scholarly journals Comparative evaluation of surgical methods for low invasive surgical treatment of diseases of the kidneys and urinary tract

2021 ◽  
Vol 6 (5) ◽  
pp. 230-236
Author(s):  
O. A. Ushakova ◽  
M. V. Suturin ◽  
Yu. S. Lobanov ◽  
A. V. Efimov ◽  
G. I. Vilsky
Keyword(s):  
Surgical Treatment ◽  
Kidney Diseases ◽  
Laparoscopic Approach ◽  
Retroperitoneal Space ◽  
Anatomical Landmarks ◽  
Access Methods ◽  
Advantages And Disadvantages ◽  
Surgical Methods ◽  
Duration Of Surgery ◽  
Retroperitoneoscopic Approach

Background. The rapid development of laparoscopic surgery can significantly reduce trauma during operations in the retroperitoneal space. These goals are also achieved by retroperitoneoscopy (RPS), which has become widespread in the last twenty years. The main difficulties for surgeons were associated with a small workspace and a lack of clear anatomical landmarks. Different access methods have different features, advantages and disadvantages, the analysis of which helps to optimize surgical treatment and accelerate patient rehabilitation.Aim: to study the advantages and disadvantages of retroperitoneoscopic and transperitoneal laparoscopic surgical methods of treatment.Materials and methods: We analyzed 305  case histories of patients operated on for various kidney diseases. The patients were divided into 2 groups: Group 1 – patients who underwent surgery using an extraperitoneal retroperitoneoscopic approach, Group 2 – patients who used the transperitoneal laparoscopic approach. A comparison of two methods of surgical treatment of kidney diseases, retroperitoneoscopic and laparoscopic access, was carried out. The following indicators were compared: duration of surgery, length of hospital stay, need for analgesics, frequency of postoperative complications.Results. The duration of the operation with retroperitoneoscopic surgery was reduced by more than 15 % compared with the laparoscopic approach. Shorter periods of pain relief were required, and the number of complications also decreased. The duration of inpatient treatment did not differ significantly.Conclusion. Retroperitoneoscopic approach can be used as the method of choice for operations on the retroperitoneal space. 

Diagnosis and treatment of craniosynostosis: Vilnius team experience

2015 ◽  
Vol 22 (2) ◽  
pp. 111-121 ◽  
Author(s):  
Linas Zaleckas ◽  
Arijanda Neverauskienė ◽  
Vidūnas Daugelavičius ◽  
Dominika Šidlovskaitė-Baltakė ◽  
Ramūnas Raugalas ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Head Shape ◽  
Time Of Surgery ◽  
Early Results ◽  
Surgical Methods ◽  
Duration Of Surgery ◽  
Csf Leakage ◽  
Team Experience ◽  
Aesthetic Results ◽  
The Mean

Background. The aim of the study was to review the methods of diagnosis of craniosynostosis and to analyze Vilnius (Lithuania) team experience of surgical treatment, surgical methods, aspects of anesthesia for patients with craniosynostosis and to present early results of surgical treatment. Materials and methods. A retrospective review of all patients with various types of craniosynostosis treated surgically during the period from 1 January 2009 to 31 December 2014 was performed. The following data were analyzed: age, type of deformity, surgical technique, surgical time, methods and course of anesthesia, intra- and postoperative complications, parents’ satisfaction, head form. Results. 24 patients were treated. The mean patient’s age at the time of surgery was 13.47 ± 8.2 months (min 7.3, max 46.5). Eliminating 3 patients whose age at the time of surgery was over 2 years (24.5, 29 and 46 months, respectively), the mean age of other 21 patients was 10.63 ± 1.77 (min 7.3, max 14.1) months. There were 9 cases of isolated trigonocephaly (37.5%), 7 cases of isolated scaphocephaly (29.2%), 7 cases of isolated anterior plagiocephaly (29.2%) and 1 case of posterior plagiocephaly combined with scaphocephaly (4.17%). All craniosynostoses were diagnosed clinically and diagnosis was confirmed with computed tomographic scanning. The median duration of surgery was 336.47 ± 59.63 minutes (min 308.13, max 364.82). The medium stay in the intensive care unit was 2.53 ± 1.28 days (min. 1.92, max 3.14). In all cases rigid osteosynthesis was performed. 2 children were diagnosed with syndromic craniofacial abnormalities. In 23 (95.83%) cases an intraoperative or postoperative blood transfusion was required. In 24 treated patients there was no mortality. During the early and late postoperative period no infections, CSF leakage and dural tears were observed. No neurological impairments or any signs of neurological deficits were observed by any of the treated patients. In all of cases parents were satisfied with their children’s changed head shape and aesthetic results. Conclusions. Cranioplasties for correction of craniosynostosis give good aesthetic results and this is a safe method, which helps to correct the head shape as well as improves the social adaptation of patients.

