scholarly journals Clinical and morphological assessment of the effectiveness of using the radiowave surgery device «surgitron» and high – frequency electrosurgical device «kls martin» for treatment of patients with combined pathology of anal canal and rectum

2019 ◽  
Vol 1 (7) ◽  
pp. 25-32
Author(s):  
V.V. Balytskyy ◽  
O.G. Kuryk ◽  
M.P. Zakharash
Keyword(s):  
Blood Loss ◽  
Anal Canal ◽  
Radio Wave ◽  
Postoperative Period ◽  
High Frequency ◽  
Inpatient Treatment ◽  
Surgical Techniques ◽  
Morphological Examination ◽  
Narcotic Analgesics ◽  
Surgical Interventions

The aim – to analyze the results of treatment of patients with combined pathology of the anal canal and rectum using Surgitron radio wave surgery and high-frequency electrosurgery "KLS Martin". Materials and methods. The analysis of surgical treatment of 236 patients with combined anal canal and rectum with Surgitron radio wave surgery, 50 patients using KLS Martin high-frequency electrosurgery and 112 patients who have been traditionally operated using a metal scalpel. After surgical interventions using radio-wave and high-frequency electrosurgery devices, morphological examination of tissues was conducted to study the depth of their necrosis. Results. It has been established that the use of Surgitron, as well as the high-frequency electrosurgical apparatus "KLS Martin", reduces the duration of the surgery to 15 ± 5 minutes, reduces the volume of blood loss to 20 ± 10 ml, the need for narcotic analgesics to 2 ± 1 ml, and terms of inpatient treatment of patients up to 4 ± 1 day. The results of the morphological study indicate that the application of the above-mentioned surgical techniques leads to a negligible depth of tissue necrosis from 0.165 ± 0.11 mm using the Surgitron apparatus to 0.192 ± 0.12 mm when used with the KLS Martin apparatus, ensuring cosmetic operations. Conclusions. The use of the Surgitron radio-wave surgery and the KLS Martin electrosurgical apparatus for the treatment of patients with combined pathology of the anal canal and rectum due to insignificant tissue effects contributes to reducing the duration of the operation, reducing the volume of intraoperative blood loss, significantly reducing the pain in the postoperative period, reduction of the terms of inpatient treatment of patients, which determines their rapid medical and social rehabilitation. Also due to the minimal effect on the tissue, the healing of the postoperative wound is faster, which contributes to the formation of a delicate elastic scar and prevents the formation of scar strictures of the anal canal, as well as insufficiency of the anal sphincter in the postoperative period.

scholarly journals Modern methods of surgical treatment of anal canal and rectum combined pathology

2021 ◽  
Vol 88 (1-2) ◽  
pp. 14-18
Author(s):  
V. V. Balytskyy ◽  
M. P. Zakharash ◽  
O. G. Kuryk
Keyword(s):  
Surgical Treatment ◽  
Anal Canal ◽  
Radio Wave ◽  
High Frequency ◽  
Narcotic Analgesics ◽  
Surgical Interventions ◽  
Combined Operations ◽  
Modern Methods ◽  
Duration Of Operation ◽  
Anorectal Pathology

Objective. To evaluate the effectiveness of surgical treatment of anal canal and rectum combined pathology, through combined surgical interventions using modern electro- and radiosurgical technologies. Materials and methods. A comparative evaluation of the results of surgical treatment of 681 patients with combined pathology of the anal canal and rectum, who underwent combined single-stage operations using high-frequency electrosurgery and radio-wave surgery. Results. In case of application the device for radio-wave surgery "Surgitron", and also devices of high-frequency electrosurgery "ERBE ICC 200", "EFA", "KLS Martin" duration of operation is reduced to (15 - 25 ± 3) minutes, volume of blood loss decreases to (15 ± 6) ml, the need for narcotic analgesics decreases up to (2 ± 1) ml, the duration of inpatient treatment was reduced up to (4 ± 1) days. Conclusions. The use of modern radio- and electrosurgical technologies for the treatment of combined anorectal pathology prevents the occurrence of anal canal strictures and scarring of the perianal areas, causing the cosmeticity of combined operations.

