Rus / Eng

Treatment in Russia. Kirov

Surgery

OFFICE

OPERATIONS

DOCTORS

In department there is a specialized, including hi-tech medical care to patients. Now in department 8 doctors having the highest and first categories works for 3 doctors there is an academic degree of candidates of medical sciences, the 4th in addition have a certificate of the oncologist.

Department has two operating rooms equipped with modern tools and the equipment, it: endoscopic rack of "Storz", the ultrasonic installation "Soring" and "Sonoca", the electrosurgical device "Energy Platform Force Triad Covidien", the generator of the Valleylab company integrating the mono and bipolar modes of a dissektion of fabrics with a simultaneous hemostasis allowing to carry out an elektroligirovaniye of fabrics by the tools "Liga Sure" in one case), electrosurgical device Erbe Vio and many other things.

In department it is possible to conduct examination with use of modern techniques of a x-ray, magnetic and resonant and computer tomography. Angiography, ultrasonic and laboratory researches, and also endoscopic methods of diagnostics, such as colonoscopy and laparoscopy.

The priority area of work of department is development and improvement of low-invasive surgery and also implementation in practice of X-ray endovascular interventions.

Hernia repair of different localization with the mesh implant installation using open-access and endoscopic methods

Description

Indications

Preoperative Examination

Rehabilitation

Through the incision of the anterior abdominal wall, the hernial sac is excised. Its contents (intestine, omentum) is reduced into the abdominal cavity. The defect of the abdominal wall is eliminated by stitching its edges with the strengthened seam line with a special polymer composite mesh.

The surgery is performed under general anesthesia or spinal anesthesia.

The surgery lasts 1-3 hours.

Abdominal wall hernias of different localization, inguinal hernias

Complete blood count (CBC) and clinical urine analysis. Biochemical analysis of blood.  RW analysis and HIV testing, markers of viral hepatitis B and C. ABO and RhD typing. ECG. Chest X–ray with the number, date, description, ticket. The valid period is one year.

In the presence of chronic diseases, especially lung diseases, it is necessary to submit the conclusion of experts if surgical treatment is possible.

In case of small hernia, the patient becomes physically active on 1st day after surgery, is discharged in 2 days if the course is uncomplicated. With large hernias, the hospital stay is 7-10 days.

Laparoscopic cholecystectomy

Description

Indications

Preoperative Examination

Rehabilitation

Laparoscopic cholecystectomy involves several stages:

- introduction of gas into the abdominal cavity (carbon dioxide or nitrogen oxide),

- introduction of the trocars with manipulating tools in the abdominal cavity,                              - examination (abdominoscopy) of the abdominal cavity,

- exposure of the gallbladder from the junctions, exposure of elements of the liver-duodenal ligament (cystic artery, cystic duct), their intersection and ligation (clipping),

- exposure of the gallbladder from the liver bed,

- removal of the gallbladder from the abdominal cavity, control examination of the abdominal cavity and completion of the operation.

The surgery is performed under general anesthesia.

The surgery lasts 30-40 minutes.

Cholelithiasis, chronic calculous cholecystitis

Complete blood count (CBC) and clinical urine analysis. Biochemical analysis of blood.  RW analysis and HIV testing, markers of viral hepatitis B and C. ABO and RhD typing. ECG. Chest X–ray with the number, date, description, ticket. The valid period is one year.                                                  

Abdominal ultrasound, fibrogastroduodenoscopy, in the presence of chronic diseases, it is necessary to submit the conclusion of experts if surgical treatment is possible.

The patient becomes physically active within a few hours after surgery, on the second day, he is an open ward patient. In most cases due to  general condition after laparoscopic intervention the patient may be discharged on 3-4 days after surgery.

