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Regional center of marginally invasive surgery and gynecology

Wednesday, 16 January 2013 14:41

The center of Marginally Invasive Surgery and Gynecology was created by a joint order of the Department of Health of the Chernivtsi Regional State Administration and Bukovynian State Medical University "On the Organization of the Center of Marginally Invasive Surgery and Gynecology" (Order of 31.05.2011, № 05-O/230).
The creation of the Center contributed to the expansion of the  extent of the laparoscopic surgical interferences - laparoscopic surgery for inguinal and femoral hernia, hiatal hernia, the esophagus, some complications of peptic ulcer disease, adhesive disease have been introduced at present. Operations for thoracic pathology are more commonly performed - spontaneous pneumothorax, hemothorax, pleurisies, transthoracic neurophrenicotomy has been developed and performed for the first time.

Surgical interferences in infertility, ovarian cysts, salpingites, ectopic pregnancy, uterine fibromyomas are performed with the assistance of gynecologists.
Laparoscopic technologies in emergency surgery are being introduced, which wasn’t possible to do before the creation of the Centre - appendectomies, viscerolysis, lancing and sanitation of delineated abscesses of peritoneal cavity are performed. These operations are made mainly by the staff members of the Department of Surgery BSMU. It is exactly the staff members of the  Department of Surgery  who were the first to have introduced in Bukovyna the performance of laparoscopic surgical interferences in cholecystites, cysts and neoplasms of the abdominal cavity, liver cirrhosis, hernias, in case of gynecological pathology and  to have performed marginally invasive surgical intervention in thoracic pathology.

Over the years of the existence of the Centre 833 marginally invasive surgical interferences have been made there. Today laparoscopic surgical interventions are performed by 12 members of the surgical staff, by 4 staff members of gynecological department of the Regional Clinical Hospital and by 5 staff members of Surgery Department of the University. Three more members of the Department received the corresponding certificates and started performing laparoscopic surgical interferences in 2012.

A list of laparoscopic procedures that are performed at the Center:

  • Laparoscopic cholecystectomies for chronic calculous cholecystitis;
  • Laparoscopic cholecystectomies for acute calculous cholecystitis;
  • Laparoscopic cholecystectomies for polyposis of the gallbladder;
  • Videolaparoscopies with  at the necessity of conversion in case of pathology of the gall bladder;
  • Laparoscopic appendectomies for acute appendicitis;
  • Videolaparoscopies with the necessity of conversion in acute appendicitis;
  • Laparoscopic appendectomies for chronic appendicitis;
  • Diagnostic laparoscopies in acute surgical pathology with the transition to laparotomy;
  • Diagnostic laparoscopies in canceromatosis with biopsy;
  • Laparoscopic drainage of bile accumulation under the liver;
  • Laparoscopic interventions for acute pancreatitis;
  • Laparoscopic interventions for diaphragmatic hernia;
  • Laparoscopic removal of the cyst liver cyst;
  • Laparoscopies in case of injuries of the organs of the abdominal cavity;
  • Laparoscopic removal apudoma of preperitoneal space;
  • Laparoscopic removal of hemangioma of the small intestine;
  • Puncture and drainage of liquid delineated accumulation under ultrasound control and roentgenoscopy;
  • Laparoscopic surgery for gynecologic pathology:
  • ectopic pregnancy;
  • tubectomy;
  • cystectomy;
  • salpingolysis;
  • ovary fenestration;
  • diagnostic laparoscopy in gynecological pathology
  • thoracoscopic surgery.

The available equipment of the Center is also used in the teaching process with 4 and 6 year students that have a possibility to observe the performance of modern marginally invasive operations that are included in the curricula; for the training of interns who actively participate in the implementation of marginally invasive surgical interferences as assistants, and clinical residents who independently perform certain stages of a surgical intervention, during cycles of the pre-attestation training. While carrying out cycles  of the pre-attestation training (4-5 per academic year) considerable emphasis is on the introduction of modern technologies in marginally invasive treatment of various pathologies. Students have the opportunity to watch the execution of operations through the system created by the Department a direct videocast from the operating theatre to the classroom and participate directly in such operations, which significantly increases the information content of training and prestige of the courses.