MODERN APPROACHES TO SIMULTANEOUS OPERATIONS IN THE URGENT LAPAROSCOPIC SURGERY

Laparoscopic simultaneous operations due to the acute surgical pathology become more common nowadays. However, the unified standards for such surgical interventions have not been established yet. Issues as to the place of the trocar insertion in the case of ventral hernia are still disputable as well as there were no discussions as for the results of simultaneous operations in the urgent surgery. We have conducted a retrospective analysis of 718 medical records of patients who were treated in the Central Medical Clinical Hospital. Simultaneous operations involved the liquidation of umbilical hernia, fenestration of hepatic cyst, laparoscopic cholecystectomy, laparoscopic appendectomy and excision of uterine annexes' cyst. The simultaneous operations have been not performed in the case of purulent peritonitis. In all the cases, when a patient suffered from the um-bilical hernia, the surgical intervention began with herniotomy. By making such access, a surgeon has the possibility to place the first trocar safely. In none of the cases, we have noticed suppuration or other significant complications from the surgical wound except for the minor reactive and inflammatory changes in skin and hypoderm at the area of the postoperative wound, which allows using synthetic materials for the abdominoplasty. Duration of laparoscopic operations has been analysed. The time for surgical operations has decreased almost by half and their number has increased for the previous 4 years. The duration of stay in the hospital did not significantly differ from the similar hospitalization period in the absence of combined pathology. Simultaneous surgical interventions in the abdominal organs with the acute surgical pathology should be actively imple-mented in practice of any surgical hospital without any risk to the patient's health.