Laparoscopic resection of the adrenal gland or adrenalectomy

Description

Indications

Preoperative Examination

Rehabilitation

Laparoscopic adrenalectomy involves several stages:

- introduction of gas into the abdominal cavity (carbon dioxide or nitrogen oxide),

- introduction of the trocars with manipulating tools in the abdominal cavity                              - examination (abdominoscopy) of the abdominal cavity,

- exposure of the affected adrenal gland from retroperitoneal tissue with ligation( clipping) of blood vessels

- exposure of the adrenal gland from the retroperitoneal space,

- removal of the adrenal gland from the abdominal cavity, control examination of the abdominal organs, the setting of safety drains and completion of the operation. The extracted adrenal gland together with the tumor is sent to the Pathology Department where histological examination is carried out. The result is given to the patient at discharge.

The surgery is performed under general anesthesia.

The surgery lasts 1-2 hours.

Benign, functioning and malignant adrenal tumors

Complete blood count (CBC) and clinical urine analysis. Biochemical analysis of blood.  RW analysis and HIV testing, markers of viral hepatitis B and C. ABO and RhD typing. ECG. Chest X–ray with the number, date, description, ticket. The valid period is one year.              

Ultrasound, CT, abdominal MRI with contrast, fibrogastroduodenoscopy , in the presence of chronic diseases, it is necessary to submit the conclusion of experts if surgical treatment is possible.

The patient becomes physically active within a few hours after surgery, on the second day, he is an open ward patient. In most cases due to  general condition after laparoscopic intervention the patient may be discharged on 3-4 days after surgery.

Laparoscopic fenestration of liver, pancreas, spleen cysts

Description

Indications

Preoperative Examination

Rehabilitation

Laparoscopic cyst fenestration involves several stages:

- introduction of gas into the abdominal cavity (carbon dioxide or nitrogen oxide),

- introduction of trocars with manipulating tools into the abdominal cavity,

- examination (abdominoscopy) of the abdominal cavity,

- visual assessment of the cyst wall that can be examined,

- puncture of the cyst and evacuation of its contents with bacteriological and biochemical analysis (for special indications)

- removal of the cyst wall with the subsequent electrochemical treatment of the cyst cavity in order to prevent relapse. The removed cyst membranes are sent to the Pathology Department where the tumor is examined under the microscope. The result is given to the patient at discharge.

The surgery is performed under general anesthesia.

The surgery lasts 1-2 hours.

Nonparasitic liver cysts more than 5 cm growing with dynamic control of cysts, complicated cysts as well as cysts that cause severe subjective discomfort

Complete blood count (CBC) and clinical urine analysis. Biochemical analysis of blood.  RW analysis and HIV testing, markers of viral hepatitis B and C. ABO and RhD typing. ECG. Chest X–ray with the number, date, description, ticket. The valid period is one year.              

Ultrasound, CT, abdominal MRI with contrast, fibrogastroduodenoscopy, in the presence of chronic diseases, it is necessary to submit the conclusion of experts if surgical treatment is possible.

The patient becomes physically active within a few hours after surgery, on the second day, he is an open ward patient. In most cases due to  general condition after laparoscopic intervention the patient may be discharged on 3-4 days after surgery.

Endoscopic papillotomy, choledocholithiasis, production of stents during mechanical jaundice

Description

Indications

Preoperative Examination

Rehabilitation

The surgery is performed in the X-ray surgery unit under local anesthesia and consists of several stages:

 - introduction of fibrogastroduodenoscope into the duodenum;

- visual inspection of the large duodenal nipple (BDS);

- introduction of a special cannula (thin tube) into the BDS to contrast the bile ducts;

- introduction of a papillotome into the BDS, dissection of the scar stenosis of the BDS;                - extraction of the concretions (stones) from the bile ducts with their preliminary fragmentation;

- control contrast study of the ducts to assess the adequacy of the procedure.


In the course of treatment in some cases there is a need for repeated procedures.


The surgery is performed under local anesthesia.


The surgery lasts about 1 hour.

