Surgical division

Surgical division

ABOUT THE DEPARTMENT

The patients of the Department are women and men of any age, who need to undergo surgical interventions.

Experienced and qualified surgeons and obstetricians-gynecologists as well as proctologists, urologists flebologists, angeologists, laparoscopists perform complex procedures in combination of several diseases.

Choosing the treatment tactics, the preference is given to organ-sparing surgical interventions, preservation and restoration of reproductive function in women.

FOCUS AREA

Advanced surgery with widespread and deep infiltrative forms of endometriosis with damage to the abdominal wall, pelvic organs, small intestine, large intestine, ureters, kidneys is one of the priorities of the Department.

The Department provides surgical care in patients with:

• uterine myoma of any size and location;
• adenomyosis;
• cervical pathology;
• intrauterine pathology (endometrial hyperplasia, submucous myoma, intrauterine synechiae, intrauterine septum);
• benign tumors and ovarian masses;
• ectopic pregnancy;
• severe adhesive process in the abdominal cavity;
• malformations of female reproductive organs;
• pelvic pain syndrome;
• stress urinary incontinence with the use of synthetic materials (TVT-O);
• vaginal prolapse;
• cholelithiasis;
• gallbladder polyps;
• abdominal wall hernias: inguinal, postoperative, umbilical, the white line of the abdomen;
• femoral hernias, hernias of rare localization, recurrent and restrained hernias;
• diseases of the gastrointestinal tract (benign tumors, diverticulosis, peptic ulcer, acute and chronic appendicitis, abdominal adhesions, serosocele, bowel reconstructive surgery);
• benign thyroid diseases (nodular and diffuse);
• hiatal hernia, achalasia, cardia;
• tumors and masses of the organs of the abdominal cavity and retroperitoneal space (liver, spleen, adrenal glands, pancreas);
• varicose veins of the lower extremities at any stage of chronic venous insufficiency;
• benign neoplasms of skin, soft tissues (lipomas, fibromas, atheromas, cysts, etc.) of any localization;
• hemorrhoids  of III, IV stage

EQUIPMENT AND TECHNIQUES

A full cycle of preoperative, surgical and postoperative care in accordance with the international standards is provided in the Department. The use of the modern equipment and techniques helps for effective and safe treatment and fast recovery after surgery of any degree of complexity.

• Very efficient high-tech medical equipment (electrosurgical devices  for monopolar and bipolar electrosurgery with the use of Vesalius molecular resonance generator; HARMONIC ultrasonic scalpels, PLASMAJET device, modern suture materials)
• Comprehensive methods of preoperative diagnostics (ultrasound with duplex scanning, spiral computed tomography, magnetic resonance imaging, cystoscopy, colonoscopy, gastroscopy, X-ray studies
• Innovative laboratory research methodologies
• Postoperative monitoring

ENDOSCOPY UNIT

Endoscopy Unit opened in 2011 due to necessity for additional examination of the patients with severe forms of extragenital endometriosis, mainly of intestinal localization.

Since that time, endoscopy was rapidly developing, and at present, the Endoscopy Unit is an inner section of the Department of Operative Gynecology and General Surgery, and the endoscopists provide a full scope of elective and emergency care.

The Endoscopy Unit performs a supplemental function in the diagnosis and clarification of the spread of the pathological process in the abdominal cavity to the organs of the gastrointestinal tract, as well as   identification of the primary pathology of the organs of the gastrointestinal tract.

FOCUS AREA

Extragenital (colorectal) endometriosis

ENDOSCOPIC  INTERVENTIONS

• Diagnostic video endoscopy with and without sedation
• esophagogastroduodenoscopy, determination of level of contamination with Helicobacter pylori (rapid urease test); PH test;
• duodenoscopy, insertion of a nasogastric tube;
• colonoscopy;
• ileoscopy;
• bronchoscopy;
• intraoperative choledochoscopy;
• retrograde cholangiopancreatography;
• chromoscopy (staining the mucous membrane with dyes to detect neoplasms and small lesions);
• NBI endoscopy (detection of early cancer and precancerous conditions of the mucous membrane);
• taking biological tissue samples for histological and cytological studies
• Flexible minimally invasive endosurgical interventions
• treatment  of esophageal varices grade 3 veins by ligation with latex rings (COOK);
• balloon dilatation of esophageal strictures (Wilson-Cook balloons);
• resolving esophageal  obstruction obstruction of the organic origin genesis by installation of  nitinol stents with an antireflux valve;
• resolving colorectal obstruction of the organic genesis by the installation of nitinol stents
• Flexible endosurgery
• electroscission of gastric (tubulovillous, papillary), duodendal, colonic and brochial polyps;
• endoscopic resection with submucosal dissection in early stage of stomach, esophagus, colon cancers;
• balloon dilatation of esophageal strictures;
• intragastric balloon placement to reduce body weight;
• insertion of nasogastric (nasogastrointestinal tube);
• endoscopic loop ligation with PolyLoop device to prevent bleeding after polypectomy procedure);
• argon plasma ablation of the echophageal mucosa and  gastric mucosa in case of gastrointestinal metaplasia
• Treatment of patients with neoplastic and non-neoplastic obstructive jaundice  (calculi in extrahepatic bile ducts, postoperative strictures of choledochous duct)
• endoscopic papillosphincterotomy;
• litho extraction;
•  intraductal lithotripsy;
• nasobiliary drainage tube insertion;
• biliary stenting;
• Emergency endoscopy
• argon plasma coagulation;
• clipping of vessel stump;
• electrocoagulation using hot biopcy forceps;
• submucosal saline solution injection containing vasoconstrictor agents
• gastrointestinal, tracheal and bronchial foreign bodies extraction;
• tracheal intubation;
• bronchoalveolar lavage;