TECHNIQUE OF INSTALLING LAPAROSCOPIC PORTS TO PERFORM SIMULTANEOUS LAPAROSCOPIC SURGERIES

Abstract

Summary. According to official WHO statistics, currently in the Western world up to 30 % of all patients who seek medical care for surgical pathology of the abdominal cavity have concomitant surgical pathology. Also, due to the course of medicine aimed at maximum efficiency, it is re­commended to perform early surgical treatment of such pathologies as gallstones, hiatal hernia, hernia of the anterior abdominal wall.

The aim of the study – to evaluate the ergonomic component when performing conventional laparoscopic surgeries and simultaneous laparoscopic surgeries for the treatment of gallstone disease and combined surgical pathologies, such as hiatal hernia, inguinal hernias, peritoneal adhesions, pancreatic and liver tumors (benign); assess the impact of ergonomics on key performance and safety indicators; identify the advantages and disadvantages of methods; assess whether the developed method affects ergonomics during the surgery.

Materials and Methods. 175 patients underwent surgery for the simultaneous treatment of concomitant and major surgical diseases in Volynian Regional Clinical Hospital. Indicators of operations were analyzed and compared, such as duration of preoperative examination, duration of surgery, number of intraoperative complications, time of hospital stay after surgery, intensity of pain syndrome, frequency of early postoperative complications. The method with the null hypothesis, Pearson's analysis and Mann-Whitney method was used.

Results and Discussion. Performing simultaneous laparoscopic interventions using the developed technique has a positive effect on the time of surgery and the number of intraoperative complications. There is also a noticeable effect on comfort of surgeons during the surgery, which is expressed in the reduction of psycho-emotional and physical fatigue in surgeons after surgeries using the developed technique in comparison with conventional technique. The technique allows performing one-time treatment of cholecystolithiasis and concomitant surgical pathology without deterioration of ergonomic conditions. Developed methodic is effective and safe.

Conclusions. The level of physical and emotional fatigue directly affects the quality of the surgery, as well as the subsequent surgical interventions, which is reflected in the statistics of complications and time of operations, which are significantly reduced after we have introduced the technique of simultaneous surgeries.