scholarly journals MINILAPAROTOMIC ACCESS UNDER INTRAOPERATIVE ULTRASOUND NAVIGATION. EXPERIENCE IN THE DEVELOPMENT AND APPLICATION

2016 ◽  
Vol 1 (1) ◽  
pp. 67-71
Author(s):  
DB B Demin ◽  
YuYu Yu Solodov ◽  
AV V Laykov ◽  
MS S Funigin ◽  
NS S Gusev
Keyword(s):  
Surgical Treatment ◽  
Ultrasound Guidance ◽  
Abdominal Cavity ◽  
Intraoperative Ultrasound ◽  
Postoperative Mortality ◽  
Retroperitoneal Space ◽  
Additional Equipment ◽  
One Step ◽  
Equipment Application ◽  
Navigation Experience

Aim - to evaluate the effectiveness of minilaparotomic access under intraoperative ultrasound navigation in the surgical treatment of liquid formations in the abdominal cavity and retroperitoneal space in comparison with the puncture-draining interventions under ultrasound guidance. Material and methods. The analysis covered the treatment of 77 patients with interventions for liquid formations of the abdominal cavity and retroperitoneal space using minimally invasive ultrasound-controlled technologies. Among them, 33 patients underwent puncture-draining interventions under ultrasound navigation (I group). Group II consisted of 44 patients with minilaparotomic surgery under intraoperative ultrasound guidance. Results. It is shown that minilaparotomic access under intraoperative ultrasound navigation allows performing one-step sanitation and drainage of abdominal structures of the abdominal cavity and retroperitoneal space, containing in the lumen not only liquid, but also dense necrotic tissues. Conclusion. The process is technically feasible in any surgical hospital, economically relevant, since it does not require the purchase of additional equipment. Application of this method can significantly reduce postoperative mortality.

scholarly journals Surgical treatment for common hepatic aneurysm. Original one-step technique

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 898-904
Author(s):  
Bruno Amato ◽  
Renato Patrone ◽  
Gennaro Quarto ◽  
Rita Compagna ◽  
Roberto Cirocchi ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Hepatic Artery ◽  
Distal Part ◽  
Intraoperative Ultrasound ◽  
Section Area ◽  
One Step ◽  
A New Technique ◽  
Open Surgical Treatment ◽  
The Right ◽  
Vascular Stapler

AbstractIntroductionHepatic artery aneurysms are rare, and their treatment represents a challenge for the surgeons.Materials and methodsA new technique is presented for common hepatic artery (CHA) aneurysm: it requires minimal vascular surgical dissection and only one linear vascular stapler is applied at the bottom of aneurysm. Aneurysm exclusion is easily obtained, which allowed retrograde thrombosis. Liver blood supply is ensured to the right and left hepatic artery, through the gastroduodenal artery, and can be previously monitored, with temporary clamping of the section area, by visual control, enzyme evaluation and intraoperative ultrasound examination. We reported an open surgical treatment, with simultaneous removal of hepatic and adrenal metastases, secondary to colon cancer.ResultsThe duration of vascular surgery was 30 min and did not involve complications. Postoperative controls confirmed the efficacy of the procedure.DiscussionThis original technique can be added to the various open and endovascular techniques so far described for the treatment of a CHA aneurysm. It is advisable as open surgery, mostly in case of associated pathologies.ConclusionsThe authors believe that this “one shot” technique by vascular staple of the distal part of CHA is minimally invasive and effective to obtain the exclusion of the aneurysm.

scholarly journals Evolution of diagnosis and surgical treatment of intra-abdominal infiltrates, abscesses of primary and postoperative origin in patients

2021 ◽  
pp. 15-29
Author(s):  
V.V. Skyba ◽  
◽  
V.F. Rybalchenko ◽  
A.V. Ivanko ◽  
R.М. Borys ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Gastric Ulcer ◽  
Surgical Treatment ◽  
Abdominal Cavity ◽  
Postoperative Mortality ◽  
Multiple Organ ◽  
Long Term Results ◽  
Control Group ◽  
Study Group ◽  
Perforated Gastric Ulcer