scholarly journals MODERN METHODS OF ENDOSCOPIC ENUCLEATION OF BENIGN PROSTATIC HYPERPLASIA AND PROSPECTS FOR THEIR MODIFICATION

2021 ◽  
pp. 20-29
Author(s):  
E. N. Bolgov ◽  
F. A. Sevryukov ◽  
V. V. Zhezdrin ◽  
R. N. Bobrovsky ◽  
M. A. Volodin
Keyword(s):  
Surgical Treatment ◽  
Benign Prostatic Hyperplasia ◽  
Laser Energy ◽  
Low Frequency ◽  
Complete Removal ◽  
Infectious Complications ◽  
Prostatic Hyperplasia ◽  
Anatomical Landmarks ◽  
Surgical Methods ◽  
Endoscopic Enucleation

The disadvantage of bipolar and holmium enucleation in transurethral surgery of benign prostatic hyperplasia (BPH) is the frequent postoperative urination disorders. To increase the effectiveness of surgical treatment, a modification of the surgical technique is necessary.Objective: to compare the perioperative results of endosurgical treatment of large sized BPH using transurethral bipolar (TUEB), laser (HoLEP) and modified laser prostate enucleation (HoLEP-M) methods. Patients and methods: A randomized prospective study was conducted according to the results of surgical treatment of 1104 patients with BPH with a volume of 80 to 350 cm3, divided by methods of endoscopic enucleation of the prostate. A mod-ification of the HoLEP technique was to optimize access to the surgical site with the designation of new anatomical landmarks.Results: Comparison of surgical methods showed their equivalence in the volume of removed tissue, the low frequency of hemorrhagic and infectious complications, the dynamics of urological indicators in the delayed period. TUEB has the least parameters for the time of surgical intervention (98.2 ± 2.24 min.), the vol-ume of blood loss (65.5 ± 1.83 ml), the terms of postoperative catheterization of the bladder (2.0 ± 0.32 days), and the days of hospitalization (3.2 ± 0.40 days). The safety of laser methods is higher than TUEB, during which 3.1% of closed perforations of the prostatic capsule and bladder were observed (versus 0.8-1.5% with laser methods). Modification of the HoLEP technique allows reducing the frequency of late dysuric disorders by 2-3 times, urinary incontinence by 3.4-4 times, cicatricial complications by 1.7-2 times.Conclusion: Bipolar and laser methods of transurethral enucleation of the prostate of large sizes are comparable by criteria of complete removal of prostatic tissue, effectiveness and tolerability in patients with thrombohemorrhagic risk. In terms of the frequency of intraoperative injuries, the safety of laser methods is higher due to the reduced penetrating ability of laser energy. Modification of surgical access to the prostate preserves the prostatic urethra as much as possible and is a promising measure for the prevention of late obstructive and functional complications of transurethral interventions.

scholarly journals Gastric bypass in modern bariatric surgery

2020 ◽  
Vol 17 (2) ◽  
pp. 130-137
Author(s):  
Oral B. Ospanov ◽  
Galymzhan A. Yeleuov ◽  
Farida K. Bekmurzinova
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Surgical Treatment ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Promising Alternative ◽  
Advantages And Disadvantages ◽  
Surgical Methods ◽  
Treatment Of Obesity ◽  
Surgical Treatment Of Obesity

