The author overviews new methods in endoscopic surgery and considers 3D-simulation for pre-surgical planning and intraoperative positioning. Due regard is given to features of working at da Vinci robot-aided surgery system, methods of surgery via special tools, clinical aspects of natural orifice transluminal endoscopic surgery (NOTES), and single-incision laparoscopic surgery (SILS).

The authors present lecture about radiological surgery
of congenital and acquired valvular diseases, including major
vessels problems, and discuss history of this method as well
as indications and contraindications for patent ductus arteriosus
occlusion and mini-surgical treatment of a number of congenital
and acquired cardiovascular malformations. Special attention is
focused upon the Russian contribution to invention of modern
low-traumatic endovascular surgical procedures. The paper provides
criteria for estimating quality of short-term and long-term
results of modern treatment of congenital and acquired valvular
diseases, including major vessels problems.

This lecture covers issues of modern hernioplasty
methods. High frequency of relapses (10 to 30%) to occur after
traditional surgeries requires searching after new treatment
methods. Based upon the literature and results of work, the
authors consider indications and contraindications for laparoscopic
surgery, its advantages compared to traditional operations
and analyse types of allografts used in the most up-to-date clinic.
Special attention is focused upon imperfections of endovideosurgical
hernioplasty and its complications, including injuries of
inferior epigastric vessels and recurrent hernias likely to occur
in 1.5% of cases. The authors classify inguinal hernias, describe
main stages of hernioplasty and come to a conclusion that development
of technology and practical surgical skills results in
a considerable increase in a number of indications for endovideosurgical
hernioplasty. Laparoscopies using allografts will allow
decreasing duration of temporary disability and social rehabilitation
of patients.

The lecture summarises modern methods of performing surgery for primary and metastatic liver cancer. Based on 183 observations and literature, the authors come to a conclusion that resection surgery still holds its dominant positions in treating malignant neoplasms of liver. Special consideration is given to surgical technique and efficiency of radio frequency ablation and portal venous embolization. Short- and long-term treatment results will appear to be improved by developing anatomicity and thereby radicality and atraumaticity of resections to be, given the indications to occur, re-performed and combined with chemotherapy, endovascular methods of dealing with cancer, and methods of local destruction of focal liver neoplasms.

This lecture covers history of endoscopy and modern methods of endoscopic diagnostics. The authors consider features of getting high resolution images, computed virtual chromography, fluorescent diagnostics, magnifying endoscopy, confocal laser endomicroscopy, endoscopic ultrasonography, and capsular and balloonintestinoscopy. Potential of new diagnostic methods offers great opportunities for early diagnosing gastrointestinal tract diseases that allow to develop organ-saving and low-invasive surgery for esophagus, stomach and small intestine.

Based on the literature and observations, the authors discuss present-day issues of diagnosing and treating benign esophageal neoplasms, such as esophageal achalasia, hiatal hernia and Barret's metaplasia, and show advantages of endoscopic methods in treating this pathology. With regard to esophageal achalasia, consideration is given to efficiency of intersphincteric introduction of botulinus toxin and laparoscopic esophagogastromyotomy. With regard to hiatal hernias and Barret's metaplasia, various methods of laparoscopic fundoplication are combined with argon plasma coagulation of metaplastic focuses and other therapeutic procedures. Special attention is focused on multistage algorithm of treating gastroesophageal reflux disease used by authors in the oncologic dispensary in efforts to efficiently prevent serious complications of benign diseases and esophageal adenocarcinoma.

The lecture summarises present-day issues of acute pancreatitis and discusses pathogenesis, clinical picture, diagnostics and treatment principles of this disease. Special consideration is given to indications and contraindications for conservative treatment and surgery of pancreatonecrosis, depending on the disease stage and severity. The author highlights that the rapid relief of acute inflammatory process in the gland does not result in absolute recovery and morphological recovery in the pancreas. As a rule, having pancreatonecrosis will lead to chronic pancreatitis, therefore after being discharged from the hospital, the patients should undergo long-term medical rehabilitation aimed at recovering tissue trophism and functions.

The author discusses issues of removal surgery for tumors of pancreaticoduodenal zone of periampullary localization and specifies features of diagnosing cancer, benign and neuroendocrinal neoplasms using up-to-date methods of instrumental, biochemical and morphological examination. Special emphasis is focused on reasonable radicality of surgical procedures due to the fact the tumors of periampullary localization are likely to be unpredictable and finally diagnosed after being removed. After timely surgery and combined chemotherapy, predicted life of patients having malignant periampullary tumors considerably improves.