Purpose – to improve the results of surgical treatment of patients with intra-abdominal infiltrates and abscesses through the introduction of the latest imaging methods and surgical technologies. Materials and methods. In the clinic of the Department of Surgical Diseases No 1, on the basis of the Surgery Center of the Kyiv City Clinical Hospital No. 1 from 2006 to 2019 218 patients with primary and secondary intra-abdominal infiltrates, abscesses and fluid formations were treated. The patients’ age ranged from 16 to 85 years. There were 107 (49.08%) male patients, 111 (50.92%) female patients. Depending on the time of hospitalization (by years), the patients were divided into two groups: the control group (CG) (2006–2012) 117 (53.67%) patients and the study group (SG) (2013–2019) 101 (46.33%) patients. The SG used the latest imaging technologies and improved methods of surgical treatment. Results. The patients were divided into two groups: primary in 191 (87.61%) and secondary postoperative infiltrates and abscesses in 27 (12.39%). The causes of primary infiltrates and abscesses were: complicated forms of appendicitis in 74 (33.94%), perforated stomach and duodenal ulcer in 48 (22.02%), complicated forms of cholecystitis in 69 (31.65%). Postoperative infiltrates and abscesses were observed in 27 (12.39%) patients who underwent urgent surgery: adgeolysis of adhesive ileus in 14 (6.42%) and complicated hernias of various localization in 13 (5.97%). Postoperative complications were diagnosed in 43 (19.72%) patients, of whom 34 (15.59%) from the surgical wound and 29 (15.18%) of the abdominal cavity, who required relaparotomy or laparoscopy, with destructive appendicitis in 10 (13.51%), perforated gastric ulcer and 12 duodenal ulcer in 6 (12.5%), destructive cholecystitis in 9 (13.04%), adhesive intestinal obstruction in 13 (19.12%) and with strangulated and complicated hernias in 14 (17.28%) of the examined patients. During relaparotomy, incompetence of the intestinal wall and intestinal sutures was established in 11 out of 32 patients, an ileostomy was imposed in 7, and cecostomy in 1 patient. Actually, in the control group, 8 (6.84%) patients died on the background of ongoing peritonitis, thrombosis of mesenteric vessels and multiple organ failure and concomitant ailments and in the study group 4 (3.96%) patients died. Conclusions. Surgical treatment is individualized depending on the disease, so with destructive appendicitis from 74 (38.74%) laparotomic in 42 (21.99%), laparoscopic in 32 (16.75%), and in 12 (6.28%) with conversion; perforated gastric ulcer and duodenal ulcer in 48 (25.13%) open laparotomy; with cholecystitis of 69 (36.13%) patients, 48 (25.13%) had laparotomy and 21 (11.00%) had laparoscopic examination. The use of the latest imaging and treatment technologies: Doppler ultrasonography, hydrojet scalpel and laparoscopy in 64 (33.51%), allowed to have better near and long-term results and to reduce postoperative mortality from 6.84% to 3.96%, with an average of 5.5%. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. The authors declare no conflicts of interests. Key words: destructive appendicitis, cholecystitis, perforated gastric ulcer and 12-duodenal ulcer, adhesive leakage, strangulated hernias, diagnosis and treatment.

scholarly journals Polypropylene endoprostheses in the surgical treatment of strangulated postoperative ventral hernias

2012 ◽  
Vol 93 (3) ◽  
pp. 541-544
Author(s):  
I M Fatkhutdinov
Keyword(s):  
Surgical Treatment ◽  
Abdominal Wall ◽  
Abdominal Wall Defect ◽  
Subcutaneous Tissue ◽  
Abdominal Cavity ◽  
Subcutaneous Fat ◽  
Postoperative Mortality ◽  
Early Postoperative Period ◽  
Mesh Endoprostheses ◽  
Ventral Hernias

