medical world and without a clear answer. “We almost always find the cause,” says Zwergal, not without pride. Around 90 percent of the patients here receive a clear diagnosis in the end. Most illnesses can be treated really well once you have figured them out, says colleague Doreen Huppert. They have around 4,500 patient contacts a year.

Out of the space curl, touch solid ground, a few rooms further on. Here is another diagnostic device. A semicircle in which a rod rotates, surrounded by a swarm of small dots simultaneously rotating in the other direction. Who can straighten the rod with a control despite provoking dizziness? And to whom does it look straight – but is in reality clearly slanted? This is where the so-called subjective visual vertical is determined. In other rooms, the patients are examined further, for example by rinsing their ears or using special glasses that measure eye movements.

Eye movements are measured using glasses. (Photo: Stephan Rumpf)
Dizziness is provoked on various devices. (Photo: Stephan Rumpf)
Andreas Zwergal is a neurologist and head of the dizziness and balance center at the LMU Hospital. (Photo: Stephan Rumpf)

In his office, Andreas Zwergal holds a model of the human balance organ in his hands. It is located in the bone behind the ear and is called the labyrinth. It helps to process the movements of the head and thus maintain balance. After all the experiments, you have to thank the labyrinth that you can walk without getting dizzy again.

Because just across the corridor, concentration and fine motor skills are required, and dizziness would be a real hindrance. Surgery invites you to perform a laparoscopic operation. Only as a dry run, of course. But with the equipment that is used every day in the operating room.

During laparoscopic surgery, the abdomen is not opened completely; instead, only individual points in the abdominal wall are opened and the operation takes place inside. This requires a special camera and special instruments, long rods with small handles on the tips. All of this is inserted into the abdomen through tubes called trocars. When doctors talk about minimally invasive abdominal surgery, they often mean laparoscopy. Small cuts, small wounds, small scars.

The laparoscopy box trainer requires good hand-eye coordination – and a lot of patience

Alexander Frank is standing at one of the two laparoscopy box trainers that he will also set up for visitors next Saturday. This allows medical students who are completing practical parts of their studies at the LMU Hospital to try out the laparoscopic equipment. Frank leads the courses they offer as a voluntary extra. And they are in great demand, he says, because they give the students the chance to get hands-on experience themselves – without the risk of hurting someone through inexperience.

Frank, wearing a white coat and dark glasses, demonstrates it, and it looks so natural, so easy and relaxed: using the forceps at the end of his laparoscopy rod, he takes a tiny bead, a few millimeters in diameter at most, lifts it up and places it in a recess provided for it. Everything is tiny. Now you really want to try it out for yourself. It should be possible!

Difficult requirement: Surgeons can only see through a screen when performing laparoscopic surgery. (Photo: Stephan Rumpf)

This much can be said: This exercise is definitely not just a test of hand-eye coordination, but also, and above all, of patience. The biggest problem with the exercise is that you have to handle the bars in the fake stomach in a three-dimensional space. However, the image from the camera that films what is happening in the stomach is only shown two-dimensionally on a screen. And only the image serves as orientation.

Because it is such a tricky job, Jens Werner, Director of the Clinic for General, Visceral and Transplant Surgery, is committed to making this exercise a mandatory part of surgical training, as has long been the case in the USA. Surgery is also a craft, says Werner, and it needs to be practiced.

Open day at the Klinikum Großhadern, Saturday, September 14, 2024, 10 a.m. to 4 p.m. More information at https://www.lmu-klinikum.de/50-jahre-grosshadern.

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