Organ–preserving operations for the gun–shot thoraco–abdominal and abdominal woundings with splenic injuries

Objective.To determine the expediency of the spleen–preserving operations performance for its injury due to gun–shot thoraco–abdominal and abdominal woundings. Materials and methods. Of 51wounded persons with the gun–shot penetrating abdominal woundings with splenic injuries 8 (15.7%) were operated on the II level of the medical help delivery, while on the ІІІ level – 43 (84.3%). Of 43 wounded persons, operated on the ІІІ level of the medical help delivery, in 35 (81.4%) splenectomy was performed, while in 8 (18.6%) – the organ–preserving operations. All the splenic injuries have been characterized as a shrapnel woundings. The splenic damage degree was estimated in accordance to Moore, taking into account its structure. In 5 (62.5%) wounded persons the open laparotomy organ–preserving operations were performed, and while using video–laparoscopic system– in 3 (37.5%). Results. Ultrasonographic investigation in accordance to the FAST–protocol was done in all the wounded persons, what have permitted to determine the blood abdominal outpouring volume as well as the splenic injury presence. The affection volume and further tactics were determined using video–laparoscopy. The Stage I splenic affection in accordance to Moore was diagnosed in 4 (50%) wounded persons, the Stage ІІ – in 3 (37.5%), and the Stage ІІІ – in 1 (12.5%). In all the patients, in whom organ–preserving interventions were performed, the surgical help volume consisted of coagulation, using the radiofrequency therapy apparatus MEDTRONICAEX and the hemostatic sponge application with drainage of the left subdiaphragmatic space, using silicone tube. Conclusion. Organ–preserving operations in splenic injury are expedient to be performed on ІІІ level of the medical help delivery, while presence of local conditions, such as the organ injury degrees І and ІІ,determined in accordance to Moore, as well as adequate time and equipment

The organisation of using videolaparoscopy in military field hospital in conditions of anti-terroristic operations in Easter Ukraine

Ministry of Defense, Kiyv, Military-Medical Clinical Centre of south region, Odessa, Military-Medical Clinical Centre of south region of Ukraine, Odessa, Odessa national medical university, Odessa, Military-Medical Clinical Center of South region, Odessa, Ukraine, Al XIII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” și al III-lea Congres al Societății de Endoscopie, Chirurgie miniminvazivă și Ultrasonografie ”V.M.Guțu” din Republica MoldovaBackground: Improvement of the medical support for injured in the region of anti-terroristic operation by using endovideo surgical techniques in the hospitals of the 2-3nd Echelon. Methods and materials: In June 2014 mobile military hospital was set up for providing qualified surgical help to warriors in the region of eastern Ukraine. 1460operations (62 laparoscopic) were carried out during first 9 months. Results: We use data of 23 patients suffered under abdomen and pelvis injuries: 18 had missile and gunshot wounds, 5 had closed traumas. Acute diseases of the abdomen cavity were diagnosed 39 patients. The penetrative character of shoot wound was excluded by 6 patients using the diagnostic laparoscopy. Out of 5 patients with closed traumas of abdomen, injuries of internal organs were identified in 2 cases, operations were finished laparoscopically. Suffering from urgent diseases of the abdomen cavity organs, 10 patients underwent the laparoscopic appendectomy for acute appendicitis; 2 persons - the laparoscopic diverticulectomy for Meckel’s diverticulitis; in 3 cases the ovarian apoplexy and haemoperitoneum were detected during the laparoscopy, the laparoscopic resection of ovarium was performed; 1 patient underwent laparoscopy for pancreonecrosis, 20 laparoscopic cholecystectomy for acute calculous cholecystitis; one laparoscopic cholecystectomy for cancer of the pancreas, obstructive jaundice; 2 patients had laparoscopic suturing of perforative ulcers in duodenum. Conclusion: Well-founded approaches of treatment and diagnosis of shoot wounds of abdomen and pelvis by using the video laparoscopic equipment in the field conditions (first time in the Ukrainian history) were performed. Application of the endovideo surgical technics allowed avoiding 20 useless laparotomies

Propagation of the electromagnetic waves in double ring waveguide with dielectric layers

In this paper the problem of electromagnetic wave propagation in periodical structure consisting of coaxial metallic rings separated by a homogeneous isotropic dielectric layer with complex dielectric permittivity is considered