scholarly journals EVOLUTION OF VIEWS ON THE DEVELOPMENT AND IMPLEMENTATION OF MODERN SURGICAL MAGNETIC INSTRUMENTS ON THE CASE OF INFLAMMATORY PENETRATING INJURIES OF THE BREAST

2020 ◽  
pp. 113-118
Author(s):  
Yu. V. Bunin ◽  
P. M. Zamyatin ◽  
R. M. Mihаylusov ◽  
V. V. Negoduyko ◽  
S. O. Beresnyev ◽  
...  
Keyword(s):  
Foreign Bodies ◽  
Pleural Cavity ◽  
Gunshot Wounds ◽  
Surgical Instruments ◽  
Internal Organs ◽  
Surgical Interventions ◽  
Magnetic Nozzle ◽  
Endoscopic Laser ◽  
Laser Visualization ◽  
Magnetic Instrument

Summary. The arms — to analyze the evolution of the development of modern surgical instruments in gunshot wounds chest. Materials and methods. 80 cases of using a modern magnetic surgical instrument for penetrating gunshot wounds of the chest were analyzed. Intraoperatively used: a magnetic multifunctional tool for the diagnosis and removal of metallic ferromagnetic foreign bodies, a flexible device for removing ferromagnetic foreign bodies, a magnetic tool for endovideoscopic diagnosis and removal of metallic ferromagnetic foreign bodies from the abdominal and pleural cavities, a magnetic nozzle for video endoscopic surgical interventions. When removing metal foreign bodies, the following methods were used: a method for preliminary determination of the material and properties of a foreign body, a method for video endoscopic laser visualization of the internal organs of the abdominal and pleural cavities. Results. Foreign bodies of the pleural cavity were diagnosed in 80 (100 %) wounded according to СT. Ferromagnetic metal foreign bodies of a gunshot origin of the pleural cavity were removed both during thoracotomy or minithoracotomy, and during thoracoscopic surgical interventions using the method of video endoscopic laser visualization of the internal organs of the abdominal and pleural cavities. The most convenient tool was the endoscopic magnetic tool for removing foreign bodies from the pleural or abdominal cavities. A magnetic nozzle for video endoscopic surgical interventions allows navigation both in the pleural cavity and along the wound channel. Conclusions. 1. The development of a surgical magnetic instrument was phased and began with the improvement of a surgical magnetic instrument to remove ferromagnetic foreign bodies of soft tissues. 2. The improvement of the tool took place as the restrictions on the use of the existing tool were established, which was a prerequisite for the development of a new tool. 3. It is advisable to create a special set of surgical magnetic instruments for video endoscopic surgery.

INDICATIONS AND CONTRAINDICATIONS FOR REMOVAL OF FOREIGN BODIES OF LUNGS OF FLAMMABLE ORIGIN

2021 ◽  
pp. 43-47
Author(s):  
V. Kupriyanchuk ◽  
Y. Bunin ◽  
R. Mikhailusov ◽  
V. Negoduyko ◽  
E. Khoroshun ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Foreign Bodies ◽  
Comparison Group ◽  
Gunshot Wounds ◽  
Northern Region ◽  
Main Group ◽  
Surgical Instruments ◽  
Surgical Trauma ◽  
Surgical Interventions ◽  
Surgical Department

Summary. The purpose of the study is to establish the indications and contraindications for the removal of foreign bodies of lungs of gunshot origin. Materials and methods. In the surgical department of the surgical clinic of the Military Medical Clinical Center of the Northern Region, 207 wounded who received gunshot wounds penetrating the chest were examined. The wounded were divided into 2 groups depending on the operational tactics used. The main group of 97 wounded who were treated using modern video endoscopic technology and magnetic surgical instruments. The comparison group consisted of 110 wounded who received traditional treatment. Results and their discussion. Using video endoscopic technologies and magnetic surgical instruments during surgery, 42 (54.5%) in the main group were removed, in the comparison group — 23 (27.4%) foreign bodies. The amount of surgery should not exceed the amount of damage that minimizes surgical trauma. The article presents indications and contraindications to the removal of foreign bodies of pulmonary origin. The differential approach allows to determine the surgical tactics depending on the location of the foreign body, its size and the fit of foreign bodies to the vessels, bronchi, mediastinum. Adherence to the rules of removal of foreign bodies of the lung, depending on the location of its location and size leads to a decrease in inappropriate surgical interventions and postoperative complications. Conclusions. 1. The distribution of foreign bodies by location and size allows you to clearly determine the tactics of treatment and avoid postoperative complications. 2. Surgical interventions to remove foreign bodies should be performed in the first days after stabilization of the patient’s condition using minimally invasive technologies.

