Vol 3, No 2 (2013)

Introduction. Robot-assisted procedures become popular all over the world. In the current article we share our experience of 100 surgeries, performed for the kidney and prostate cancer. Patients and methods. Operations were performed on da Vinci S system (Intuitive Surgical, USA) and enclosed 31 radical nephrectomies, 22 partial nephrectomies and 49 radical prostatectomies. All procedures were made through transperitoneal approach. Partial nephrectomy was performed under total ischemia and under regional ischemia via clamping renal parenchyma or segmental renal artery. Results. The mean operation time was 105, 133 and 165 minutes and the mean blood loss was 110, 140 and 150 ml for radical nephrectomy, partial nephrectomy and radical prostatectomy respectively. The mean warm ischemia time during partial nephrectomy was 15 minutes. Cancer-specific and overall survival rate was 100% though all the period of observation

Introduction. The aim of the study is to share the experience in performing robotic and laparoscopic partial nephrectomy in the conditions of regional ischemia by placing a special surgical clamp on renal parenchyma or by selective clamping of segmental renal artery. We describe the main pros for performing regional ischemia, i. e. lower risk of acute kidney injury in the postoperative period. Matherials and methods. Laparoscopic and robot-assisted partial nephrectomy under regional ischemia was performed in 7 cases aged 35–72. The tumor size varied from 2 to 4 cm. Special surgical clamp was used in 6 cases and segmental renal artery clamping was performed in 1 case. Results. The operative time varied from 120 to 190 minutes, regional ischemia time was 13–30 minutes and blood loss — 30–270 ml. The were neither conversions nor complications. The serum creatinine level did not vary significantly before and after the procedure. Conclusion. Partial nephrectomy under regional ischemia prevents the onset of acute kidney injury. The special surgical clamp makes the surgery easier and reduce the operative time and blood loss.

The aim of the study: to clarify the diagnostic value of the seminal vesicles mucus in chronic prostatitis using an experiment in small laboratory animals. Material and methods. The research was carried out on 98 not purebred white male rats in two series of experiments (acute and chronic prostatitis — 46 and 52 rats respectively). In both series rats were divided into four groups. In the 1st group there were intact rats (controls). The 2nd group rats received 0,25 ml of dymexide through rectum. The 3rd group rats received 0,25 ml of turpentine same administration. The 4th group rats received 1 ml of the mix of turpentine and dymexide through rectum. The nature and characteristics of macro- and microscopic changes in the prostate in acute and chronic prostatitis were analyzed (in 10 and 35 days from the beginning respectively). Results. In 10 days a clear inflammatory process was seen in the prostates of 3rd and 4th group rats. It was accompanied by acute inflammation of the seminal vesicles, which was confirmed by their increase and seal. The analysis of weight factor indicators of the prostate and seminal vesicles showed its increase in 3rd and 4th groups in comparison with corresponding factors in 1st and 2nd groups. In 35 days from the beginning of the experiment these factors became significantly higher in 3rd and 4th groups comparing with the controls. Histological examination of the prostate and seminal vesicles showed signs of chronic inflammation (in 80 and 57% respectively) in 3rd and 4th group rats. Mucus stretch between the jaws of tweezers increased to a level, which was 5 times higher than normal (controls) in seminal vesicles chronic inflammation. Conclusion. The sign, indirectly indicating the presence of inflammation in the seminal vesicles in this experiment can be regarded as an increase in the size of the seminal vesicles, increased mucus stretch between the jaws of tweezers as well as an increase in weight factor indicators. The basis for this conclusion has served as a direct dependence of the frequency of the above symptoms occurrence with evidence to confirm the presence of inflammation obtained by morphological study.

Лекция посвящена эндовидеохирургическому лечению патологической подвижности почки — нефроптоза. Рассмотрены причины и факторы риска развития нефроптоза, клиническая симптоматика, диагностика, показания к оперативному лечению. Подробно описана техника эндовидеохирургической нефропексии и особенности послеоперационного ведения больных.