scholarly journals Morphological evaluation of anal canal wound healing after combined operations for combined anorectal pathology

2021 ◽  
Vol 27 (4) ◽  
pp. 13-21
Author(s):  
V.V. Balytskyy
Keyword(s):  
Wound Healing ◽  
Connective Tissue ◽  
Anal Canal ◽  
Postoperative Period ◽  
High Frequency ◽  
Inpatient Treatment ◽  
Study Groups ◽  
Postoperative Wound ◽  
Combined Operations ◽  
Morphological Assessment

The urgency of the problem of postoperative wound healing after combined operations for combined pathology of the anal canal and rectum is quite high and contributes to the introduction into the practice of coloproctologists of new modern surgical technologies for the treatment of this pathology. The aim of the study was to conduct a comparative morphological assessment of postoperative wound healing in patients with combined pathology of the anal canal and rectum after combined operations using modern high-frequency electrosurgical and radiosurgical technologies. The results of surgical treatment of 689 patients with combined pathology of the anal canal and rectum using high-frequency electrosurgery and radiowave surgery with morphological assessment of wound healing on 3, 5, 7, 14, 21 days of the postoperative period, which were divided into 4 study groups. Using of “Surgitron” and “KLS Martin” devices for the treatment of patients with combined pathology of the anal canal and rectum was accompanied by the formation of the thinnest layers of coagulation necrosis in tissues with a depth of 0.189±0.085 mm and 0.194±0.090 mm respectively and as result patients of the first and fourth study groups had the shortest duration of inpatient treatment, which was 3-5 days and the average time of wound healing, which was 14-15 days. Patients in these study groups had the lowest inflammatory neutrophil reaction in postoperative wounds on day 3, which rapidly disappeared by day 5, on days 7-14 they had active reparative processes with the appearance of fibroblasts and connective tissue fibers, and on 21 day squamous epithelial cells, which indicated the processes of active epithelialization of wounds. The effect on the tissues of the devices “EFA” and “ERBE ICC 200” was deeper than in the above groups, forming a layer of coagulation tissue necrosis with a depth of 0.208±0.097 mm and 0.302±0.107 mm respectively, which was accompanied by patients of the third and second study groups with longer terms of inpatient treatment, which amounted to 5-7 days and increase the duration of wound healing, which amounted to 16-19 days. Patients in the 2nd and 3rd study groups showed a more pronounced inflammatory neutrophilic reaction in postoperative wounds on the 3rd day, which did not disappear until the 5th day and in half of the cases the presence of a significant number of segmental neutrophils and bacterial accumulations persisted. On days 7-14 they had weak reparative processes with the appearance of single fibroblasts and a small number of connective tissue fibers and on the 21st day single squamous epithelial cells, which indicated slow processes of wound epithelization. Using of radio-wave surgery and high-frequency electrosurgery devices promotes active epithelialization of tissues preventing scar strictures of the anal canal and improves the rehabilitation of patients in the postoperative period.

scholarly journals Effectiveness of the concept of fast-trak surgery for simultaneous laparoscopic hernioplastics and cholecistectomy

2021 ◽  
Keyword(s):  
Postoperative Period ◽  
Inpatient Treatment ◽  
Fast Track ◽  
Early Postoperative Period ◽  
Wound Complications ◽  
Fast Track Surgery ◽  
Surgical Interventions ◽  
Group I ◽  
Laparoscopic Hernioplasty ◽  
Group Ii