BDS stenosis, choledocholithiasis

Complete blood count (CBC) and clinical urine analysis. Biochemical analysis of blood.  RW analysis and HIV testing, markers of viral hepatitis B and C. ABO and RhD typing. ECG. Chest X–ray with the number, date, description, ticket. The valid period is one year.              

Ultrasound, CT, abdominal MRI with contrast, fibrogastroduodenoscopy, in the presence of chronic diseases, it is necessary to submit the conclusion of experts if surgical treatment is possible.

The patient becomes physically active within a few hours after surgery, on the second day, he is an open ward patient. In most cases due to  general condition after endoscopic intervention the patient may be discharged on 3 day after surgery.

Reconstructive plastic surgery on hepato-pancreato-biliary zone

Description

Indications

Preoperative Examination

Rehabilitation

The surgery is performed in the surgery unit by surgeons of the highest qualification in hepatopancreatobiliary surgery. The most common surgeries are various biliodigestive (gastrointestinal) anastomoses providing free bile flow from the liver to the gastrointestinal tract. During surgery, temporary intraductal drainage frames are used .

The surgery is performed under general anesthesia.

The surgery lasts  2-4 hours.

Cicatricial strictures of the bile ducts including those resulting from damage during cholecystectomy, complicated forms of cholelithiasis (gallstone disease) accompanied by partial or total destruction of the bile ducts (syndrome of Mirizzi), malignant and benign tumors of the bile ducts

Complete blood count (CBC) and clinical urine analysis. Biochemical analysis of blood.  RW analysis and HIV testing, markers of viral hepatitis B and C. ABO and RhD typing. ECG. Chest X–ray with the number, date, description, ticket. The valid period is one year.              

Ultrasound, CT, abdominal MRI with contrast, fibrogastroduodenoscopy, in the presence of chronic diseases, it is necessary to submit the conclusion of experts if surgical treatment is possible.

The patient becomes physically active on 1-2 days after surgery, the postoperative period if the course is uncomplicated is 12-14 days. The removal of frame drains is carried out in 1-2 months after discharge at the place of residence.

Liver resection of malignant, benign and parasitic lesions

Description

Indications

Preoperative Examination

Rehabilitation

In most cases the surgery is carried out by open laparotomic access and consists of the following stages:

- middle section with cross-section to the right;

- revision of the abdominal cavity, liver revision, assessment of the lesion volume, operability of the process;

- mobilization (exposure) of the affected parts of the liver from the surrounding tissues;

- ligation of vessels supplying the division of the liver along with the tumor scheduled for removal;

- resection of the liver with tumor;

- control of the liver wound in regard to bleeding and bile leakage;

- setting of the drainage;

- suturing of the surgical wound.

The surgery is performed under general anesthesia.

The surgery lasts 2-4 hours.

Malignant primary and metastatic liver tumors, parasitic diseases (echinococcosis and alveococcosis), benign tumors (if indicated ) - hemangiomas, adenomas

Complete blood count (CBC) and clinical urine analysis. Biochemical analysis of blood.  RW analysis and HIV testing, markers of viral hepatitis B and C. ABO and RhD typing. ECG. Chest X–ray with the number, date, description, ticket. The valid period is one year.              

Ultrasound, CT, abdominal MRI with contrast, fibrogastroduodenoscopy , in the presence of chronic diseases, it is necessary to submit the conclusion of experts if surgical treatment is possible.

The patient becomes physically active on 1-2 days after surgery, the postoperative period if the course is uncomplicated is 12-14 days. At discharge, patients with malignant liver diseases are given a copy of the pathohistological conclusion, blocks and cover-glass preparation of the surgical material for postoperative chemotherapy.

