Journal of obstetrics and women's diseasesJournal of obstetrics and women's diseases1684-04611683-9366Eco-Vector8760610.17816/JOWD87606Research ArticleEstablishment of urgent gynecological endovideosurgery in conditions of small townSheshunovI. V.<p>Doctor of Medical Sciences, Professor, Rector</p>info@eco-vector.comDanilovD. V.<p>PhD</p>info@eco-vector.comSubbotinD. N.info@eco-vector.comRozuvanА. А.info@eco-vector.comKirovsk State Medical AcademyMedical Centre-52, Federal medicobiological agency15112005545S1011011511200511112021Copyright © 2005, Eсо-Vector2005<p><strong>Material and methods. </strong>To assess the psychological reaction to the stress connected to the laparoscopic intervention Spilberg - Hanyn scale have been used. Comparative analysis was used in two groups of patients with fallopian tube rupture (as a result of tubal gestation). In the Ist group there were 15 patients who had undergone laparoscopic surgery. In the IInd group there were 15 patients who had undergone laparotomy. In both groups average age of patients was 28 3,1 and 30 2,3 respectively. We estimated correlation between degree of anxiety and risk appraisal for surgical treatment of patients with ectopic pregnancy in both groups.</p>emergency gynecological endovideosurgeryultrasound diagnosticspathology of the small pelvisectopic pregnancyovarian apoplexyendovideosurgical interventionэкстренная гинекологическая эндовидеохирургияультразвуковая диагностикапатология малого тазавнематочная беременностьапоплексия яичникаэндовидеохирургическое вмешательство<p><strong>Material and methods. </strong>To assess the psychological reaction to the stress connected to the laparoscopic intervention Spilberg - Hanyn scale have been used. Comparative analysis was used in two groups of patients with fallopian tube rupture (as a result of tubal gestation). In the Ist group there were 15 patients who had undergone laparoscopic surgery. In the IInd group there were 15 patients who had undergone laparotomy. In both groups average age of patients was 28 3,1 and 30 2,3 respectively. We estimated correlation between degree of anxiety and risk appraisal for surgical treatment of patients with ectopic pregnancy in both groups.</p>
<p><strong>Results. </strong>Most patients, who displayed high level of anxiety (75%) were found within IInd group, i.e. there was revealed correlation between level of anxiety and risk appraisal for forthcoming laparotomy (r 0,7). In both groups assessment of patients reaction to specific situation (hospitalization), has displayed that level of anxiety, that was estimated by Spilberg - Hanyn test, was mild (31 - 45 point; date of test authors), whereas the same indicator for the patients from IInd group was positively higher (44,4 6,5 и 39,9 8,0 correspondingly). The same time, more then 65% of patients have displayed high level of anxiety (46) and only every tenth of patients have shown low level of anxiety (30). The biggest increase of the indicators of anxiety was noticed among patients who was diagnosed of ectopic pregnancy (47,75 0,46).</p>
<p><strong>Conclusions.</strong> The introduction of round-the-clock ultrasound examination and endovideosurgical interventions into the practice of the gynecological department made it possible to:</p>
<ol>
<li>Develop criteria for differential clinical and sonographic diagnosis.</li>
<li>To refuse unjustified painful and traumatic interventions - punctures of the posterior fornix.</li>
<li>Refuse surgery for ovarian apoplexy.</li>
<li>Almost completely replace the laparotomic method of access for emergency surgery on the uterine appendages, which made it possible to reduce the cost of treating emergency patients, reduce trauma, hospitalization duration, and disability of patients.</li>
</ol>