The Roux-en-Y Gastric bypass surgery has long been considered as the gold standard method for the surgical treatment of obesity and its complications. But at present, this position is disputed by supporters of one-anastomotic gastric bypass and sleeve gastrectomy. The decrease in the share of gastric bypass in the structure of bariatric operations is explained by technical complexity, surgical and malabsorption complications. This review reflects the main role of gastric bypass as a bariatric surgery in the treatment of obesity and metabolic syndrome, and discloses various options for the technical implementation of gastric bypass surgery according to Roux-en-Y and alternative one-anastomotic gastric bypass surgery. The advantages and disadvantages of the stapler-use and stapleless method for performing bariatric operations are shown. In our opinion, one of the promising alternative concepts for the surgical treatment of obesity is stapleless one-anastomotic direction in gastric bypass surgery, but the known stapleless methods are imperfect and unsafe. Thus, based on the presented literature review, we can conclude that the imperfection of not only the stapler gastric bypass methods, but also the stapleless method. Therefore, a further research is needed for alternative surgical methods that would reduce the likelihood of surgical complications, reduce the cost of bariatric surgery and increase the accessibility of surgical treatment of obesity for the population.

LASER TECHNOLOGIES IN SURGERY BENEFICIAL PROSTATE HYPERPLASIA

2021 ◽  
pp. 144-153
Author(s):  
Rakhimov S.A. ◽  
Feofilov I.V. ◽  
Arbuzov I.A.
Keyword(s):  
Surgical Treatment ◽  
Benign Prostatic Hyperplasia ◽  
Transurethral Resection ◽  
Prostate Gland ◽  
Prostatic Hyperplasia ◽  
Prostate Hyperplasia ◽  
Advantages And Disadvantages ◽  
Laser Technologies ◽  
Surgical Methods ◽  
Laser Systems

Benign prostatic hyperplasia is one of the most common diseases in urological practice. The classical method of surgical treatment of benign prostatic hyperplasia is transurethral resection of the prostate gland. However, this operation is accompanied by a fairly large number of postoperative complications and is not recommended for patients with a large prostate volume, with a high cardiovascular risk, and receiving anticoagulant therapy. In recent years, the medical community has been paying close attention to laser technologies. The article provides an overview of the literature on laser methods for the treatment of benign prostatic hyperplasia. Modern laser systems are considered: holmium, thulium, diode, «green» lasers. The advantages and disadvantages of each technique are described. The results of studies of the efficacy and safety of laser surgical methods for the treatment of benign prostatic hyperplasia and their influence on the indicators of urodynamics, symptoms of the disease, and the quality of life of patients are presented. Based on the analysis of scientific literature sources, it was concluded that laser methods of surgical treatment of benign prostatic hyperplasia are clinically effective and safe. Compared with transurethral resection of the prostate, laser technologies can shorten the period of hospitalization and catheterization of patients, have a low number of complications, provide good hemostasis, and can be used regardless of the volume of the gland in patients with concomitant diseases who are taking anticoagulants. Laser methods of surgical treatment of benign prostatic hyperplasia are currently a full-fledged worthy alternative to transurethral resection of the prostate gland. Among the disadvantages of using laser systems are the duration of the operation and the need to train specialists in the technique of surgical intervention.

scholarly journals Surgical techniques used for tonsil disease in children

2015 ◽  
Vol 62 (3) ◽  
pp. 294-297
Author(s):  
A. Zamfir-Chiru-Anton ◽  
◽  
D.C. Gheorghe ◽  
Keyword(s):  
Quality Of Life ◽  
Surgical Treatment ◽  
Surgical Techniques ◽  
The Other ◽  
Intraoperative Blood Loss ◽  
Advantages And Disadvantages ◽  
Surgical Methods ◽  
Surgical Options ◽  
The Difference

The authors review the techniques described for the surgical treatment of the tonsils. Each new method has its own advantages and disadvantages. The difference can be evaluated by studying the intraoperative blood loss and safety of the procedure. Also, the postoperative complications and quality of life can be used as an adjunct to objectively appreciate the different surgical techniques. There is no literature consensus about the superiority of one technique over the other. Multiple studies brought multiple significant results. It is also hard to evaluate the entire panel of surgical methods described concomitantly. The experience of one surgeon and his/her mastering of a certain technique is the actual cause of so many surgical options still in use for tonsil treatment in children.