Aim. To determine and implement the best ways to position mesh endoprostheses in the anterior abdominal wall during strangulated postoperative ventral hernias; to introduce methods of non-stretch hernioplasty into emergency surgery of giant hernias. Methods. 115 patients (27 males and 88 females) with strangulated postoperative ventral hernias aged 30-73 years were under observation. Depending on the size of the hernia and on the intraoperative findings different methods of implantation of the mesh endoprostheses were used, which prevented the mesh contact with subcutaneous fat and abdominal organs. For small and medium-sized hernias the mesh was placed under or over the abdominal membrane, it was fixed to the abdominal wall, the aponeurosis was sewn together in an «edge to edge» fashion. In cases with giant hernias non-stretch hernioplasty was performed. During the operation of non-stretch hernioplasty, dissection and excision of the hernial sac was performed in such a way that made it possible to use it to cover the abdominal wall defect. Results. In the early postoperative period in 17 (14.8%) patients seromas had formed in the wound, which were treated by needle puncture under ultrasound guidance. Postoperative mortality was 5.2% (6 people). In 5 cases the deaths were due to myocardial infarction and pulmonary embolism. One patient developed peritonitis due to suture insufficiency of the enteric anastomosis. Of all patients with lethal outcomes five patients were admitted after more than 6 hours from the start of the strangulation, one patient was admitted after 3 hours. Conclusion. The usage of techniques that delimit the mesh prosthesis from the abdominal cavity and subcutaneous tissue, and the introduction of non-stretch methods for giant hernias in the surgical treatment of strangulated postoperative ventral hernia contribute to improved outcomes of treatment in this group of patients.

Deep Vegetal Foreign Bodies in Cats: A Retrospective Study of 10 Cases

2019 ◽  
Vol 55 (5) ◽  
pp. 249-255
Author(s):  
Veronica Cola ◽  
Sara Del Magno ◽  
Simona Valentini ◽  
Stefano Zanardi ◽  
Armando Foglia ◽  
...  
Keyword(s):  
Foreign Bodies ◽  
Ultrasound Guidance ◽  
Ultrasound Examination ◽  
Clinical Signs ◽  
Intraoperative Ultrasound ◽  
Retroperitoneal Space ◽  
Surgical Removal ◽  
Thoracic Cavity ◽  
Common Location ◽  
Anatomic Locations

ABSTRACT The aim of this study was to describe the anatomic locations and treatments available for deeply located vegetal foreign bodies in cats. Ten cases of migrating vegetal foreign bodies (vFBs) requiring surgical removal are reported. The diagnoses of vFBs in the thoracic cavity (4/10), retroperitoneal space (2/10), and paratracheal region (1/10) were obtained by ultrasound examination; however, in the perineum or penile urethra (2/10) and peritoneum (1/10), the vFBs were found during surgery. Intraoperative ultrasound guidance helped remove vFBs from the retroperitoneal space and paratracheal tissues. Clinical signs resolved in 8 out of 10 cases, 1 out of 10 cases had recurrent draining fistula, and 1 out of 10 was euthanized for ethical reasons. The intrathoracic was the most common location in the present study, followed by retroperitoneal space and urethra/perineum. Ultrasound guidance was essential for the diagnosis and/or treatment of vFBs located in the thoracic, retroperitoneal, and cervical regions.

scholarly journals Extrathoracic lung sequestration in newborns: cases report

2021 ◽  
Vol 11 (3) ◽  
pp. 387-394
Author(s):  
Tatiana V. Patrikeeva ◽  
Svetlana A. Karavaeva ◽  
Alexey N. Kotin ◽  
Yuri V. Levadnev ◽  
Maria V. Golubeva ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Surgical Treatment ◽  
Computed Tomography Angiography ◽  
Ultrasound Examination ◽  
Abdominal Cavity ◽  
Retroperitoneal Space ◽  
City Hospital ◽  
Arterial Vessel ◽  
Long Term Treatment