Analysis of data of implementation of the «controlled fistula» method and VAC-therapy in a complex treatment of perforation of the middle and lower third of thorathic esophagus complicated by mediastinitis and pleural empyema

2020 ◽  
pp. 17-21
Keyword(s):  
Foreign Bodies ◽  
Pleural Cavity ◽  
Pleural Empyema ◽  
Operation Technique ◽  
Thoracic Esophagus ◽  
Complex Treatment ◽  
Surgical Interventions ◽  
Vac Therapy ◽  
Common Causes ◽  
Comprehensive Examination

A retrospective analysis of the results of a comprehensive examination and treatment of 34 patients with perforation of the middle and lower third of the thoracic esophagus complicated by mediastinitis and pleural empyema for the period from 2010 to 2020 was performed. The most common causes of perforation of the middle and lower third of the thoracic esophagus were foreign bodies of the esophagus ‒ 52,9 %, spontaneous rupture of the esophagus ‒ 35,4 % and penetrating stab wounds ‒ 8,8 %. It was revealed that the improvement of the results of the complex treatment of this category of patients was achieved due to the implementation of the «off» operation technique in surgical practice by creating the so-called «controlled fistula». The introduction of this method of treatment into the structure of surgical interventions, supplemented by subsequent VAC-therapy of the mediastinal space and pleural cavity, significantly reduced mortality from 56,3 % to 11,1 %.

scholarly journals DIAGNOSTICS AND SURGICAL TREATMENT OF GUNSHOT WOUNDS OF THE UPPER AND LOWER LIMBS WITH THE PRESENCE OF FOREIGN BODIES

2020 ◽  
pp. 36-43
Author(s):  
P.N. Zamyatin ◽  
V.V. Negoduiko ◽  
G.R. Mikhailusov ◽  
S.A. Beresnev ◽  
L.V. Provar ◽  
...  
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Spatial Perception ◽  
Pain Syndrome ◽  
Gunshot Wounds ◽  
Visual Control ◽  
Lower Limbs ◽  
Morphological Data ◽  
Surgical Interventions ◽  
X Ray

Summary. The aim. Comparison of clinical, clinical instrumental and morphological data to establish the most informative signs of extremity foreign bodies, the possibility of choosing surgical tactics and improving treatment results. Materials and methods. Removal of ferromagnetic metallic foreign bodies of various sizes was carried out under visual control using a magnetic search tool. Visual control of the removal of a foreign body allows you to assess the adequacy of its removal. Results and its discussion. Removal of a foreign body was carried out using general surgical instrumentation under tactile control using the surgeon's finger and a Billroth curved hemostatic clamp or a mosquito curved hemostatic clamp. Removal of foreign bodies of extremities under hardware control is possible both in continuous time (on line) and intermittent (step-by-step) mode - detection of foreign bodies, marking (leaving marks on the skin). Removal of a foreign body was also carried out under X-ray control. Most often, a step-by-step technique was used, in which the characteristics of a foreign body were first determined, then it was removed and, finally, a control X-ray study was performed with uncertainty about the completeness of removal. In cases where there were problems with the spatial perception of the location of foreign bodies, the removal of foreign bodies under visual, tactile and hardware control was difficult, we used a combination of these methods. Conclusions. As a result of using the proposed modern diagnostic technologies, the completeness of removal of extremities foreign bodies significantly increased from 6.2±0.1 to 1.4±0.1 (p<0.005); the duration of their removal decreased from 30.4±1.8 to 11.2±1.3 minutes (p<0.005); the number of surgical interventions decreased from 2.8±0.2 to 1.7±0.1 (p<0.005); the expressiveness of the pain syndrome decreased from 7.3±0.2 to 5.2±0.4 points (p<0.005); the duration of inpatient treatment decreased from 18.6±1.1 to 16.5±1.3 days.

scholarly journals Endoscopic removal of metal foreign bodies by magnet: case report