scholarly journals Surgical correction of degenerative sagittal imbalance of the lumbar spine

2020 ◽  
Vol 17 (2) ◽  
pp. 49-57
Author(s):  
E. S. Baikov ◽  
A. V. Peleganchuk ◽  
A. J. Sanginov ◽  
O. N. Leonova ◽  
A. V. Krutko
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Interbody Fusion ◽  
Leg Pain ◽  
Sagittal Imbalance ◽  
Number Of Patients ◽  
Surgical Methods ◽  
Duration Of Surgery ◽  
Surgical Data ◽  
The Ideal

Objective. To analyze the early clinical and radiological outcomes of lumbar spine fusion in patients with degenerative sagittal imbalance.Material and Methods. The data of 45 patients who were operated on sequentially using a combination of surgical methods for vertebrogenic pain syndrome and (or) neurological deficit and who had a violation of the sagittal balance of degenerative origin were analyzed. All patients underwent anterior spinal fusion at the L4–L5, L5–S1 levels to correct and restore lower lumbar lordosis. The next stage was decompression through posterior approach, if necessary supplemented by interbody fusion at clinically significant lumbar levels above the L4–L5 segment. In all patients, surgical treatment was completed with screw transpedicular fixation at the levels of interbody fusion.  Demographic, clinical and surgical data, and radiological parameters were evaluated.Results. The study included data from 6 men and 39 women with an average age of 58.9 ± 7.8 years. Duration of hospital stay was 27.1 ± 7.4 days. The primary surgery was performed in 33 (73.3 %) patients, and the reoperation for pain recurrence after previous surgery at the same lumbar level – in 12 (26.7 %) patients. The duration of surgery was 529.8 ± 117.8 min, the blood loss was 1130.4 ± 560.1 ml. Back and leg pain VAS score decreased after surgery from 6.7 ± 0.9 and 4.7 ± 1.4 to 3.3 ± 0.9 and 0.5 ± 0.6, respectively (p < 0.001). The ideal sagittal type according the Russoly’s classification was restored in 27 (60 %) cases, that below the ideal – in 9 (20 %), and hypercorrection was in 9 (20 %). PT decreased from 26.1° ± 5.7° to 17.4° ± 3.9° (p < 0.001) and SVA – from 6.7 ± 3.5 to 2.7 ± 2.3 cm (p < 0.001). LL increased from 36.3° ± 18.5° to 55.1° ± 11.8° (p < 0.001) and Low LL – from 13.5° ± 9.8° to 37.9° ± 8.2° (p < 0.001). According to GAP, the number of patients with severe and moderate imbalance was reduced (p < 0.001). Surgical complications were observed in 26 (57.7 %) patients.Conclusion. The multi-stage surgical treatment of patients with degenerative spinal deformities using corrective fusion in the lumbar spine significantly improves parameters of the spinopelvic and global sagittal balances in the early postoperative period.  

Evaluation of mid-term results of bipolar transurethral resection in the treatment of benign prostatic hyperplasia

2018 ◽  
pp. 1-9
Author(s):  
А.С. Векильян
Keyword(s):  
Surgical Treatment ◽  
Benign Prostatic Hyperplasia ◽  
Blood Loss ◽  
Endoscopic Surgery ◽  
Transurethral Resection ◽  
Operating Time ◽  
Clinical Results ◽  
Massive Bleeding ◽  
Prostatic Hyperplasia ◽  
Surgical Methods