BACKGROUND: Extrathoracic lung sequestration is a rare variant of a developmental malformation that can be diagnosed prenatally and should be included in the differential diagnosis of abdominal tumor-like formations. CASES REPORT: From 1996 to 2020, 70 children with confirmed lung sequestration were treated at the Children's City Hospital No. 1 in St. Petersburg. Of these, 29 had intralobar sequestration, and 41 had extralobar sequestration. Four of these patients were diagnosed with a rare extrathoracic (intraabdominal) form. All four were born full-term without clinical manifestations of the defect. Ultrasound examination of all children revealed a solid formation up to 3 cm in diameter, located in the upper left quadrant of the abdominal cavity or retroperitoneal space in the projection of the left adrenal gland. Due to the location of the formation and the inability to visualize the aberrant arterial vessel during ultrasound examination, the first two patients were differentially diagnosed with an adrenal tumor (neuroblastoma). The cancer markers were negative, and adrenal cortex hormones were normal. The children underwent multispiral computed tomography-angiography to clarify the diagnosis. In both cases, the diagnosis of intraabdominal extrapulmonary sequestration with a feeding arterial vessel extending from the thoracic aorta was confirmed. Two children, previously treated in the last two years, were diagnosed by the ultrasound examination results that enabled the visualization of an aberrant arterial vessel feeding the sequester. Indications for surgical treatment have been set. The parents of one child refused treatment. Three children underwent sequestration removal (two by laparoscopic access, one had a laparotomy). Histologically, extrathoracic sequestration in combination with cystoadenomatosis was confirmed. The postoperative period proceeded without complications. RESULTS: Long-term treatment results were observed in all operated patients for a period of four to 10 years. The assessment was performed based on complaints and ultrasound data. All patients matured and developed according to their ages. CONCLUSIONS: Extrathoracic lung sequestration is a rare type of defect that is subject to surgical treatment. This pathology should be included on the spectrum of differential diagnosis of tumorous formations of the abdominal cavity and retroperitoneal space in newborns. The main methods for postnatal diagnosis of the defect are ultrasound and multispiral computed tomography-angiography.

scholarly journals Staged treatment strategy in patients with acute abdomen

2015 ◽  
Vol 96 (1) ◽  
pp. 22-27
Author(s):  
P V Polenok
Keyword(s):  
Surgical Treatment ◽  
Treatment Strategy ◽  
Abdominal Cavity ◽  
Intervention Group ◽  
Postoperative Mortality ◽  
Control Group ◽  
Early Total Care ◽  
Abdominal Organs ◽  
Total Care ◽  
Staged Treatment

Aim. To reason the strategy of staged surgical treatment in patients with acute abdomen.Methods. The study included 72 patients, of them 32 were included in the main group, in which the staged surgical treatment strategy was implemented. To assess the effect of such approach, control group including 40 patients who were treated using the early total care strategy, was formed retrospectively. The decision on the certain strategy use (early total care strategy or staged treatment strategy («aborted operation») was made in every included patient by operating surgeon during the operation.Results. The modern method of surgical treatment («aborted operation» strategy) was introduced into the clinical practice for treating acute surgical abdominal diseases. A new method for patient’s condition severity assessment and operative risk prognosis based on the physical signs, as well as the scale of the indications for the «aborted operation» approach were developed. An original method for laparotomy wound closure was proposed. Device for laparostomy consists of two details - frame, which is stitched to the edges of surgical wound, and replaceable cap, which can be fixed to the frame. The device is made of soft elastic organic material, which is transparent and non-reactive. The key advantage of the device is the transparency of the cap material, allowing to review the condition of abdominal organs at any moment after the surgery without additional analgesia. The device act as a «viewport», allowing to clearly visualize the changes of abdominal organs, to diagnose the possible complications and to timely recognize the indications for programmed abdominal cavity debridement. The mortality in the control group was 100%, in the intervention group - 59%.Conclusion. Staged treatment strategy may significantly reduce the postoperative mortality, being an alternative to standard tactical and technical approaches used in emergency abdominal surgery.