The aim of the research was to study the feasibility and effectiveness of simultaneous laparoscopic hernioplasty and cholecystectomy in patients with combined abdominal pathology. Material and methods. Simultaneous laparoscopic hernioplasty and cholecystectomy during 2015–2019 performed on 70 patients, including 49 (70 %) women, mean age 57.3 ± 6.5 g. In 37 patients the principles of Fast-track surgery were applied (group I), including thorough examination for diagnostics of combined abdominal pathology and clinically significant general somatic pathology; if necessary a course of therapy for full compensation of general somatic pathology was prescribed; during the operation of epidural prolonged anesthesia; choice in favor of laparoscopic technology; at the end of the operation – irrigation of the subdiaphragmatic space with local anesthetic; postoperatively: early drainage removal; withdrawal from opioids by prescribing parenteral paracetomol; activation of the patient 6-8 hours after surgery; on the day of surgery – use of chewing gum and fluid intake. In 33 patients the standard complex of perioperative management (group II) is applied. The immediate results of surgical interventions have been studied. Results. There were no significant complications during the operation and in the early postoperative period. In the first group, seroma (after open alloplasty) was detected in 2 (5 %) cases, and in the second group, small wound complications were detected in 4 (12 %) cases (p > 0.05 according to the χ2 criterion). The duration of inpatient treatment in patients of group I is 4.4 ± 1.2 months, in group II – 7.0 ± 1.3 days (р < 0.001 by Student’s test). Conclusion. Application of the principles of Fast-track surgery and accelerated recovery at all stages of simultaneous laparoscopic hernioplasty and cholecystectomy (preparation for surgery, during the operation and in the postoperative period) does not increase the number of postoperative complications and decreased duration of inpatient treatment from 7,0 ± 1,3 in patients with traditional postoperative management to 4,4 ± 1,2 days.

scholarly journals Methods of reducing blood loss during reconstructive operations on the uterus

2003 ◽  
Vol 52 (3) ◽  
pp. 85-94
Author(s):  
V. M. Orlov ◽  
Y. V. Kovalyova
Keyword(s):  
Blood Loss ◽  
Postoperative Period ◽  
Young Patients ◽  
Surgical Techniques ◽  
Early Postoperative Period ◽  
Muscular Tissue ◽  
Operative Blood Loss ◽  
Massive Blood Loss ◽  
Reconstructive Operations ◽  
Tissue Defects

There can be no doubt about expediency of reconstructive operations on the uterus in young patients. These operations make it possible to preserve reproductive and menstrual function. However, such operations are accompanied by formation of extensive wound surfaces, considerable muscular tissue defects and characterized by high traumatism, quite often impossibility to ensure effective hemostasis and massive blood loss during operation. In this connection a number of complications during early postoperative period is higher than after hysterectomy. Taking into account the above, it is actual to use the surgical techniques which allow to reduce traumatism of operation and ensure effective hemostasis. In present review different methods used for ensuring hemostasis and reducing operative blood loss during reconstructive operations on the uterus are considered.

scholarly journals Comparative estimation of a pain syndrome in patients after combined operations for coexistent pathology of anal channel and rectum with application of modern and standard surgical technologies

2021 ◽  
Vol 88 (5-6) ◽  
pp. 36-41
Author(s):  
V. V. Balytskyy
Keyword(s):  
Surgical Treatment ◽  
Thin Layer ◽  
Radio Wave ◽  
Postoperative Period ◽  
High Frequency ◽  
Pain Syndrome ◽  
Coagulation Necrosis ◽  
Control Group ◽  
Combined Operations ◽  
Frequency Apparatus

Objective. Comparative estimation of the pain syndrome in patients with concomitant pathology of anal channel and rectum after performance of combined operations, using modern high-frequency electro-surgical and radio-surgical apparatuses, as well as conventional scalpel. Materials and methods. The results of surgical treatment of 689 patients with concomitant pathology of anal channel and rectum, using apparatuses of a high-frequency electro-surgery and radio-wave surgery, were analyzed, using the pain syndrome estimation on 1-7th postoperative day. The patients were distributed into 4 investigation groups and a control group, consisting of 112 patients, operated on using metallic conventional surgical scalpel. Results. The pain syndrome on the first postoperative day was mostly expressed in patients of control group, for anesthesia they needed (4 ± 1) ml of 2% solution of promedol, while the patients of the first, third and fourth groups investigated, in which, accordingly, apparatus of radio-wave surgery «Surgitron» and high-frequency electro-surgical apparatuses «EFA» and «KLS Martin» were used, needed for anesthesia (2 ± 1) ml of 2% solution of promedol. While application of the electro-surgical high-frequency apparatus «ERBE ICC 200» the necessity for the 2% solution of promedol for anesthesia have constituted (3 ± 1) ml. Conclusion. Combined operations, using modern apparatuses of high-frequency electro-surgery and radio-wave surgery give significantly better results, than application of conventional surgical metallic scalpel, because it produces significantly reduced pain syndrome due to thin layer of coagulation necrosis, promoting formation of delicate elastic cicatrix and preventing development of cicatricial strictures of anal channel in postoperative period.