Представлены клинические результаты хирургического лечения доброкачественной гиперплазии предстательной железы (ДГПЖ) объемом до 100 см3 методом биполярной трансуретральной резекции простаты (БТУР -74 пациента) в сравнении с открытой чреспузырной простатэктомией (ОПЭ - 96 пациентов), ранее применявшейся для подобных клинических случаев в урологической клинике "Железнодорожной больницы" г. Волгоград. При статистически равном операционном времени обоих хирургических методов для БТУР отмечено существенное снижение интраоперационной кровопотери, сроков послеоперационной катетеризации и пребывания в стационаре, минимальная частота геморрагических и инфекционно-воспалительных осложнений. Наблюдение за урологическим статусом пациентов в течение первого послеоперационного года показало одинаковую клиническую эффективность сравниваемых хирургических методов. Значительное снижение объема кровопотери в ходе операции БТУР можно считать большим достижением, поскольку улучшение видимости в зоне хирургического вмешательства позволяет оптимизировать гемостаз, предотвратить массивные кровотечения как во время, так и после операции, сократить сроки послеоперационной катетеризации мочевого пузыря, что в свою очередь, снижает частоту развития инфекционно-воспалительных осложнений. Более быстрое восстановление пациентов после эндоскопических операций имеет медико-социальное и экономическое значение, поскольку минимальное количество послеоперационных осложнений и сокращение сроков госпитализации позволяет существенно снизить затраты на лечение и быстрее нормализовать качество жизни пациентов. Полученные результаты демонстрируют перспективность внедрения биполярных методов эндоскопических операций для лечения ДГПЖ в хирургическую практику урологических стационаров в целях повышения безопасности оперативного лечения и экономии затрат на госпитализацию. The clinical results of surgical treatment of benign prostatic hyperplasia (BPH) up to 100 cm3 by bipolar transurethral resection of the prostate (BTUR - 74 patients) in comparison with open transvesical prostatectomy (OPE - 96 patients), previously used for such clinical cases in the urological clinic "Railway hospital" in Volgograd are presented. With statistically equal operating time of both surgical methods, there was a significant decrease in intraoperative blood loss, the terms of postoperative catheterization and hospital stay, the minimum frequency of hemorrhagic and infectious-inflammatory complications. Observation of the urological status of patients during the first postoperative year showed the same clinical efficacy of the compared surgical methods. A significant reduction in the volume of blood loss during the operation, can be considered a great achievement, since the improvement of visibility in the area of surgical intervention allows to optimize the hemostasis, to prevent massive bleeding during and after surgery, to reduce the duration of postoperative bladder catheterization, which, in turn, reduces the incidence of infectious-inflammatory complications. Faster recovery of patients after endoscopic surgery of medical,social and economic importance, as the minimum number of postoperative complications and reduction of hospitalization can significantly reduce the cost of treatment and quickly normalize the quality of life of patients. The results demonstrate the prospects of the introduction of bipolar methods of endoscopic surgery for the treatment of BPH in the surgical practice of urological hospitals in order to improve the safety of surgical treatment and save costs for hospitalization.

Experience in surgical treatment of idiopathic macular ruptures in Orenburg branch of The S. Fyodorov Eye Microsurgery Federal State Institution

2021 ◽  
pp. 97-100
Author(s):  
A.S. Firsov ◽  
◽  
A.D. Chuprov ◽  
V.A. Trubnikov ◽  
A.E. Voronina ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Silicone Oil ◽  
Platelet Rich Plasma ◽  
Functional Results ◽  
State Institution ◽  
Federal State ◽  
Rate Of Increase ◽  
Surgical Methods ◽  
Medical Effectiveness ◽  
Group 5

Purpose. To study the anatomical and functional results of various methods of surgical treatment of idiopathic macular rupture. Material and methods. In the course of this study, 50 medical records of patients with a diagnosis of macular rupture were randomly selected from the total number of those, who underwent the surgery at the Orenburg branch of The S. Fyodorov Eye Microsurgery Federal State Institution for 2020 year. Patients were divided into 3 groups. In the first group (38 eyes), the macular rupture was closed using ACP and PRP, in the second group (7 eyes) – using an inverted flap of the internal border membrane, in the third group (5 eyes) – by mechanical convergence of the edges of the rupture followed by tamponade of the vitreous cavity with silicone oil. Results. To assess the medical efficiency of the studied methods of surgical treatment of idiopathic macular rupture, the rate of increase in the maximum corrected visual acuity (MCVA) was calculated for each patient. Conclusion. The calculated indicator of the dynamics of vision improvement «the rate of BCVA growth» as a whole reflects the positive dynamics of the treatment of idiopathic macular rupture by surgical methods and can be used to assess the medical effectiveness of methods of treating patients with eye diseases initially with different values of the BCVA parameter. In the course of the analysis, no significant differences were found between the influence of various methods of surgical treatment of macular rupture on the rate of BCVA growth or rupture closure. Correlation analysis did not establish a statistically significant dependence of the growth rate of BCVA on the initial size of the rupture. Key words: macular rupture, inverted flap, platelet-rich plasma (PRP), autologous conditioned plasma (ACP).

