Endovideosurgical Method Research Articles

СРАВНИТЕЛЬНЫЙ АНАЛИЗ РЕЗУЛЬТАТОВ ЛАПАРОСКОПИЧЕСКОЙ ПРЕДБРЮШИНННОЙ ПЛАСТИКИ ПАХОВЫХ ГРЫЖ И ГЕРНИОПЛАСТИКИ ПО ЛИХТЕНШТЕЙНУ

The purpose of the study is a comparative analysis of the results of transabdominal preperitoneal laparoscopic surgery and inguinal hernioplasty according to Lichtenstein. From 2017 to 2023, 695 patients with inguinal hernias were operated on in Clinic 2 of the Central City Clinical Hospital of Veliky Novgorod. 322 (46.3%) patients had surgery performed by endovideosurgical method and 373 (63.7%) had open surgery according to Liechtenstein.

Robot-assisted partial nephrectomy with calicolithotomy

The combination of renal cell carcinoma and urolithiasis in the same kidney is rare. The management of patients who have two such diseases simultaneously is primarily determined by renal cell carcinoma as the dominant disease. To date, modern diagnostic and surgical technologies make it possible to perform partial nephrectomy with simultaneous removal of a calculus from the pelvicalyceal system using minimally invasive endovideosurgical methods.
 This study aimed to demonstrate the possibility of performing robot-assisted nephrectomy with calicolithotomy in a patient with abnormalities of renal vessels.
 This work presents a clinical case of a 36-year-old man hospitalized with a neoplasm of the right kidney measuring 38 35 35 mm, detected during multislice computed tomography. In the lower group of calices of the kidney, a 5 4 mm calculus with a density of 1200 HU was found. The presence of anomalies of the renal vessels served as the basis for a three-dimensional (3D) reconstruction of the right kidney using the 3D Slicer modeling program. The patient underwent a robot-assisted kidney resection with calicolithotomy on a da Vinci SI robot. Intraoperatively, an ultrasound examination of the kidney was performed using an intracavitary sensor BK Flex Focus 800.
 The console operating time of the operating surgeon was 110 min. Blood loss was approximately 100 ml. The warm ischemia time was 20 min. The postoperative period proceeded without complications. At 3 weeks postoperatively, nephrogenic arterial hypertension disappeared. Laboratory studies conducted 3 months after surgery indicated an increase in the glomerular filtration rate compared with preoperative results.
 3D reconstruction allows rational planning of the scope of surgical intervention during preoperative preparation. Kidney resection with calicolithotomy is optimally performed using the da Vinci robot, which allows complex surgical techniques to be performed using endovideosurgical methods.

Эндогенный гиперкортизолизм: достижения и перспективы в диагностике и лечении

The results of examination and treatment of 647 patients with endogenous hypercortisolism were studied: pituitary corticotropinoma was detected in 494 (76.4%) patients, corticosteroma and pre corticosteroma of the adrenal gland in 142 (21.9%), bilateral macro-nodular hyperplasia of the adrenal glands of primary adrenal origin-in 11 (1.7%). Differential diagnosis of clinical forms of endogenous hypercortisolism was based on the assessment of the level of adrenocorticotropic hormone and cortisol, both in peripheral blood, and with selective bilateral blood sampling from the adrenal veins and lower stony sinuses, and the study of the nature of samples with 8 mg of dexamethasone. Topical diagnostics consisted in assessing the state of the adrenal glands and pituitary gland during computed tomography and magnetic resonance imaging with the use of contrast agents, and the use of special software 3D-Volume Rendering Technique allowed optimizing tactical and technical approaches to performing surgical interventions. Of the operated patients with adrenocorticotropic hormone dependent endogenous hypercortisolism, total removal according to the control magnetic resonance imaging was achieved in 92.3% of cases, subtotal in 7.7%. However, hormonal remission was achieved only in 82.4% of cases. All patients with corticosteroma and pre-corticosteroma of the adrenal gland underwent adrenalectomy: in 6 patients by open method, in 136 patients by endovideosurgical method (in 11 patients by laparoscopic method, in 124 patients by retroperitoneoscopic method, and in 1 patient by thoracoscopic transdiaphragmatic adrenalectomy). In all patients, the operation led to recovery. Patients with benign macronodular hyperplasia of the adrenal glands needed conservative treatment with steroidogenesis blockers. Indications for surgical treatment in the volume of unilateral adrenalectomy occurred only in 2 patients.