scholarly journals Results of combined anesthesia application with the usage of non-narcotic analgesics in the surgical oncology practice

2012 ◽  
Vol 93 (3) ◽  
pp. 431-434 ◽  
Author(s):  
S Z Tanatarov
Keyword(s):  
Postoperative Period ◽  
Rating Scales ◽  
Surgical Oncology ◽  
Early Postoperative Period ◽  
Cardiac Monitoring ◽  
Control Group ◽  
Narcotic Analgesics ◽  
Surgical Interventions ◽  
Combined Anesthesia ◽  
Oncology Practice

Aim. To evaluate the effectiveness of pre-, intra- and postoperative intravenous administration of paracetamol in combined anesthesia in patients undergoing surgical interventions in the surgical oncology practice. Methods. Examined were 35 patients aged from 43 to 75 years, operated on under combined anesthesia. During the operation and after its completion an infusion of liquid paracetamol at a dose of 3.3 mg/h was performed. Cardiac monitoring was conducted, the content of cortisol in the blood and the Bispectral Index were determined. The pain indices measured by visual analogue and digital rating scales were determined in the postoperative period. The control group included 35 patients in whom anesthesia was performed without the use of paracetamol. Results. During the infusion of paracetamol an adequate level of analgesia was achieved without development of adverse reactions on the part of the vital systems. The use of paracetamol in the early postoperative period contributed to the reduction of pain on digital rating and visual analogue scales compared to the group with basic anesthesia. Conclusion. The use of liquid paracetamol is a promising and safe method of additional analgesia.

scholarly journals SURGICAL TREATMENT OF COMBINED ANORECTAL PATHOLOGY USING CURRENT TECHNOLOGIES

2021 ◽  
Vol 29 (4) ◽  
pp. 434-444
Author(s):  
V.V. Balytskyy ◽  
◽  
M.P. Zakharash ◽  
E.G. Kuryk ◽  
Y.M. Zakharash ◽  
...  
Keyword(s):  
Radio Wave ◽  
High Frequency ◽  
Tissue Necrosis ◽  
Treatment Results ◽  
Surgical Interventions ◽  
Combined Operations ◽  
Study Results ◽  
Cosmetic Effect ◽  
Operation Duration ◽  
Anorectal Pathology

