scholarly journals History of surgical treatment of obesity and metabolic disorders

2018 ◽  
Vol 9 (4) ◽  
pp. 87-104
Author(s):  
Dmitrij I. Vasilevsky ◽  
Yuri I. Sedletsky ◽  
Kristina A. Anisimova ◽  
Leysan I. Davletbaeva

Surgery of obesity (bariatric surgery) as a separate area of medical science dates back its history from the middle of the previous century. The foundation for its development was based on the ideas of physiology of digestion, the causes and mechanisms of its disturbances that had been formed at that time. An important role was played by achievements in related areas of medicine: anesthesiology, transfusiology. Before that effective antibacterial drugs have already been created. Rich experience in various fields was brought for medicine by the Second World War. The return of society to pre-war cultural values became the impetus for bariatric surgery genesis. For two first decades, the main method of surgical treatment of overweight was shunting operations in the small intestine, aimed at reducing absorption of nutrients (malabsorption techniques). However, a significant number of negative side effects gradually forced to abandon this group of procedures and were the basis for the search for other options in surgical interventions. Since the late 60-es of the 20th century for two decades, methods have been actively developed that limited the flow of nutrients (restrictive approach). The main idea in the development of this group of operations was to reduce the volume of the stomach. At the same time, attempts were made to combine both malabsorptive and restrictive mechanisms in one technique. By the beginning of the 90-es, practically all the available variants of surgical interventions have been proposed and introduced into clinical practice. At the same time, minimally invasive surgical technologies began to be actively introduced into this area of medicine. By the beginning of the 21st century almost all surgical techniques have been adapted to endovideo- (laparoscopic-) surgery. Over the past decade, intraluminal (endoscopic) methods for reducing stomach volume and reducing nutrient absorption have been developed.

2018 ◽  
Vol 177 (6) ◽  
pp. 20-26
Author(s):  
E. A. Tseimakh ◽  
V. A. Bombizo ◽  
P. N. Buldakov ◽  
A. A. Averkina ◽  
D. N. Ustinov ◽  
...  

The objectiveis to study the results of different methods of surgical treatment of patients with infected pancreonecrosis and to conduct a comparative analysis of minimally invasive and traditional surgical interventions.Material and methods.The results of treatment of 206 patients with infected pancreonecrosis were analyzed. In accordance with the used method of surgical treatment, the patients were divided into 2 groups: 105 (51.0%) patients with “traditional” open interventions were included in the first group (comparison), and 101 (49.0%) patients treated with various miniinvasive technologies, or a combination of minimally invasive and “open” interventions were included in the second group.Results.It was found that the mortality rate in the second group was less than in the first group by 12.8% (p<0.05).Conclusion.Minimally invasive surgical techniques are the method of choice for delimited pancreatogenic ulcers. The use of combined surgical interventions leads to a significant reduction of postoperative mortality and duration of inpatient treatment.


2011 ◽  
Vol 18 (4) ◽  
pp. 3-10
Author(s):  
A V Krut'ko ◽  
Shamil' Al'firovich Akhmet'yanov ◽  
D M Kozlov ◽  
A V Peleganchuk ◽  
A V Bulatov ◽  
...  

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.


2021 ◽  
Vol 61 (3) ◽  
pp. 27-30
Author(s):  
A. B. Riabov ◽  
M. S. Kubirov ◽  
A. V. Khizhnikov ◽  
M. Yu. Rykov

Relevance: Surgery is one of the main methods of treating patients with liver neoplasms. At that, minimally invasive surgical techniques facilitate the course of the postoperative period and rehabilitation. The purpose of the study was the selection of optimal surgical treatment for children with liver tumors. Results: In 2014-2020, five patients aged 3-9 years with liver tumors underwent laparoscopic resection at the Morozovskaya Children’s City Clinical Hospital (Moscow, Russia). Out of 3 patients with hepatoblastomas, two patients had stage PRETEXT I, one – stage II. All patients underwent radical surgical treatment (R0); in one child (4%), the resection volume was R1. The duration of operations did not exceed 60 minutes; intraoperative blood loss was within 10 ml/kg; no intraoperative complications were registered. Conclusion: Laparoscopic techniques reduce surgery time and blood loss, prevent intraoperative and postoperative complications, shorten the hospital stay, decrease enteral and drug burden, and the need for chemotherapy. They also facilitate radical surgery and early patient mobilization.


