[Redo laparoscopic surgery for recurrent gastroesophageal reflux disease and hiatal hernia]. / Povtornye laparoskopicheskie operatsii pri retsidive gastroézofageal'noi refliuksnoi bolezni i gryzhi pishchevodnogo otverstiia diafragmy.

AIM: To assess mechanisms of recurrent gastroesophageal reflux disease and the ability to perform adequate surgical correction after previous surgery. MATERIAL AND METHODS: The authors from various surgical centers have operated 2678 patients with gastroesophageal reflux disease and hiatal hernia for the period 1993-2018. 127 (4.74%) patients underwent redo surgery for recurrent disease, 46 of them were previously operated in other clinics. RESULTS: Median follow-up after redo surgery was 63 months (12-139). Satisfactory functional result was achieved in 76.4% of patients.

[Characteristics and results of retroperitoneoscopic operations in urology].

The aim of the study was analysis of retroparietoscopic operations made in patients with renal cysts, anomalies of the kidneys, uretero-pelvic strictures, concrements of the upper third of the ureter to optimize treatment policy. A total of 29 patients were treated in the urological department (17 males, 12 females, age 23-70 years, mean age--49.7 years). Of them, 18--for renal cysts, 4--for ureteropelvic stricture (postoperative structure--1, ureterovasal conflict--2, high position of the ureter--1), postoperative stricture of the lower third of the left ureter--1, urolithiasis--5 (located in the upper third of the ureter--4, located in the pelvis and lower calyces of the dystopic left kidney--1), hydroureteronephrosis of the upper half of the double right kidney--1. Ultrasound scanning was followed by multispiral computed tomography. Retroparietoscopic method is characterized by limited positions of the instrumental trochar, absence of definite anatomic marks and difficulties in maintenance of necessary pressure in the cavity. Valid position of the trochars in the retroperitoneoscopic operation is a necessary condition of successful operation. In retroparietoscopic interventions the operative approach includes creation of the primary cavity, placement of trochars and creation of working cavity. Duration of retroperitoneoscopic operations ranged from 1 hour to 4 hours 30 min. Only short-term fever was a complication. Postoperative hospital stay was 1 to 7 days. Thus, retroperitoneoscopic operations are a good alternative to conventional surgery.