[Endovideosurgical technology in diagnosis and treatment of perforating gastroduodenal ulcers].

The authors have analyzed their experiences with using endovideosurgical technologies in surgical treatment of 67 patients with perforation of gastroduodenal ulcers. The diagnosis was made in all the patients using laparoscopy, in 56.7% esophagogastroduodenoscopy was used. In 91% of the cases ulcers were localized on the anterior wall of the duodenum bulb, in 9%--in the area of the pylorus. The diameter of the perforation orifice could be from 1 to 7 cm. In 35 (52.2%) patients the perforation defect was sutured with intracorporeal formation of the nodes. The intracorporeal nodes could not give complete closure of perforations with the diameter of more than 1 cm. So, in 18 patients (26.7%) closure of the defect was made using extracorporeal node after Roeder. The zone of suturing was additionally peritonized with an omentum strand. Ulcer could not be sutured in one patient, which required conversion. All patients recovered. The duration of staying at hospital was from 3 to 5 days.

[Potentialities of edovideosurgery in treatment of patients with acute adhesive intestinal obstruction].

The article analyses an experience with treatment of 96 patients with acute intestinal obstruction caused by peritoneal commissures. The technique of laparoscopic operations and principles of their realization are described. The observation of these principles is shown to give high effectiveness and safety of endovideosurgical interventions for acute intestinal obstruction. Their advantages consist in minimal invasiveness, short periods of postoperative rehabilitation and little frequency of postoperative complications.

[Programmed sanation laparoscopy in treatment of peritonitis].

An analysis of experiences with endovideosurgical sanation of the abdominal cavity was analyzed in 168 patients with diffuse peritonitis which complicated the course of different acute diseases. Relaparoscopy might be programmed and "on request". Programmed laparoscopy allowed adequate sanation of the abdominal cavity in most cases. It was impossible in 11.3% of cases associated with a pronounced commissural process and uncared peritonitis with formed pyogenic abscesses in the abdominal cavity. The indications and contraindications to laparoscopic sanation of the abdominal cavity are described.

[Endovideosurgical antireflux operations in combination with cholecystectomy].

In the city center of endovideosurgery during 1999-2005 there were 205 patients examined and treated for cholelithiasis combined with gastro-esophageal-reflux disease (GERD) and hiatal hernias. Simultaneous interventions, antireflux operation and cholecystectomy were performed in 150 patients. Cholecystectomy followed by conservative treatment of GERD was performed in 55 patients. The results of treatment were followed up during 1 and 6 months.

[The place of endovideosurgical interventions in treatment of inguinal hernias].

Endovideosurgical hernioplasty was performed in 3020 patients. Complex forms of inguinal hernias were diagnosed in 280 of them. These forms included: bilateral and combined inguinal hernias, inguinoscrotal hernias, sliding hernias, fixed and irreducible inguinal hernias, recurrent inguinal hernias after traditional herniorrhaphy and recurrent hernias after endovideosurgical hernioplasty. Original technical maneuvers are described, indications and contraindications were established, complications and results of treatment of patients with inguinal hernias were analyzed and evaluated. Recommendations are given for the treatment of patients with complex forms of hernias.

[Endovideosurgery in treatment of Meckel's diverticulum].

The authors made an analysis of using endovideosurgery in diagnosing and treatment of Meckel's diverticulum and its complications in 18 patients. They describe signs and diagnostic criteria of the disease. Adequate treatment was proved to be possible by laparoscopy.

[Features of video laparoscopic interventions in patients operated earlier on abdominal organs]. / Osobennosti videoéndokhirurgicheskikh vmeshatel'stv u bol'nykh, ranee operirovannykh na organakh briushnoi polosti.

Laparoscopic operations in patients who have undergone earlier "open" operations on abdominal organs are described. Before 1994 open laparoscopy by Hassan was used for penetration into the abdominal cavity. There were 46 such manipulations (2.14% of all 9100 endosurgical operations), in 5 cases of them the conversion to open operation was necessary. From 1994 the optic trocar "Visiport" was used permitting to image tissues in its passage through anterior abdominal wall. 195 operations with optical trocar were performed. All the patients had been operated earlier. Trocar was introduced without damages of abdominal organs in all the cases. Trocar was introduced in the left iliac area, where the comissures were found in 4 cases only. In 147 patients during revision unions of intestinal loops and great omentum with anterior abdominal wall were revealed. In one patient significant comissural process was revealed, so conversion to laparotomy was necessary. In 2 other patients laparotomy was performed because of damage of ileum and ceclim during endoscopic operation. Main criterion of rejection laparoscopic operation in patients operated earlier on abdominal organs is the results of laparoscopy with trocar.