scholarly journals Mini-invasive methods of treatment of liquid formations of parhychymatic ogrgans and abdominal cavity in planned and urgent abdominal surgery

2018 ◽  
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Clinical Laboratory ◽  
Abdominal Cavity ◽  
Social Indicators ◽  
Pancreatic Head ◽  
Retroperitoneal Space ◽  
Diagnostic Methods ◽  
Head Tumors ◽  
Minimally Invasive Methods

The problem of diagnosis and treating-tactical criteria for liquid formations of the abdominal cavity and retroperitoneal space of non-parasitic genesis remains unsolved. The purpose of this study is to improve the results of surgical treatment of patients with liquid formations of the parenchymal organs, abdominal cavity and retroperitoneal space through the complex use of minimally invasive diagnostic methods and surgical treatment. Clinical-physical, then clinical-laboratory methods of examination of patients were performed, during which liquid structures were suspected Comparing different methods of surgical treatment of non-parasitic liquid formations of parenchymal organs and the abdominal cavity, it was established that the use of minimally invasive methods allowed to improve the medical and social indicators in this group of patients significantly. The use of puncture drainage methods in combination with conservative therapy for the treatment of pancreatic pseudocyst is effective. This method is important for diagnosing and determining the connection of a cyst with a duct, as well as for differential diagnosis with tumors. In patients with pancreatic head tumors complicated by obstructive jaundice, decompression of the gall tree by means of percutaneous transhepatic microcholecystostomy for 7–15 days significantly improved and normalized the functional state of the liver, which allowed for the application of bilidigents anastomoses. The use of puncture drainage methods under the control of sonography in liver cysts leads to a positive result of the treatment of this pathology and the prevention of complications. When comparing various methods of surgical treatment of non-parasitic fluid formations of parenchymatous organs, the abdominal cavity, it was found that the use of minimally invasive methods has significantly improved medical and social indicators in this group of patients.

scholarly journals SURGICAL TREATMENT OF DAMAGES OF INTERNAL-TASK BODIES AND RETROPERITONEAL SPACE IN THE CONDITIONS OF MASSIVE HEMORRHAGE

2019 ◽  
pp. 105-108
Author(s):  
P. M. Zamyatin ◽  
Yu. I. Miroshnichenko ◽  
S. O. Beresnev ◽  
V. M. Cheverda ◽  
L. V. Provar ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Postoperative Mortality ◽  
Massive Hemorrhage ◽  
Retroperitoneal Space ◽  
Internal Organs ◽  
Septic Complications ◽  
Pelvic Bones ◽  
Results Of Treatment ◽  
Unstable Fractures

Summary. The results of treatment of 108 patients with unstable fractures of the pelvic bones and internal organs lesions were provided for the period from 2009 to 2017, 56 of them were victims of the proposed tactic, which allowed to reduce the postoperative mortality by 17,3 %, the frequency of purulent-septic complications by 14,7 %.

scholarly journals The case of rare pseudocyst of pancreas located in posterior mediastinum

2011 ◽  
Vol 2 (4) ◽  
pp. 53-57
Author(s):  
О. R. Shablovsky ◽  
Yu. V. Ivanov ◽  
N. Yu. Urazovskii ◽  
Yu. V. Kemezh ◽  
О. Е. Nechaeva
Keyword(s):  
Surgical Treatment ◽  
Abdominal Cavity ◽  
Posterior Mediastinum ◽  
Retroperitoneal Space ◽  
Space Case

The article includes findings of ethiology, classifications, basic methods of surgical treatment of pancreas pseudocysts and their typical localizations in abdominal cavity and retroperitoneal space. Case of pancreas pseudocyst which is rarely located in posterior mediastinum is reported. This pseudocyst of pancreas has been required many additional investigations and much time for updating of diagnosis.

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