Minimally invasive surgery for benign prostatic hyperplasia: causes, forms, and prevention of urinary disorders (literature review)

Benign prostatic hyperplasia (BPH) ranks 4th among all diagnoses in the group of men 50 years of age and older. With an increase in prostate volume of more than 20 cm³, patients develop lower urinary tract symptoms (LUTS), which negatively affect the quality of life of men. Currently, minimally invasive endovideosurgical methods of treating BPH have proven themselves successfully: transurethral resection (TUR) of monopolar or bipolar type, transurethral bipolar enucleation of the prostate (TUEP), holmium laser enucleation of the prostate (HoLEP). However, despite the clinical efficiency of endoscopic operations, the incidence of postoperative complications remains quite significant. After surgical intervention, the main causes of urinary disorders are detrusor overactivity or a decrease in its functional activity, as well as bladder obstruction. Prolonged bladder catheterization in the postoperative period prevents early recovery of independent urination, which is a risk factor for the development of urinary disorders. Stress urinary incontinence has a significant impact on patients, both physically and mentally. For the treatment of postoperative stress urinary incontinence, behavioral therapy, drug treatment of disorders, minimally invasive methods of treatment are used: injections of hyaluronic acid into the submucous layer of the urethra, botulinum toxin into the detrusor, as well as the technique of sacral neuromodulation. Surgical methods include the implantation of a synthetic sphincter or the installation of male sling.

Risk factors, morbidity rates and long-term prognosis in benign hyperplasia and prostate cancer (literature review)

Diseases of the urological profile are one of the most important medical and social issues of the modern world. According to various sources, from 50 % to 75 % of men over 50 years old have benign prostatic hyperplasia (BPH), and by the age of 80, BPH is detected in 90 % of the male population. BPH manifests itself with lower urinary tract symptoms (LUTS) in most patients. Prostate cancer ranks 2nd or 3rd in the structure of malignant neoplasms in men, and the prevalence of this pathology continues to grow. This trend is associated with an increase in average life expectancy, improved diagnosis of pathologies and early detection of the disease. Risk factors affecting the development of both prostate cancer and BPH include the patient’s age, race, family history, eating habits, the presence or absence of bad habits, and a sedentary lifestyle. Surgical methods for treating prostate cancer include open retropubic prostatectomy and laparoscopic adenomectomy. The «gold standard» of surgical treatment of BPH is transurethral resection of the prostate (TURP), but the emergence of new endovideosurgical methods (bipolar TURP, transurethral enucleation of the prostate (TUEP) allows to expand the scope of their use and reduce possible complications in the early and late postoperative period.

CHOOSING A METHOD OF SURGICAL TREATMENT OF ACUTE APPENDICITIS IN PATIENTS WITH CONCOMITANT PULMONARY PATHOLOGY

Summary. The article analyzes the experience of using endovideosurgical method of treatment of patients with АA with pulmonary pathology, determines the indications for the use of different methods of applying pneumoperitoneum when performing laparoscopic appendectomy (LA).
 Material and method. The result of treatment of 46 patients with acute appendicitis (АA) and concomitant pulmonary pathology in the last 5 years is given. Group I included 14 patients diagnosed with AA with concomitant pulmonary pathology who underwent open appendectomy, and II — 32 patients with a diagnosis of AA with concomitant pulmonary pathology, who underwent laparoscopic appendectomy with the imposition of pneumoperitoneum and metaphormia.
 Result. The evaluation of the treatment of 32 patients (84.8 %) with concomitant pulmonary pathology performed by LA, which allowed to dramatically reduce the number of complications from the abdominal organs, as well as to reduce the frequency of decompensation of concomitant pulmonary pathologies.
 Conclusions. Performing a laparolifting laparoscopic appendectomy is the optimal method for patients at high risk for cardiopulmonary disease.

Clinical case of successful combined computer assisted surgery treatment of inguinal hernia

In the article the characteristics of combined inguinal hernia, and presents a rare clinical case of diagnosis and successful surgical treatment of combined inguinal hernia with 3 gruzaviki gate endovideosurgical method using mesh Explant.