[Immediate results of laparoscopic hernioplasty in inguinal and femoral hernias]. / Blizhaishie rezul'taty laparoskopicheskoi gernioplastiki pri pakhovykh i bedrennykh gryzhakh.

In 1992-1994 laparoscopic hernioplasty was performed in 403 patients with inguinal (371) and femoral (32) hernias. Mean duration of hospital-stay 2.3 days, period of incapacity 9.7 days. Complication were encountered in 25 (3.7%) patients, including perforation of the small intestine and commissural ileus for which laparotomy had to be performed. Recurrent hernias occurred in 7 (1.7%) patients in periods of 2 weeks to 1.5 month due to poor fixation of the implant and choice of an inadequate operative method.

[Complications of endovideosurgical repair of inguinal and femoral hernias]. / Oslozhneniia éndovideokhirurgicheskoi gernioplastiki pri pakhovykh i bedrennykh gryzhakh.

On the basis of an experience with 1800 operations of endovideosurgical hernioplasty in patients with inguinal and femoral hernias, the authors analyze the frequency and character of complications after such operations. Complications were noted in 37 (2.05%) patients. The most frequent complication was injury of the vessels. It could be liquidated in all the cases using laparoscopic technology. In three cases hollow organs were injured. In these cases laparotomy was used. The laparoscopic hernioplasty, if all details are fulfilled thoroughly, is a minimally invasive and effective method of treatment of inguinal and femoral hernias. The frequency of recurrences after these interventions is considerably less than that after traditional operations.

[Laparoscopic extraperitoneal hernioplasty in the treatment of patients with an inguinal hernia]. / Laparoskopicheskaia venbriushinnaia gernioplastika v lechenii bol'nykh pakhovoi gryzhei.

The first experience with using laparoscopic extraperitoneal hernioplasty with implant Prolene" in 300 patients since November 1992 is analyzed. The analysis of the original method of laparoscopic extraperitoneal hernioplasty has shown its efficiency and safety for patients with inguinal hernias (recurrences were noted in 2,3%).

[Acute tumorous obstruction of the colon in elderly and senile patients]. / Ostraia opukholevaia neprokhodimost' obodochnoi kishki u bol'nykh pozhilogo i starcheskogo vozrasta.

The authors present the results of surgical treatment of 106 elderly and senile patients. In 30 patients admitted in a extremely severe condition the acute intestinal obstruction was combined with peritonitis. Postoperative mortality in this group of patients was 86.7% in spite of intensive treatment. In 28 patients generalization of the process was detected and they were given palliative interventions for liquidation of acute intestinal obstruction. Postoperative mortality in this group was 39.2%. Conventional radical operations were fulfilled on 48 patients. Postoperative mortality in this group was 20.8%. Later on the intestinal patency was reestablished in 15 patients. The data obtained show the possibility to widen the indications to radical operative interventions and to improve results of treatment of such patients.

[Laparoscopic appendectomy in acute appendicitis]. / Laparoskopicheskaia appendéktomiia pri ostrom appenditsite.

Laparoscopic technology was applied as diagnostic method in 608 patients, 50 patients have undergone laparoscopic appendectomy. There were no diagnostic errors in laparoscopy application. Laparoscopic technology allowed to perform appendectomy quite safely and without any complications. This method permitted considerably reduce terms of treatment of the acute appendicitis patients and quickly restore their ability to work.

[Laparoscopy in the differential diagnosis and treatment of acute appendicitis and acute gynecological diseases]. / Laparoskopiia v differentsial'noi diagnostike i lechenii ostrogo appenditsita i ostrykh ginekologicheskikh zabolevanii.

Laparoscopy was used in differential diagnostics of acute appendicitis in 524 female patients. Acute gynecological diseases were diagnosed in 123-of them, inflammatory processes in appendages being most frequent. The laparoscopic technology allowed not only to avoid diagnostic errors in all the cases, but also to take all necessary surgical measures. The effectiveness of laparoscopic operations for acute gynecological diseases was confirmed by the absence of complications and recovery within short terms.