[Laparoscopic adrenalectomy in surgery of the adrenal gland diseases].

In 2002-2012 yrs in The Department of Laparoscopic Surgery and Choledocholithiasis laparoscopic adrenalectomy (LA) for various adrenal gland diseases was done in 94 patients. The operation time while doing right-sided and left-sided LA have had constituted, accordingly, at average (73.6 +/- 12.1) and (121.6 +/- 11.9) min, intraoperative blood loss - (49.3 +/- 9.2) ml. Hemotransfusion was not applied. There was no need for conversion. In 1 (1,1%) patient hemoperitoneum have had occurred as a consequence of traumatic injury of spleen while performing left-sided LA. Nonspeciphic postoperative complications were absent.

[Mini-invasive interventions for cystic formations of the spleen].

The data of complex clinical examination and surgical treatment of 89 patients, having splenic cysts (SC), are analyzed. Indications and contraindications for miniinvasive methods of treatment (laparoscopic and puncture-draining procedures under ultrasonographic control) application are substantiated, taking into account their size, localization, pathogenesis and presence of SC complications. Diagnostic efficacy of abdominal ultrasonography, computer tomography for SC was estimated, the significance of these methods, while choosing a rational tactics of treatment, was determined. There were elaborated and introduced into clinical practice the stages of endosurgical procedures, including performance of organpreserving operations for SC. Introduction of the elaborated diagnostic algorithm and tactics of treatment of SC have permitted to reduce postoperative complications rate and the patients stay in hospital, improving their quality of life as well.

[Experience of performance of laparoscopic adrenalectomy using lateral transabdominal approach].

In 2002-2008 yrs. in the Department of Laparoscopic Surgery and Cholelithiasis in 52 patients laparoscopic adrenalectomy (LA) was accomplished, performed for different diseases of suprarenal glands. Incidentaloma was diagnosed in 8, fibroma--in 4, pheokhromocytoma--in 10, aldosteroma--in 11, adrenocortical cancer--in 3, corticosteroma--in 13, suprarenal gland cyst--in 3 patients. The operation time in right-sided and left-sided LA had constituted accordingly 85 and 118 minutes. Intraoperative blood loss had constituted 60 ml at average. Hemotransfusion was not done. In 1 (2.4%) observation hemoperitoneum had occurred as a result of traumatic damage of spleen during performance of left-sided LA. Intraoperative complications were absent. The stationary treatment duration was 2.6 days at average.

[Laparoscopic interventions for adrenal gland tumor].

Clinical course, hormonal characteristics and efficacy of rehabilitation were studied by the authors in 12 patients with suprarenal gland tumor, operated, using minimally invasive endoscopic intervention--laparoscopic adrenalectomy (LA). Efficacy, indications, contraindications, role of LA in the treatment of surgical adrenal diseases were analyzed. LA is characterized by invasiveness and traumaticity, adequate radicalism, quick rehabilitation, and good remote results. LA is indicated for the treatment of majority of hyperplastic and tumoral diseases of suprarenal glands: it is possible to operate 60% of patients with surgical diseases of suprarenal glands using endoscopic technology.

[Experimental substantiation of the method of biological tissue welding in surgical hepatology]. / Eksperimental'noe obosnovanie primeneniia metoda élektrosvarki biologicheskikh tkanei v khirurgicheskoi gepatologii.

Application of the welding method for biological tissues in hepatobiliary surgery was experimentally substantiated. In 14 pigs (25-30 kg body mass) resection of one hepatic lobe, using electric welding method, was done. In control group (4 pigs) the similar operative intervention was accomplished, using conventional method. Application of the electric welding method guarantees secure hemostasis and cholestasis, do not causes specific pathological changes in the adjacent region of affection tissues, speed of restoration of the structures damaged exceeds such in application of the suturing method.

[The application of extracorporeal shock-wave lithotripsy in the treatment of choledocholithiasis]. / Primenenie ékstrakorporal'noi udarnovolnovoi litotripsii v lechenii kholedokholitiaza.

The method of extracorporal shockwave biliary lithotripsy was introduced in the clinic since 1993 yr in patients with residual choledocholithiasis. The method was applied in 25 patients. Cholecystectomy with external drainage of common biliary duct was performed in all patients beforehand. Positive result was noted in 16 observations. All patients are alive.

[Application of electro-thermo-adhesion in hepatobiliary surgery]. / Primenenie metoda élektrotermoadgezii tkanei v gepatobiliarnoi khirurgii.

Since 1999 yr. 283 laparoscopic operations were performed in the clinic for diseases of liver, biliary ducts, pancreas using electrothermoadhesion method, including 201 cholecystectomies, 62--in presence of hepatic cyst, 6--enucleation of hemangioms, 3--hepatic edge resection, 1--cholecystectomy, in 10 patients the puncture biopsy of pancreas was done.

[Lessons on laparoscopic cholecystectomy (summary of the experience]. / Uroki laparoskopicheskoi kholetsistéktomii (obobshchenie opyta)].

The experience of laparoscopic cholecystectomy conduction in 6524 patients with nontumoral diseases of gallbladder (chronic calculous cholecystitis, an acute calculous cholecystitis, chronic noncalculous cholecystitis, the gallbladder polyposis) was summarized. While comparing the initial seizing experience in laparoscopic cholecystectomy in the clinic the tendency was noted, trusting the skills improvement in management of laparoscopic technique, permitting to reduce the contraindications quantity for laparoscopic cholecystectomy. Several principles were elaborated, which is necessary to follow doing laparoscopic cholecystectomy for improvement of results of treatment in patients and for complications reduction.