Surgery on the pancreas with malignant, benign lesions, cysts

Description

Indications

Preoperative Examination

Rehabilitation

In case of uncomplicated cysts, it is possible to carry out a minimally invasive procedure - external drainage of the cyst under ultrasound control under local anesthesia as well as laparoscopic drainage of the cyst in the surgery unit under general anesthesia. Pancreatoduodenal resection is performed on operable tumors located in the head of the pancreas. If the tumor is located in the tail and (or) the body of the pancreas, distal resection of the pancreas is performed. Patients suffering from chronic pancreatitis with a violation of the outflow of pancreatic juice undergo drainage surgery of the ductal system of the pancreas with partial resection of the altered gland tissue in the head area.

The surgery is performed under general anesthesia.

The surgery lasts 2-4 hours.

False pancreatic cysts after acute pancreatitis, benign and malignant pancreas tumors, chronic pancreatitis with the expansion of the main pancreatic duct

Complete blood count (CBC) and clinical urine analysis. Biochemical analysis of blood.  RW analysis and HIV testing, markers of viral hepatitis B and C. ABO and RhD typing. ECG. Chest X–ray with the number, date, description, ticket. The valid period is one year.              

Ultrasound, CT, abdominal MRI with contrast, fibrogastroduodenoscopy, in the presence of chronic diseases, it is necessary to submit the conclusion of experts if surgical treatment is possible.

The patient becomes physically active on 1-2 days after surgery, the postoperative period if the course is uncomplicated is 12-14 days. At discharge, patients with malignant liver diseases are given a copy of the pathohistological conclusion, blocks and cover-glass preparation of the surgical material for postoperative chemotherapy.

Surgical treatment of the esophageal diverticula

Description

Indications

Обследования перед операцией

Rehabilitation

Depending on the localization, cervical or abdominal (transperitoneal) access is used. The appropriate part of the esophagus is exposed from the surrounding tissues, the esophagus (diverticulum) is protruded to the base and resected, the defect of the esophagus wall is sutured. A safety drain is installed to the area of the operation.

The surgery is performed under general anesthesia.

The surgery lasts 2-4 hours.

Large or complicated diverticula of the cervical (Zenker) and abdominal esophagus

Complete blood count (CBC) and clinical urine analysis. Biochemical analysis of blood.  RW analysis and HIV testing, markers of viral hepatitis B and C. ABO and RhD typing. ECG. Chest X–ray with the number, date, description, ticket. The valid period is one year.              

Esophagus fluoroscopy, fibrogastroduodenoscopy, in the presence of chronic diseases, it is necessary to submit the conclusion of experts if surgical treatment is possible.

The patient becomes physically active on 1 day after surgery, the postoperative period if the course is uncomplicated is 5-7 days.

Plastic repair of the esophagus in cicatricial strictures of the esophagus

Description

Indications

Preoperative Examination

Rehabilitation

The operation is usually carried out in 2 stages. Stage 1 is the plastic repair itself, namely the replacement of the affected esophagus with a portion of the intestine on the feeding vascular leg. The right half of the colon is used as a transplant. The transplant is carried out behind the sternum and removed to the neck.  Stage 2 is performed in 4-6 months. The operation consists in connecting the cervical esophagus with the transplant.

The surgery is performed under general anesthesia.

The surgery lasts 2-4 hours.

Cicatricial esophageal strictures insusceptible of medical treatment (bougienage)

Complete blood count (CBC) and clinical urine analysis. Biochemical analysis of blood.  RW analysis and HIV testing, markers of viral hepatitis B and C. ABO and RhD typing. ECG. Chest X–ray with the number, date, description, ticket. The valid period is one year.        

Esophagus fluoroscopy, fibrogastroduodenoscopy, in the presence of chronic diseases, it is necessary to submit the conclusion of experts if surgical treatment is possible.

The patient becomes physically active on 1 day after surgery, the postoperative period if the course is uncomplicated is 10-12 days.