Pharmacoeconomics research identifies, measures, and compares the costs (resources consumed) and consequences of medical products and services, where at least one of the compared alternatives is pharmacotherapy. Pharmacoeconomics has been designed to enable the decision maker to identify the preferred choice among existing alternatives. One of the most commonly used types of pharmacoeconomic analysis is cost-effectiveness analysis.

Authors' experience in treating 142 patients aged 32 to 94 suffered from cancer of the major duodenal papilla allows to substantiate indications and contraindications for various types of surgeries. The authors consider the gastropancreatoduodenal resection to be feasible in small number of observations; it often appears to be impossible in respect of elderly patients due to associated serious pathology. The preference should be given to endoscopic methods of treatment that allow to arrest obstructive jaundice. These methods can be both separate palliative and staged surgical procedures to be performed prior to radical surgery.

The authors compare efficiency of endoscopic mucous membrane resection method and loop electrosurgical excision procedure used to remove large non-polypous and polypous growth in large bowel, and estimate results of 19 endoscopic resections and 19 loop electrosurgical excision procedures. These growths most often localized on the left half of large bowel were in the form of glandular or villous adenoma, and corresponded to surface tumors (16 cases) and wide base tumors (22 cases). The tumors were from 20 to 54 mm (30±10 mm) in size. Incomplete removal, complications and relapses were observed during both resection method and electrosurgical excision procedure. The tumor of over 22 mm in size was a factor indicating low possibility of removing en bloc. Therefore, the endoscopic mucous membrane resection method was more efficient compared to the loop electrosurgical excision in case of large non-polypous and polypous tumors of large bowel.

Male-rat experiments using right general carotid ligation included simulation of cerebral ischemia and intra-arterial introduction of basic Fibroblast Growth Factor (control - physiological solution) and showed that bFGF has enhanced NADPH-diaphorase activity and endothelial proliferation in vessels and pericytes of pariental cerebral cortex. These processes corresponded to thickening of microvessels and reached their maximum after 12 days from ischemia. The paper discusses interaction between bFGF-dependent and nitroxidergic mechanisms of post-ischemic cerebrovascular re-organization. The authors believe stimulation of angiogenesis and maintenance of neuron viability against the bFGF introduction were indicative of decreasing toxic effects of nitric oxide in the focus of ischemia.

Histochemical NADPH-diaphorase reaction during white rat experiments allowed to research into structural elements of afferent innervation of the pia mater arteries and neurons of lower jugular node and solitary tract nucleus and discover three types of receptors and afferent fibres characterized by high, moderate and low activity of nitric oxide synthase and neurons (17.4 и 24.5%, respectively) with positive NADPH diaphorase reaction - in the lower jugular node.

The author gives consideration to invention and application of transverse pararectal mini-access to head of blind colon in case of acute appendicitis. 277 appendectomies (including 187 performed as mini-laparoscopic ones) allow coming to a conclusion that low-invasive interventions are the indication for surgery in case of patients with normal weight or underweight suffering from typical signs of acute appendicitis. Dynamics of post-operative laboratory analyses is indicative of decreasing frequency of pyoinflammatory complications and accelerated rehabilitation of patients underwent mini-laparoscopic appendectomy.

The authors analyze treatment results of 185 patients having post-operative intra-abdominal complications. The first patient group was comprised of 74 persons underwent surgical correction of complications by means of laparoscopic operation. The second group consisted of 111 patients underwent relaparotomy. The lethality rate was 2.7 and 18.9%, respectively. The most frequent post-operative complications were peritonitis (15.7%), early bowel obstruction (30.3%), peritoneal abscess (31.9%), outflow of bile (10.3%), post-operative hemorrhage (9,2%), and foreign bodies left in the abdominal cavity (1,1%). The laparoscopic operation was final method of treating 94.6% of the patients from first group. 4 patients appeared to have indications for laparotomy during laparoscopy.

The paper provides analysis of direct treatment results with respect to acute post-operative pain in 68 patients underwent thoracoabdominal operations. The immediate postoperative period included anaesthesia by means of intravenous infusion of ketamine and morphine using balloon dosers as well as intramuscular anaesthesia with morphine. Applying prolonged intravenous infusion of ketamine and morphine allowed to ensure efficient and safe anaesthesia with low rate of side effects.