scholarly journals Endoscopic 3-S Technique Tympanoplasty: Taking the Convention a Step Ahead

2019 ◽  
Vol 27 (3) ◽  
pp. 179-185
Author(s):  
Mridul Janweja ◽  
Sayan Hazra ◽  
Arindam Das ◽  
Arya Brata Dubey
Keyword(s):  
Endoscopic Surgery ◽  
Routine Activity ◽  
Middle Ear Surgery ◽  
Graft Material ◽  
Operating Microscope ◽  
Advantages And Disadvantages ◽  
Post Operative Pain ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Introduction Endoscopic Surgery has immense potential for middle ear surgery and is currently favoured by many surgeons. The 3 (vascular) Strips/ 3 Flap Tympanoplasty with operating microscope is popular but Endoscopic 3-Flap Tympanoplasty remains less explored. Hence this study was conducted to compare advantages and disadvantages of Endoscopic and Microscopic 3-Flap Tympanoplasty. Materials and Methods Forty two patients with large/subtotal perforation of tympanic membrane were divided into two equal groups (Group A & B). Endoscope was used in Group A, whereas, operating microscope in Group B. Temporalis fascia was the graft material in all patients. Patients were followed up for six months. Pre and post-operative audiograms, post-operative pain, graft uptake, time taken for surgery and intra-operative visualization convenience were compared. Results Mean Air-Bone Gap closure at the end of six months was 9.23 dB (SD-0.88 dB) in the endoscope group and 8.95 dB (SD-0.66 dB) in microscope group whereas the graft uptake rate was 95.2% and 90.2% respectively. Post-operative pain, cosmesis, ease of doing surgery and time taken for surgery were better in ‘Endoscope’ as compared to ‘Microscope’ group. Conclusion The three flaps produce adequate exposure in very large or subtotal perforations, very thin anterior rim or with anterior bony overhang. Results in terms of mean hearing gain and graft uptake were comparable. In terms of morbidity (post-op pain), recovery (return to routine activity), mean duration of surgery and cosmesis, endoscopic surgery produced better outcome.

scholarly journals Treatment of Facial Nevi with Ideal Design and Splitting Technique

2021 ◽  
Author(s):  
Qiang Sun ◽  
Jiayan Guo ◽  
Siyu Liu ◽  
Mengru Zhu ◽  
Jingyi Feng ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Plastic Surgery ◽  
Surgical Excision ◽  
Added Value ◽  
Complete Excision ◽  
Splitting Technique ◽  
Surgical Methods ◽  
Serial Excision ◽  
Non Surgical Treatment

Abstract Background: The treatment of nevi includes surgical treatment and non-surgical treatment. Non-surgical treatment has many defects in the clinic, whereas surgical treatment is applicable to any type of nevi. However, there is no unified standard for surgical methods. Methods: Patients with facial nevi ( width ≤4 cm) and high requirements for beauty were included. Preoperatively, incision design and resection range based on the recommended wrinkles or folds of each region and principle of plastic surgery. Intraoperatively, a nevus flap was formed, and then equally divided by splitting technique. After the splitting nevus flap was resected, suture without tension was performed. Results: 21 patients underwent surgical excision. 14 patients underwent complete excision, while 7 patients underwent serial excision. The patients were satisfied with the appearance, local sensations were normal, and there were no secondary deformities of the surrounding facial organs without recurrence.Conclusion: This method is of added value, which achieved by the correct assessment of the size and location of facial nevi and designed according to the reference marks in each region and complete or serial excision.

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