EVALUATION OF THE PARAMETERS OF LAPAROSCOPIC APPROACHES USING SPIRAL COMPUTED TOMOGRAPHY
https://doi.org/10.17238/issn2223-2427.2019.1.23-32
Abstract
The parameters of a single incision laparoscopic surgery (SILS) to the base of the vermiform process, the neck of the gallbladder and the duodenal bulb were assessed using spiral computed tomography (CT) in 101 patients and in an anatomical study on 98 unfixed corpses. Four median approaches and access in the left iliac region to the base of the vermiform process, umbilical and epigastric accesses to the neck of the gall bladder, the vertical subcostal, left subcostal and umbilical accesses to the duodenal bulb were evaluated. According to the CT and anatomical data, it has been established that the umbilical access to the appendix provides the optimal conditions for performing surgical interventions using the SILS - technology. In addition, access “2” by individual criteria has the most advantageous spatial characteristics and can also be used for minimally invasive access to the appendix. When comparing the umbilical and epigastric accesses to the neck of the gallbladder, it was found that the epigastric approach is appropriate for the introduction of a manipulation trocar, the umbilical approach is for extracting the gallbladder and visualizing it in minimally invasive surgery. According to the CT and anatomical studies, it was found that the vertical subcostal access to the duodenal bulb has the characteristics sufficient to perform surgical interventions using a SILS - technology.
About the Authors
R. G. Akhmetzyanov
Novokuznetsk State Institute for Further Training of Physicians – Branch Campus of the Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation; State autonomous health care institution of the Kemerovo region «Novokuznetsk city clinical hospital №1»
Russian Federation
Russian Federation
Akhmetzyanov Rustam Gabdylokhanovich – Applicant, Radiology Department, Novokuznetsk State Institute for Further Training of Physicians - Branch Campus of the Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical Academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation; Head of the Radiology Unit, State autonomous health care institution of the Kemerovo region «Novokuznetsk city clinical hospital №1»
5, Stroiteley avenue, Novokuznetsk, Kemerovo Region, 6540054
28, Bardina street, 654057, Novokuznetsk
Yu. B. Razvozzhaev
Novokuznetsk State Institute for Further Training of Physicians – Branch Campus of the Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Razvozzhaev Yuriy Borisovich – Candidate of Medical Sciences, Head of the Radiology Department, Novokuznetsk State Institute for Further Training of Physicians - Branch Campus
5, Stroiteley avenue, Novokuznetsk, Kemerovo Region, 6540054
A. I. Baranov
Novokuznetsk State Institute for Further Training of Physicians – Branch Campus of the Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Baranov Andrei Igorevich – Ph.D., professor, Head of the Department of Surgery, Urology and Endoscopy, Novokuznetsk State Institute for Further Training of Physicians - Branch Campus, Chairman of the Kemerovo Regional Branch of the Russian Society of Surgeons
5, Stroiteley avenue, Novokuznetsk, Kemerovo Region, 6540054
I. Yu. Danilchenko
Novokuznetsk State Institute for Further Training of Physicians – Branch Campus of the Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation; State autonomous health care institution of the Kemerovo region «Novokuznetsk city clinical hospital №1»
Russian Federation
Russian Federation
Danilchenko Ivan Yurevich – Assistant, Department of Radiology
5, Stroiteley avenue, Novokuznetsk, Kemerovo Region, 6540054
A. V. Alontsev
Novokuznetsk State Institute for Further Training of Physicians – Branch Campus of the Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Alontsev Andrei Vladimirovich – Assistant, Department of Radiology, Novokuznetsk State Institute for Further Training of Physicians - Branch Campus
5, Stroiteley avenue, Novokuznetsk, Kemerovo Region, 6540054
A. A. Faev
Novokuznetsk State Institute for Further Training of Physicians – Branch Campus of the Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation
Russian Federation
Russian Federation
Faev Aleksei Alexeyevich – Ph.D., Assistant, Department of Surgery, Urology and Endoscopy, Novokuznetsk State Institute for Further Training of Physicians - Branch Campus
5, Stroiteley avenue, Novokuznetsk, Kemerovo Region, 6540054
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Review
For citations:
Akhmetzyanov R.G., Razvozzhaev Yu.B., Baranov A.I., Danilchenko I.Yu., Alontsev A.V., Faev A.A. EVALUATION OF THE PARAMETERS OF LAPAROSCOPIC APPROACHES USING SPIRAL COMPUTED TOMOGRAPHY. Surgical practice (Russia). 2019;(1):23-32. (In Russ.) https://doi.org/10.17238/issn2223-2427.2019.1.23-32
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