Objective. To evaluate the effectiveness of application radio-wave surgery device “Surgitron” and high-frequency electrosurgery devices “ERBE ICC 200”, “EFA”, “KLS Martin” for treatment of patients with combined anorectal pathology. Methods. The treatment results of patients (n=635) with a combined anorectal pathology have been analyzed. The use of the «Surgitron» radio-wave surgery apparatus 245 (38.6%) patients were operated on, the «ERBE ICC 200» high-frequency electrosurgery apparatus - 169 (26.6%) patients, the «EFA» high-frequency electrosurgery apparatus - 114 (17.9 %) patients, «KLS Martin» high-frequency electrosurgery apparatus - 107 (16.9%) patients. After those surgical interventions to assess the effectiveness of the abovementioned current technologies, patients were conducted a morphological examinationto determine the depth of the necrosis of tissues. Results. According to the study results it has been established that application of the “Surgitron” radio-wave surgery device, “ERBE ICC 200” high-frequency electrosurgical devices “EFA”, “KLS Martin” reduces duration of the operation up to 15-30 min, the volume of bleeding - up to 10-30 ml, need in narcotic drugs - up to 1-4 ml, period of hospitalization - up to 3-6 days. Using these technologies prevented the formation of anal strictures and scar pararectal deformations due to the insignificant depth of tissue necrosis (the depth 0,036 -l 0,453 mm), ensuring the cosmetic effect of combined operations. Conclusion. Application of the “Surgitron” radio-wave surgery device and “ERBE ICC 200” high-frequency electrosurgical devices, “EFA”, “KLS Martin” for treatment of patients with combined anorectal pathology reduces the operation duration, volume of bleeding and intensity of the postoperative pain. Use of these current technologies promotes the formation of a delicate elastic scar causing faster healing of postoperative wounds and improving the terms of patients’ rehabilitation. What this paper adds A comparative evaluation of the effectiveness of using high-frequency electrosurgery devices “ERBEICC 200”, “EFA”, “KLSMartin” and radio-wave surgery device “Surgitron” for treatment of patients with combined anorectal pathology has been firstly made; also a degree of pathomorphological changes in tissues of anal canal and rectum after using the aforementioned current technologies has been studied to assess the effectiveness of their use for treatment of combined anorectal pathology.

scholarly journals Technique for Spleen Resection Using Radiofrequency Ablation

2021 ◽  
pp. 1-7
Author(s):  
Ionkin Dmitry ◽  
Ionkin Dmitry ◽  
Stepanova Yulia Aleksandrovna ◽  
Alimurzaeva Maksalina Zakaryaevna ◽  
Vishnevsky Vladimir Aleksandrovich
Keyword(s):  
Comparative Analysis ◽  
Radiofrequency Ablation ◽  
Blood Loss ◽  
Postoperative Period ◽  
Surgical Intervention ◽  
Clinical Manifestations ◽  
Spleen Tissue ◽  
Surgical Interventions ◽  
National Medical ◽  
A New Technique

From modern positions, removal of the spleen is undesirable due to the risk of post-splenectomy syndrome development, where first of all, the clinical manifestations of the syndrome of suppressive post-splenectomy infections are taken into account, which justifies either performing organ-preserving surgical interventions on the spleen, or heterotopic autotransplantation of spleen tissue. Spleen resection is accompanied by significant blood loss, both during the intervention and in the postoperative period. The various methods of prevention of bleeding (clips, coagulation instruments, local hemostatics, etc.) are not always effective. Currently, there have been reports of the possibility of using radiofrequency ablation (RFA) in interventions on the spleen. The literature data and own 10 observations of spleen resection with the use of RFA in patients with focal organ lesions are presented. All described in literature technologies use the Rita® device for RF destruction and the corresponding attachment, which consists of 4 needle active electrodes. The spleen parenchyma is "burned" blindly, and the organ parenchyma is divided in the middle, between the treated injections. A new technique for performing spleen resection using radiofrequency ablation has been proposed at A.V. Vishnevsky National Medical Research Center of Surgery. The essence of our proposed method for minimizing blood loss during spleen resection is as follows: RFA-exposure is carried out along the zone of organ ischaemia under the control of ultrasound. For RFA, we used a Radionics Cool-Tip® Ablation System and a set of water-cooled electrodes (MEDTRONIC, USA). The features of the surgical intervention are noted. No bleeding was noted either intraoperatively or in the postoperative period in any case. A comparative analysis of the results of various methods of organ-saving surgical treatment is presented.

scholarly journals The choice of surgical treatment in patients with infected pancreonecrosis

2018 ◽  
Vol 177 (6) ◽  
pp. 20-26
Author(s):  
E. A. Tseimakh ◽  
V. A. Bombizo ◽  
P. N. Buldakov ◽  
A. A. Averkina ◽  
D. N. Ustinov ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Surgical Treatment ◽  
Minimally Invasive ◽  
Inpatient Treatment ◽  
Surgical Techniques ◽  
Postoperative Mortality ◽  
Group Comparison ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Minimally Invasive Surgical

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.

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