DEPARTMENT OF SURGERY

DEPARTMENT OF SURGERY

Head of the Department: Vladimir Chuprynin, M.D.

E-mail:  v_chuprynin@oparina4.ru

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 comorbid diseases.

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

The Department provides surgical care to patients with solitary or concomitant conditions:

• infiltrative forms of endometriosis with involvement of pelvic organs, small intestine, large intestine, ureters, kidneys;
• 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;
• vaginal prolapse;
• cholelithiasis;
• gallbladder polyps;
• abdominal wall hernias: white line, inguinal, postoperative, umbilical;
• 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;
• 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 ensures 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 diagnostics
• Postoperative monitoring

ENDOSCOPY UNIT

Endoscopy Unit was opened in 2011 due to necessity for advanced diagnostics in patients with severe forms of extragenital endometriosis, mainly of intestinal localization.

The endoscopists now provide a full scope of elective and emergency care.

The Endoscopy Unit provides specification of  involvement  of the organs of gastrointestinal tract in endometriosis, leiomyomatosis and gynecologic cancer,  as well as   identification of the primary pathology.

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 of the mucous membrane with dyes to detect neoplasms and small lesions);
• NBI endoscopy (detection of early cancer and precancerous conditions of the mucous membrane);
• biological tissue sampling for histological and cytological studies

Flexible minimally invasive endosurgical interventions

• treatment  of esophageal varices grade 3 by ligation with latex rings (COOK);
• balloon dilatation of esophageal strictures (Wilson-Cook balloons);
• correction of esophageal  obstruction of the organic origin by installation of  nitinol stents with an antireflux valve;
• correction of colorectal obstruction of the organic genesis by the installation of nitinol stents;

Flexible endosurgery

• electroexcision of gastric (tubulovillous, papillary), duodendal and colonic 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-extractions;
• intraductal lithotripsy;
• nasobiliary drainage tube insertion;
• biliary stenting

Emergency endoscopy

• argon plasma coagulation;
• electrocoagulation of bleeding sites;
• gastrointestinal, tracheal and bronchial foreign bodies removal;
• tracheal intubation;
• bronchoalveolar lavage