2020 ◽  
Vol 10 (4) ◽  
pp. 467-472
Author(s):  
Vladimir I. Petlakh ◽  
Vladimir A. Borovitsky ◽  
Alexander K. Konovalov ◽  
Natalya N. Strogova
Keyword(s):  
Case Report ◽  
Conservative Therapy ◽  
Foreign Bodies ◽  
Intestinal Wall ◽  
The Body ◽  
Surgical Interventions ◽  
Number Of Children ◽  
The Past ◽  
A Chain ◽  
The Right

The number of children swallowing magnetic foreign bodies has been a significantly high for the past decades, increasingly needing endoscopic or surgical interventions. Case report. In our observation, a 12-year-old girl swallowed magnetic balls from childrens designer 10 days prior to hospital admission. Foreign bodies (5 balls) were found during X-ray examination in the projection of the cecum. Conservative therapy carried out for 4 days had no success, thus colonoscopy was performed to remove foreign bodies. Foreign bodies were fixed to the intestinal wall, and attempts to separate them were unsuccessful. When a medical magnet was placed outside the body in the right iliac region, a chain of magnetic balls detached from the intestinal wall and made it possible to be captured in a trap loop and be removed. The girl avoided a laparotomy with an opening of the colon. Conclusion. External use of a medical magnet is effective for navigation and assistance during colonoscopic extraction when magnetic foreign bodies are found in the colon.

scholarly journals Application of the method of ultrasound imaging in the removal of foreign bodies in gunshot wounds.

2018 ◽  
Vol 23 (4(part1)) ◽  
pp. 101-104
Author(s):  
E. V. Svitlychnyi ◽  
K. R. Muradian ◽  
O. S. Herasymenko ◽  
M. O. Koshykov ◽  
Ya. I. Haida ◽  
...  
Keyword(s):  
Ultrasound Imaging ◽  
Foreign Bodies ◽  
Gunshot Wounds

scholarly journals The place and role of videothoracoscopic surgical interventions in war wounds and injuries of the chest organs

2018 ◽  
Vol 22 (3) ◽  
pp. 522-524
Author(s):  
I.P. Khomenko ◽  
K.P. Gerzhyk ◽  
B.M. Kucher
Keyword(s):  
Wounds And Injuries ◽  
General Structure ◽  
Traumatic Injury ◽  
Gunshot Wounds ◽  
Severe Injuries ◽  
Surgical Interventions ◽  
War Wounds ◽  
Medical Evacuation ◽  
Video Assisted ◽  
Surgical Tactics

Thoracic injuries are considered to be one of the most severe injuries of human systems and organs, which are characterized by a large number of complications and high mortality. According to the ATO data in eastern Ukraine, the frequency of chest injuries in the general structure of combat surgical injuries is 11.7%, the overwhelming majority of which were non-penetrating injuries (83.6%). The overall mortality rate for penetrating wounds of the breast is 5–10%. Surgical tactics for injuries and injuries of the chest is diverse and depends on the type of traumatic injury, the time of first medical and specialized care, the severity of the condition of the victims, the presence of complications, the technical capabilities of the hospital. Objective: optimization of surgical tactics for wounds and injuries of the chest through the use of video-assisted thoracoscopic techniques. A retrospective analysis of the surgical treatment of 103 thoracic wounded and injured, which were located in the Military Medical Clinical Center of the Southern Region in Odessa and the area of responsibility (level II–IV medical care) from June 2014 to July 2017, was carried out. At the stages of medical evacuation of all 103 thoracic wounded and injured in most cases (41 people (39.8%)), drainage of the pleural cavity was sufficient to eliminate hemo- and pneumothorax — 25 (24.3%) underwent various surgical interventions from thoracotomic approaches, 16 (15.5%) had various video-assisted thoracoscopic surgeries, 16 (15.5%) had only surgical treatments for gunshot wounds, and 5 (4.9%) wounded and injured had only conservative therapy. Conclusions: Promising, in our opinion, can be the widespread introduction of video-assisted thoracoscopic interventions into the practice of surgeons who are involved in the ATO, followed by a multicenter assessment of the results.

scholarly journals Stage Reconstructive and Restorative Surgical Treatment of Gunshot Wounds of the Groin, Scrotum and Penis (Case Report)

Health of Man ◽  
2021 ◽  
pp. 85-90
Author(s):  
Serhii Golovko ◽  
Oleksandr Savytskiy ◽  
Oleksandr Netrebko ◽  
Yevhen Bidula ◽  
Volodymyr Bondarchuk
Keyword(s):  
Surgical Treatment ◽  
Gunshot Wound ◽  
Foreign Bodies ◽  
Soft Tissues ◽  
Gunshot Wounds ◽  
Soft Tissue Defects ◽  
Initial Stage ◽  
The Right ◽  
Upper Third ◽  
Tissue Defects