Total and subtotal resections of thyroid and parathyroid glands

Description

Indications

Preoperative Examination

Examination required for a Consultation

Rehabilitation

The surgery is performed in the surgery unit under general anesthesia. A standard access to the thyroid gland is made by an arcuate incision above the jugular notch of the sternum. After the dissection of the overlying layers (skin, muscles and fascia), the thyroid gland is released from the surrounding tissues. The isthmus is crossed. After the ligation of the feeding vessels, the left and then the right lobe of the thyroid gland are removed. Depending on the endocrinologist's recommendations, complete (total) removal of the thyroid gland or subtotal resection with a small amount of tissue left is performed. This operation is carried out with toxic goiter or multi-node non-toxic goiter. In case of single-node goiter, when the node is located in one of the thyroid lobes, only this lobe with the isthmus is removed. Parathyroid glands are removed in a similar way while the thyroid gland remains intact. The surgery is performed with the maximum possible cosmesis.  

The surgery is performed under general anesthesia.

The surgery lasts 1-2 hours.

Diffuse toxic goiter insusceptible of medical treatment, large nodular goiters or goiters which tend to grow, functioning adenomas of the parathyroid glands

Complete blood count (CBC) and clinical urine analysis. Biochemical analysis of blood.  RW analysis and HIV testing, markers of viral hepatitis B and C. ABO and RhD typing. ECG. Chest X–ray with the number, date, description, ticket. The valid period is one year.      

Thyroid ultrasound, thyroid hormones, parathyroid hormone, TSH (thyroid-stimulating hormone), puncture biopsy of the thyroid gland in nodular goiter.

Consultation of the endocrinologist, the otorhinolaryngologist, the conclusion of the histopathologist based on the results of puncture biopsy

The patient becomes physically active on 1 day after surgery, the postoperative period if the course is uncomplicated is 3-5 days. In case of thyroid gland removal, lifelong hormone replacement therapy is assigned.

Surgical treatment of malignant and benign tumors of the stomach, small and large intestine

Description

Indications

Preoperative Examination

Rehabilitation

The surgery is carried out in an open way under general anesthesia. Stages of the operation:

- laparotomy (dissection the abdomen in the midline);

- revision of the abdominal cavity;

- mobilization of the affected area of the gastrointestinal tract in compliance with cancer principles;

- removal of the affected area with the tumor;

- restoration of the integrity of the gastrointestinal tract.


The surgery is performed under general anesthesia.


The surgery lasts 2-4 hours.

Malignant and benign tumors of the stomach, duodenum, small colon and rectum.

Complete blood count (CBC) and clinical urine analysis. Biochemical analysis of blood.  RW analysis and HIV testing, markers of viral hepatitis B and C. ABO and RhD typing. ECG. Chest X–ray with the number, date, description, ticket. The valid period is one year.      

Abdominal ultrasound, fibrogastroduodenoscopy, fibrocolonoscopy or virtual colonoscopy, CT-enterography, in the presence of chronic diseases, it is necessary to submit the conclusion of specialists if surgical treatment is possible.

The patient becomes physically active on 1-2 days after surgery, the postoperative period if the course is uncomplicated is 12-14 days. At discharge, patients with malignant diseases of the pancreas are given a copy of the pathohistological conclusion, blocks and cover-glass preparation of the surgical material for postoperative chemotherapy.

YANCHENKO VLADIMIR ALEKSANDROVICH

Manager of office of surgical No. 1, doctor-surgeon

Doctor of higher category

Education: graduated from the Kirov GMI majoring in medical business in 1994

Qualification: doctor

Specialty: surgery

POPYRIN IGOR ANATOLYEVICH

Doctor-surgeon

Doctor of higher category

Education: graduated from the Kirov GMI majoring in pediatrics in 1998

Qualification: doctor

Specialty: surgery

ZOLOTAREV ALEXEY SERGEYEVICH

Doctor-surgeon

Doctor of higher category

Education: graduated from the Kirov GMA majoring in pediatrics in 2013

Qualification: doctor

Specialty: surgery

Consultation with the doctor