Correction of complications portal hypertension syndrome

The results a new approach of simultaneous correction of complications of portal hypertension with endovideosurgical method are considered. Surgeries of 4 patients, suffering from portal hypertension, were performed by laparoscopic access and included gastric devascularization with ligation and the transection of the left gastric and short gastric veins; ligation of the splenic artery; resection of the parietal peritoneum, retroperitoneal tissue, and lumbar muscles in the lumbar triangle. Average duration of one surgery was 120±22 minutes. The highest volume of blood loss was 150±35 ml. There were no intraoperative complications. The average time spent in the IC unit was 14±4,2 hours. On the day following the surgery, all patients were able to get out of the bed, walked on their own and were allowed to have liquid food. Each patient had one session of endoscopic ligation with an overlay of 5 to 8 Cook ligatures to eradicate varicose veins of the esophagus. The postoperative period of hospital treatment was 10±2,3 days, treatment responses were favorable in all patients. The total time of inpatient stay was 22±3 days. All patients underwent two sessions of reinfusion of externally modified ascitic fluid. The postoperative spiral computer tomographies and subtraction digital angiographies showed effectiveness of disconnection of vessels in the gastroesophageal system. Blood flow in the splenic artery is not detected, ultrasound shows shrinkage of spleen. The maximum follow-up after the operation was 10 months. There were no episodes of bleeding recurrence and no signs of ascites. All patients are socially adapted and able to work, and do not present any complaints during follow-up examinations.

Experience of endovideosurgical method in treatment of patients with inguinal hernias

OBJECTIVE. This article analyzed the results of surgical treatment of patients who underwent laparoscopic hernioplasty. MATERIAL AND METHODS. The results of surgery of 1303 patients with inguinal hernia were assessed. All the patients were operated on in City Centre of Innovative Medical Technologies at the period from March 2013 to December 2016. Laparoscopic prosthetic hernioplasty using mesh prosthesis was carried out on 1199 patients. Traditional Liechtenstein hernia repair had 104 patients. RESULTS. The research showed that laparoscopic hernia repair had greater clinical efficacy as compared with traditional hernia repair. It appeared to be preferable choice of surgical treatment of inguinal hernias of any complexity.

EVALUATION OF THE COPULATIVE FUNCTION IN PATIENTS AFFECTED BY TRANSRETRAL AND ENDOVIDEOSURGERIC INTERVENTIONS FOR BENIGN PROSTATIC HYPERPLASIA

Relevance. Absence of studies on the effect of various transurethral and endovideosurgical methods (EVS) of operative treatment of benign prostatic hyperplasia (BPH) on the state of the copulative function, which includes the analysis of its main components within the framework of a single study. Aim. Study the effect of the above methods of correction of BPH on the state of the main components of the copulatory function. Materials and methods. Analysis of the results of surgical treatment of 220 patients with BPH who underwent transurethral resection-TUR (n = 80), transurethral enucleation with bipolar TUEB (n = 51), holmium laser enucleation of the prostate-HoLEP (n = 43), and endovideosurgical adenomectomy- EVS AE (n = 46). The study included: the international index of erectile function, the scale of the male copulative function score, the score of the questionnaire for the aging males symptoms (AMS), the quality of life index for erectile dysfunction, the degree of bulbocavernosis reflex, the testosterone fraction and the globulin binding sex hormones (GBSG). Patients were examined before the operation, and also after 3 and 6 months. Results. The number of patients with decreased libido was significantly lower in the TUR groups (from 56.3% to 53, 75% (3 months) and 47.5% (6 months)) and EVS AE (from 43.4% to 39.1% (3 months) and 32.6% (6 months)). A decrease in the specific gravity of ED in the postoperative period (group TUR BPH (from 50% to 45% (3 months) and 42.5% (6 months), group TUEB (from 52.9% to 51.5% (3 months) and 49.2% ( 6 months), the HoLEP group (from 69% to 66.6% (3 months) and 60% (6 months) and EVS AE (from 68.75% to 65% (3 months) and 62.5% (6 months)) with a parallel improvement in severity (from 40% to 37.5% (3 months), 35% (6 months), and EVS AE (from 31.25% to 28.3% (3 months) and 25% (6 months)), the number of patients with hyporgasmia. With respect to retrograde ejaculation, there was a decrease in the incidence of its occurrence in the TUR group (from 25% to 22.5% (3 months) and 19.6% (6 months) and EVS AE (from 18.75% to 15.3% (3 months) and 12% (6 months.) In addition, there was no statistically significant difference in the level of testosterone and GBSG fractions in the pre- and postoperative period (3 months), but when monitoring at a more distant time (6 months), there was a tendency to increase testosterone fractions with a parallel decrease in the concentration of GBSG. Conclusions. Surgical correction of BPH with endoscopic and EVS methods has a positive effect on the copulatory function and hormonal status, which is especially pronounced in the groups of TUR BPH and EVS AE.