The frequency of external genital lesions in armed conflicts can reach up to 5%. The complexity of gunshot wounds is the presence of significant soft tissue defects, widespread necrosis around the wound, the possibility of progression in the hours and days after injury, the high probability of infection, and the presence of foreign bodies. The tactics of gunshot wounds are determined by the location, nature and extent of damage to soft tissues, organs, large vessels, nerves, bones and includes several stages. At the initial stage, bleeding is stopped, hematomas and foreign bodies are evacuated, non-viable tissues are removed, drainages are installed and skin defects are closed. The stage of reconstructive surgery can be started when the active wound process is over. In this report, we present a clinical case of a 22-year-old man who received a gunshot wound to the right groin, upper third of the right thigh, perineum and external genitalia in a combat zone of Operation Allied Forces, Ukraine. Bullet wound led to: damage to the skin and subcutaneous tissue in the right buttock, right groin, on the inner surface of the upper third of the thigh, penis (skin defect up to 1/3 of the circumference), scrotum, partial destruction of corpora cavernosa, m. iliopsoas and adductor muscles of the thigh, sphincter of the rectum, crushing of the right testicle. The wound was contaminated with earth and foreign bodies At the initial stage, the patient underwent: primary surgical treatment of a gunshot wound, suturing of cavernous bodies with sutures, fixation of the penis in the groin, removal of the right testicle, tamponade of the wound, sigmostomy (due to sphincter damage). Subsequently, the patient underwent regular surgical treatment of wounds, a vacuum suction system VAC was installed. After 7 months (upon completion of the healing process) suturing of the sigmostoma was performed. After 2 months, the penis and the scrotum were reconstructed. Preoperative examination (ultrasound of the penis with assessment of cavernous hemodynamics, MRI) revealed: post-traumatic scarring of the soft tissues of the right groin, inner surface of the right thigh, buttocks, right inguinal canal of the penis and scrotum, deformation of the cavernous cavity, normal indicators of cavernous blood circulation. In the early postoperative period (2 months after the intervention), the patient indicated satisfaction with the cosmetic and functional results, the preservation of morning erections, moderate discomfort in the penis during erection. Prosthetics of the right testicle are planned. The clinical case once again confirms the need for qualified surgical care during the first “golden” hour and subsequent phased treatment at a specialized level using the VAC therapy system in patients with gunshot wounds and large soft tissue defects. The experience of military medicine demonstrates the importance of involving specialists of various profiles in the treatment of combined gunshot wounds of the pelvis. An important stage of treatment in the wounded is plastic and reconstructive surgery in the long term, which is aimed at improving the functional, cosmetic and psychological results of treatment.

scholarly journals ENCAPSULATION OF METALLIC SOFT-TISSUE FOREIGN BODIES WITH A LONG CARRIER LIFE

2020 ◽  
pp. 160-164
Author(s):  
V. V. Negoduyko ◽  
R. M. Mikhailusov ◽  
T. P. Yakimova ◽  
P. M. Zamyatin ◽  
S. O. Beresnev ◽  
...  
Keyword(s):  
Foreign Body ◽  
Soft Tissue ◽  
Foreign Bodies ◽  
Soft Tissues ◽  
Clinical Laboratory ◽  
Gunshot Wounds ◽  
Analysis Data ◽  
Capsule Formation ◽  
Iron And Steel ◽  
Morphological Studies

Sumary. The aim is to investigate the features of pathogenesis in capsule formation around metallic foreign bodies of soft tissues. Materials and methods. The results of a study of 6 patients with metallic foreign bodies of soft tissues with a carrier period of 16 to 50 years were analyzed. 3 injured had foreign bodies of gunshot origin and 3 patients had foreign bodies as a result of personal injury. Used clinical, laboratory, instrumental, histological, immunohistochemical, X-ray spectrometric studies. Results. All foreign soft tissue bodies were removed with the capsule. By gender: 5 men and 1 woman. By localization - the lower extremity. Pain was present in all the victims. Radiography and ultrasound were informative, magnetodetection is informative only at the superficial location of a foreign body. The foreign bodies were made of gray cast iron and steel needle wire. Histologically, immunohistochemically and radiospectrometrically, it has been found that the capsule formation around the foreign body is affected by the mechanism and extent of damage to the soft tissues, the composition of the metal and its coating, and the carrier term of the foreign body. Conclusions. Depending on the composition of the metal and its coating, there is a different rate of oxidation of the foreign body in the soft tissues: oxidation of metal foreign bodies of fire origin is faster. The formation of the capsule around the foreign body is affected by the mechanism of tissue damage: when the needle penetrates, the soft tissues are destroyed minimally, in the case of gunshot wounds, they are destroyed more. Spectral analysis data in conjunction with morphological studies are the basis for the removal of a foreign body of inflammatory origin along with the capsule.