Author(s):  
Robert M. MacGregor ◽  
Spencer J. Melby ◽  
Richard B. Schuessler ◽  
Ralph J. Damiano

The surgical treatment of atrial fibrillation has evolved over the past 2 decades due to the advent of ablation technology, and the introduction of less invasive surgical approaches. Current devices produce ablation lines that aim to replace the incisions of traditional surgical ablation strategies, such as the Cox-Maze procedure. This has helped to simplify and shorten surgical ablation procedures and has allowed for the development of minimally invasive surgical techniques. This review discusses surgical ablation energy sources and devices, providing background on device characteristics, mechanism of tissue injury, and success in creating transmural lesions.


Neurosurgery ◽  
2004 ◽  
Vol 54 (1) ◽  
pp. 107-112 ◽  
Author(s):  
Faheem A. Sandhu ◽  
Paul Santiago ◽  
Richard G. Fessler ◽  
Sylvain Palmer

Abstract OBJECTIVE Synovial cysts are a rare cause of lumbar radiculopathy and back pain. Surgical treatment is directed at complete excision of the cyst. We used minimally invasive surgical techniques for a series of patients, to assess the effectiveness of this approach for resection of synovial cysts. METHODS Seventeen patients (10 female and 7 male patients) with presumed synovial cysts, as indicated on magnetic resonance imaging scans, underwent surgical resection with the 18-mm METRx tubular retractor system (Medtronic Sofamor Danek, Memphis, TN). A unilateral approach was used, with either an operating microscope (13 cases) or a magnifying endoscope (4 cases), depending on the preference of the surgeon. Outcomes were reported by using modified MacNab criteria. RESULTS The average patient age was 64 years (range, 46–82 yr). The L4–L5 level was most commonly affected (82% of cases). Grade 1 spondylolisthesis at the level harboring the synovial cyst was observed for 47% of the patients; all cases of spondylolisthesis involved the L4–L5 level. The mean operative time was 97 minutes, and the average blood loss was 35 ml. Excellent or good results were achieved for 94% of the patients. A dural tear that did not violate the arachnoid membrane occurred during surgery for one patient but did not require further treatment. CONCLUSION Synovial cysts can be effectively treated with a tubular retractor system in conjunction with an endoscope or microscope. Use of the tubular retractor minimizes soft-tissue trauma, incision length, blood loss, and disruption of ligamentous and bony structures. This may be particularly significant when synovial cysts are associated with spondylolisthesis, minimizing the risk of progressive instability and the need for fusion.


2018 ◽  
Vol 14 (3) ◽  
pp. 45-48
Author(s):  
Наталья Нуриева ◽  
Natal'ya Nurieva ◽  
Юрий Васильев ◽  
Yuri Vasilev

Subject. The obturator for dissociation of an oral cavity from a nose cavity, the maxillary of cavities, the post surgeons of defects of maxillary bones. Purpose ― to carry out stomatology rehabilitation of the patient with the acquired defect of the lower jaw with use of the obturator. Methodology. Surgical treatment in maxillofacial area, often doesn't do without appearance of defects of maxillary bones. Elimination of the arising deformations unconditionally perhaps both surgical techniques, and orthopedic designs. Temporary closure of the formed defects and restoration of functions of breath, the speech and food can be the purpose of orthopedic maintenance, at surgical interventions, as division of an oral cavity from cavities of a nose, a bosom, and. We made use of experience of production of various obturator at more than 50 patients needing orthopedic rehabilitation for writing of this article, and in honesty in production of various designs the obturator of artificial limbs, at the moment and after the surgical and combined methods of treatment of new growths of maxillary bones postponed. All of them are at different stages of rehabilitation. Results. On example of a clinical case is shown a possible orthopedic way of closing of temporary defect of the lower jaw, by production of the obturator artificial limb adapted in an oral cavity. The Obturator artificial limb has the small sizes, can independently be established and be taken by the patient, for hygienic leaving, doesn't influence diction and an articulation, helps to avoid of postoperative defect and also to normalize meal. Conclusions. The assessment of results of the carried-out orthopedic treatment is carried out, its efficiency is established, practical recommendations about clinical use and ways of production are made.


Author(s):  
Volodymyr Kopchak ◽  
Mykhailo Nychytailo ◽  
Oleksandr Duvalko ◽  
Vasyl Khanenko ◽  
Volodymyr Trachuk ◽  
...  