THE ROLE OF MINIMALLY INVASIVE TECHNOLOGIES IN THE SURGICAL TREATMENT OF NONPARASITIC LIVER CYSTS

Aim. To assess the efficacy of minimally invasive procedures to improve the results of surgical treatment of nonparasitic liver cysts. Material and methods. The experience of treatment of 42 patients with nonparasitic liver cysts is presented, technical aspects and efficacy of minimally invasive methods in this category of patients are described. Results : using of an endovideosurgical method of treatment significantly reduces the time spent in hospital, minimizing postoperative complications. Long-term results of surgical treatment of nonparasitic liver cysts in the form of good cosmetic effect, absence of recurrences of the disease and clinical manifestations were improved. Conclusion . A laparoscopic treatment of nonparasitic liver cysts is characterized by the low number of complications, low frequency of relapses, and the absence of necessity for re-operation. The use of external drainage for nonparasitic liver cysts under the ultrasound supervision is preferable for infectious complications of liver cysts as a first stage before the radical surgical treatment.

Modern surgical approaches in treatment of simple solitary, multilocular, multiple cysts and polycystic kidney disease in children

In a review of current literature, the evolution of technology of endovideosurgical treatment approaches of simple solitary, multilocular, multiple cysts and polycystic kidney disease in children is presented. The article describes different puncture, «open», retroperitoneoscopic and laparoscopic types of surgical interventions used in this disease, their negative and positive aspects. Over the past two decades, endoscopic surgery for cystic kidney disease minimize surgical trauma so that they became comparable to puncture techniques, and surpass them in the intervention radicality. Herewith cosmetic effect is not inferior to that when using puncture techniques. When comparing videoscopic with «open» operations, the advantage of the first in a traumatic effect on the child’s body, and cosmetic results also were noted, while the surgical treatment radicality of compared techniques was identical. Presented statistical data obtained from the international literature analysis (more than 500 cases of endovideosurgical treatment of cystic kidney disease in 22 hospitals) demonstrate the short duration of surgery, short-term hospitalization and a high proportion of treatment success up to 90-100%. The comparative analysis of surgical procedures performed in the renal cysts endoscopic fenestration performance by retroperitoneal access is conducted. All presented in the literature review surgery methods are original and can be used in the treatment of children with cystic kidney disease, however, each operation has its own complexities of the technical performance. In this connection, the search for the best method of surgical treatment that can become the «gold standard» treatment for children with cystic kidney disease continues. In conclusion, it is noted that endovideosurgical methods of treatment of solitary, multilocular, multiple cysts and polycystic kidney disease in children have excellent prospects for the widespread implementation in pediatric urology and andrology.

Mini-invasive technologies in complex treatment of esophagus cancer

It was evaluated mini-invasive endovideosurgical technologies using in complex treatment of esophagus cancer. The investigation included 28 patients with thoracic esophagus cancer. Age of patients operated in terms from April 2012 to December 2013 was from 42 to 74 years (mean 61.7 ± 8.7 years). Only surgical treatment was used in 10 patients. Neoadjuvant chemotherapy and radiotherapy were performed in 18 patients. Hybrid mini-invasive esophagectomy (laparoscopic stomach mobilization and right-side thoracotomy) were used in 14 cases. The frequency of postoperative complications was 35.5%. Mini-invasive endovideosurgical esophagectomy was done in 14 patients. The frequency of postoperative complications was 57.1%. There were not deaths. Our experience demonstrates good results of mini-invasive technologies using in treatment of patients with esophagus cancer. Endovideosurgical methods permit to perform adequate volume of surgery in case of oncological diseases.

Total nephrectomy by endovideosurgical methods with transperitoneal access

The article presents the results of clinical introduction of minimally invasive urological operations in patient with renal tumors in comparison with open urological operations. The methods of endovideosurgical operations with laparoscopic access were described. Advantages of minimally invasive methods were shown.

Endovideosurgery in urology: terminology, history, indications, possibilities, complications

In the first series of lectures devoted to an endovideosurgery in urology the information concerning modern terminology, history, indications, possibilities and complications of these treatment methods is presented. Difficulties which arise during the implementation of endovideosurgical methods in practical medicine are separately detailed

Endovideosurgical method for ectopic pregnancy treatment

Endovideosurgical method for ectopic pregnancy treatment

The results and prospectives of gynecological endovideosurgery development

Authors, on the basis literary given and by the results of researches present the detailed analysis of efficiency and expediency of endovideosurgical methods of diagnostics and treatment in GYN practice. There are considered indications, contra-indication, features of the methodical approaches with use of specified methods under urgent condition and in planned GYN. Prospective directions of development of the new technological approaches in modern operative GYN are also considered.