In efforts to ensure impartiality in estimating efficiency of spontaneous respiration during prolonged gynaecological surgeries under spinal epidural anaesthesia (SEA), the authors examined 34 patients. The surgery lasted from 2.5 to 5 hours. 17 patients underwent combined spinal-epidural anaesthesia, as compared to the control group (17 patients) underwent general anaesthesia with artificial lung ventilation. Efficiency of lungs ventilation was assessed by spirography, metabolic processes - by blood concentration of lactic and pyruvic acids, and excess of lactate. Adequacy of anaesthesia was judged by blood concentration of catecholamines and number of heart beats, blood pressure and oxyhemoglobin concentration. As shown, SEA did not have negative effect on lung ventilation, gas exchange and metabolic processes in case of stable hemodynamic and moderate sedation.

The authors estimated bone tissue mineral density in 45 patients with various terminal lung pathologies awaiting lung transplantation. Decreasing bone tissue mineral density down to osteopenia and osteoporosis level was observed in most cases (89%). Only 5 patients had normal parameters of bone tissue mineral density (11%). The lowest average values of bone tissue mineral density, both in lumbar spine and femoral neck, were detected in patients with chronic obstructive pulmonary disease and emphysema, as distinguished from these parameters observed in patients suffered from pulmonary fibrosis, mucoviscidosis and other terminal lungs pathology.

The authors analyze treatment of 155 patients with non-specific pleural empyema in Primorsky Krai: 6 cases of pyopneumothorax, 129 cases of acute empyema and 20 cases of chronic empyema. All patients underwent combined treatment including adequate antimicrobial therapy, detoxication therapy, and immune drugs. Drainage was performed in all cases. The pleural cavity was flushed with bleach solution with subsequent active aspiration. All these methods were efficient in 98 patients. 57 patients were operated, including 28 persons underwent decortication and pleurectomy, 27 patients underwent pleurolobectomy, bilobectomy and pulmonectomy, and 2 patients underwent thoracoplasty and myoplasty. 3.9% of cases were lethal. The average length of hospital stay was 38 bed days. 96.1% of patients recovered and were discharged.

The authors notify of application and prospects of natural orifice transluminal endoscopic surgery and impart results of experimental and clinical researches into transluminal access technique for cholecystectomy, surgeries for internal female genital organs, appendectomy, and other mini-invasive surgical procedures. The Russian Endoscopic Surgeon Society's board refrains from popularising NOTES-technique and restricts the possibility of applying this method by specialised centres and endosurgeons who are good at fibre-optic endoscopy and specially trained.

This paper summarises practice of three surgeries for complicated urinary system tuberculosis with microcystis. The authors have pioneered in Primorye to apply cystoplasty method combined with creation of a reservoir made of detubulated sigmoid colon with the use of surgical stapling instrument. Three months later, the bladder volume was 200-300 ml, the miction was every 2 hours. The authors come to a conclusion that creating a reservoir made of detubulated sigmoid colon and its orthotopic positioning with urination via urethra is the most physiological and reliable method of restoring urine outflow under tuberculosis-affected urinary bladder diseases.

About 50% of patients with choledocholithiasis are persons of elderly and old age. The authors analyze treatment results of 148 patients aged 60 to 89 suffered from choledocholithiasis characterised by various clinical manifestations of choledocholithiasis. The treatment approach was selected individually with due regard to the course of main and associated somatic pathology. To reduce invasiveness of surgical treatment, in some cases these operations were combined and divided into 2 to 4 stages. The lethality rate was 10.8%, being two times less than that compared to the previous period (19.7) when traditional surgical procedures had been applied to treat patients with choledocholithiasis complicated by obstructive jaundice in patients of elderly and old age.

The authors represent a method of forming locomotor eyebulb stump with implant made of polytetrafluoroethylene under back evisceration. The possibility of forming the stump was studied on 20 eyes of 10 rabbits by performing biomicroscopy, determining passive mobility of the stump and carrying out light microscopy after experimental ophthalmosurgical procedures. The observation period lasted 6 months. The findings allowed to justify expediency of applying this method in clinical practice.

In recent years, diagnostic laparoscopy in children has become a method of choice to treat abdominal injuries and acute surgical pathology. This paper summarises practice of 296 endovideosurgical procedures in patients aged 1 to 14 years: 152 cases of acute appendicitis (open surgeries), 144 cases of other pathology. As the last observations showed, 5 patients required conversion, therefore in 139 cases the patients underwent diagnostic or therapeutic laparoscopy. The authors has highlighted the sensitivity of this method and the possibility of using it as therapeutic technique.