We reviewed the charts of 752 patients, who have undergone surgery for various forms of chronic pancreatitis at “Shalimov’s National Institute of Surgery and Transplantation of the NAMS of Ukraine” in the years from 2007 to 2017. The average age of the 591 males (78,6 %) and 161 females (22,4 %) was 43,0 ± 3,2 years. Out of these, 446 (62,4 %) patients with pseudocysts and pancreatic fistula and also with isolated main pancreatic duct lithiasis underwent drainage procedures. The 269 (37.6%) patients were subjected to different types of resection, including the Frey operation, pancreatoenterostomy with artificial pancreatic duct formation, the Berne technique, the Beger procedure, pancreatoduodenectomy, distal-pancreatic resection and other procedures. After pancreatic resections, the patients did not require repeated surgical interventions for chronic pancreatitis. In some cases of chronic pancreatitis, there was an isolated lesion of the pancreas: in such cases (13 patients), we performed distal resection of the pancreas. Among the observed patients here were no fatal cases. Satisfactory results were obtained in 92.6 % of cases at longterm follow-up. Post-operative complications occurred in 27 patients (4.6 %), in 6 (1.03 %) patients there was a need for repeated surgery. Progression of the disease in patients previously operated in our clinic was observed in 32 (5.5 %), and 72 patients, initially operated in other medical institutions. Patients after direct resection of the pancreas did not require repeated surgery for chronic pancreatitis. The main causes of unsatisfactory results of the surgical treatment for chronic pancreatitis have been found to be: false indications for initial surgery, improper primary surgical techniques, insufficient use of drainage procedures, as well as, performing a drainage procedure instead of a resection. Key words: chronic pancreatitis, surgical treatment, resection and drainage procedures. For citation: Usenko OY, Kopchak VM, Nychytailo MY, Duvalko OV, Khanenko VV, Trachuk VI, Khomiak AI. Modern principles of surgical treatment of chronic pancreatitis. Journal of the National Academy of Medical Sciences of Ukraine. 2019;25(3):306–12


2018 ◽  
Vol 99 (3) ◽  
pp. 504-507
Author(s):  
G P Kotel'nikov ◽  
P V Ryzhov ◽  
Yu V Lartsev ◽  
D S Kudashev ◽  
S D Zuev-Ratnikov ◽  
...  

The aim of the study was the analysis of domestic and foreign medical literature of different time periods, which describes the basic methods of surgical and conservative treatment of congenital or habitual dislocation of patella, as well as statistical analysis of the results of treatment. Due to the existence of a large number of options of surgical treatment for this pathology (more than 150 methods were developed) and high variability of its manifestations, it is necessary to know the basic methods and their results for planning tactics of treatment with individual approach to each patient. Based on this review, analysis was performed for the results of using different options for invasive treatment of congenital or habitual dislocation of patella. Also, the paper contains the indications and efficacy of conservative therapy for this disease. A comparative analysis was made on the results of surgical and conservative methods of treatment of patellar dislocation, which were used in different time periods, from the initial description of the first results of treatment of this pathology to modern surgical techniques that are currently used. It is shown that all methods of surgical treatment of the pathology are divided into three main groups: myofascioplastic surgeries, osteoplastic and combined surgical interventions. It is underlined that the diseases requires individual approach to the choice of correction method in each certain case to achieve positive outcomes.


Author(s):  
D. I. Vasilevskiy ◽  
Yu. I. Sedletskiy ◽  
L. I. Davletbaeva

Surgical treatment of obesity and associated diseases, like any other field of practical medicine, is based on certain laws and conditions. All the principles of bariatric surgery were formulated in the process of accumulating a positive and negative experience of using various surgical interventions. The article presents an historical perspective on the evolution of views on the fundamental principles of the operative treatment of obesity and associated diseases.


2019 ◽  
pp. 82-86
Author(s):  
A. Z. Tibilov ◽  
N. B. Kireeva

The article contains the analysis of the literature devoted to the correction of hypospadias in children. Parallels are drawn between classical works and modern trends in the treatment of this malformation. New surgical techniques (with reference to the history of their appearance) and developments are described. There is a discussion about the use of single and staged surgical interventions in the proximal hypospadias, the analysis of literary data about the complications, results of operations. New classification parameters of hypospadias, methods of assessing the severity of the defect before surgery, functional and cosmetic results after surgery are described. Attention is paid to such direction as standardization of approaches to surgical treatment of hypospadias, unification of methods of urethroplasty and correction of penile curvature. The data of clinical studies on the use of various operational techniques are presented.


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