scholarly journals Extragenital endometriosis as a cause of catamenial pneumothorax in women: own experience

2021 ◽  
pp. 27-31
Author(s):  
Valery Boyko ◽  
Andriy Krasnoyaruzhsky ◽  
Anastasiia Sochnieva ◽  
Vasyl Kritsak
Keyword(s):  
Pleural Cavity ◽  
Treatment Algorithm ◽  
Parietal Pleura ◽  
Medical Sciences ◽  
Treatment Results ◽  
Surgical Interventions ◽  
Catamenial Pneumothorax ◽  
Second Stage ◽  
Minimally Invasive Surgical ◽  
Extragenital Endometriosis

Introduction. Catamenial pneumothorax is one of the most difficult to diagnose types of spontaneous pneumothorax in women. The cause of the latter is ectragenital localization of endometriosis. To date, there is no clear pathogenetically determined treatment and treatment algorithm for the management of this category of patients. Objective: to analyze and structure our own experience in the treatment of catamenial pneumothorax. Materials and methods. For the period 2011–2020 in the Thoracoabdominal Department of the SI "Zaytcev Institute of General and Emergency Surgery of the National Academy of Medical Sciences of Ukraine" 7 women with catamenial pneumothorax were on inpatient treatment. Results. After additional examination, all patients underwent draining of the pleural cavity with Bulau as the first stage after the diagnosis was established. At the second stage, all patients underwent minimally invasive surgical interventions – videothoracoscopic resection of the endometriosis-affected areas of the costal parietal pleura and diaphragm, mechanical pleurarasion and pleurodesis, using fibrin-collagen plates in the areas of diaphragm defects. There were no postoperative complications or deaths. Conclusion. In the treatment of extragenital endometriosis complicated by catamenial pneumothorax, not only thoracic surgeons, but also obstetrician-gynecologists should take part in order to create multidisciplinary commissions aimed primarily at determining the pathogenetically determined treatment tactics. Key words: extragenital endometriosis, catamenial pneumothorax, videothoracoscopy, surgical treatment.

scholarly journals EVALUATION OF THE POSSIBILITY OF USING CORYOLIS VITRATOMYER IN THE DIAGNOSIS OF PULMONARY DAMAGE IN VICTIMS WITH FIRE PENETRATION EARLY WOUNDS

2021 ◽  
pp. 52-55
Author(s):  
E. A. Chernyavsky ◽  
Yu. V. Bunin ◽  
V. V. Negoduyko ◽  
R. M. Mikhailusov ◽  
E. M. Khoroshun ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Pleural Cavity ◽  
Gunshot Wounds ◽  
Early Complications ◽  
Video Assisted ◽  
Chest Injuries ◽  
Coriolis Flowmeter ◽  
Lung Injuries ◽  
Pulmonary Damage ◽  
Air Discharge

Summary: The aim of the study was to determine the dependence of the volume of air discharge from the pleural cavity on the choice of surgical treatment in patients with penetrating chest injuries. Materials and methods. Of the 39 observations, video-assisted thoracoscopy (VATS) was performed in 24 patients due to existing hemothorax. Results and their discussion. Among patients with penetrating chest injuries and early complications in the form of isolated pneumothorax on the first day, VATS was performed in three cases, due to increased air discharge from the pleural cavity. On the second and third day, 3 and 1 patient needed PBX, respectively. The article presents the experience of using a Coriolis flowmeter to objectify the diagnosis of lung injuries in victims with gunshot wounds penetrating the chest. Depending on the speed and volume of air discharge from the pleural cavity, the dynamics can be determined by the tactics of treatment. Conclusions: 1. Observation in the dynamics of the rate (

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