The aim of the study is to evaluate the effectiveness of a personalized algorithm for determining the technique of surgical treatment of inguinal hernias, which allows choosing the optimal operational tactics (its modifications) depending on the anthropometric, clinical, instrumental data of the patient.

In the course of the study, the results of the application of a clinical algorithm in the Medical research and Educational center of Lomonosov Moscow State University for patients with unilateral non-incarcerated symptomatic inguinal hernias were analyzed. The frequencies of the main postoperative adverse outcomes of the research group were compared using the algorithm and patients of the German Herniamed Hernia Register, for whom only standard principles of surgical intervention selection are applied, the main provisions of the recommendations of the international HerniaSurge Group of experts. In some cases individual exceptional factors of patients were taken into account.

The frequency of chronic pain and pain requiring repeated surgery was significantly lower than the average frequencies of the German Herniamed register (13.8% vs 28.7% (p<0.00001) and 0.99% vs 3.8% (p=0.0103) respectively). At the same time, the frequency of adverse outcomes, such as relapses and early postoperative complications, is similar to international population data.

Background: Over the past two decades, synthetic loop surgeries have gained widespread popularity due to their ease of implementation, relatively high efficiency and low cost in the treatment of women with stress urinary incontinence (SUI). To date, several dozen variants of minimally invasive surgical procedures are known, but none of the known methods provides a 100% reliable result. At the same time, the effectiveness of the performed operation to eliminate involuntary loss of urine is inexorably reduced in the follow-up.

Aims of the study. On the basis of a neuroregulatory theory published in 2019 and according to a neurophysiological model, provide an explanation for both the mechanism of urinary retention and the role of the tape implanted under the urethra in its recovery.

Material and methods. Analysis of a large number of foreign and domestic literary sources, the results of clinical observations of surgery using the original author's version of the trocar synthetic sling (TSS) for 19 years, the data of the original method of uroflowmetric monitoring.

Results. Taking into account the created and published theoretical basis, an explanation is presented for the effect of increasing the tone of the pelvic floor muscles in women with urinary incontinence after surgical correction using modern synthetic materials.

Conclusions. The restoration of the mechanism of urinary retention in women after the operation of a synthetic sling occurs under the condition of activation of the 4th mictional reflex. In the event of a violation of the components of this reflex, the effectiveness of the sling procedure decreases and a recurrent form of the disease occurs, regardless of the type and volume of the operation used. The presence of a theoretical basis that explains both the mechanism of urinary retention itself and the pathogenesis of the development of the disease allows us to offer options for conservative therapy to prepare for the sling procedure and thereby increase the follow-up efficiency of any loop surgery.

Purpose of the study is to evaluate the effectiveness of treatment of gastroesophageal reflux disease in patients after sleeve gastrectomy using botulinum toxin injections into the pylorus.

Materials and research methods. A prospective controlled study of 42 patients undergoing laparoscopic sleeve gastrectomy with a postoperative period of one to six months. The patients were divided into two groups: the main group (21 patients) underwent complex treatment, including basic conservative therapy, supplemented by endoscopic injection of botulinum toxin into the pylorus; the comparison group (23 patients) received only basic conservative therapy. All patients included in the study were questioned using the GERD-HRQL questionnaire.

Research results. In the main group, one month after the botulinum toxin injection, the overall score according to the GERD-HRQL questionnaire reliably reflected the positive dynamics in the course of gastroesophageal reflux disease. Six months after the start of treatment in the main group, the average score was significantly lower than in the comparison group (p  0,05), and the general satisfaction of patients with respect to control over symptoms of gastroesophageal reflux was 85% (satisfactory + neutral). In the comparison group, after 6 months, there was no significant and reliable dynamics, and the general dissatisfaction with the state remained at the level of 65%.

Conclusion. Basic conservative therapy in combination with the procedure of endoscopic injection of botulinum toxin into the pylorus effectively helps to reduce the clinical manifestations of gastroesophageal reflux in the immediate postoperative period after sleeve gastrectomy.

The purpose of the study is to present and evaluate the results of treatment of patients with parasitic liver damage using a modern diagnostic algorithm, various methods and stages of surgical treatment.

Material and methods. The results of treatment of 81 patients (34 men (42%), 47 women (58%)) who underwent 104 surgical interventions for liver echinococcosis in the surgical department No. from 2015 to 2021. The difference in the number of operations performed and actual patients is explained by the use of a staged method of surgical treatment in some cases.

Results. Of the total number of operated patients, one-stage surgical interventions were applied in 64 (79%) cases. In 17 (21%) patients, various staged methods of surgical treatment were applied, which made it possible to exclude some of them from the category of "non-resectable" and perform surgical treatment with good results. An unsatisfactory result of treatment with a fatal outcome was noted in one case from the total array of patients.

Conclusion. The use of a modern diagnostic algorithm, various surgical techniques, including staged minimally invasive and laparoscopic ones, makes it possible to achieve good treatment results in a specialized surgical center.

Aim: To compare and evaluate the immediate and long-term results of performing transabdominal preperitoneal hernioplasty (TAPP) and total extraperitoneal hernioplasty (TEP) for the treatment of inguinal hernias after surgical treatment of prostate cancer;

Material and method: the study is a clinical analytical prospective study, with the use of randomization. The study included 88 patients with inguinal hernia, who were randomly divided into two groups (group A (n = 44) and group B (n = 44)). Patients in group A received TEP, those in group B received TAPP. The end points of the study were the results associated with the operation itself and the prognosis of the disease in the two groups.

Results: Group A: one patient had a scrotal hematoma, in 2 cases nosocomial pneumonia or infectious complications from the postoperative wound. The overall rate of early postoperative complications was 6.8%. In group B, the following postoperative complications were reported: in one case, intestinal injury, 1 case of acute urinary retention, 2 cases of scrotal hematoma. The overall incidence of early postoperative complications was 9.1%. There was no statistically significant difference in the incidence of postoperative complications between the two groups (χ = 0.009, P > 0.05).

Conclusion: During the analysis of the obtained results, no statistically significant difference was found in the duration of hospitalization, the volume of blood loss and the severity of the pain syndrome (P> 0.05); however, the comparison groups differed in the duration of the operation: the operation time in group A was longer than in group B. (P＜0.05).

Aim: improvement of outcomes of slipped caput femoral epiphysis.

Materials and methods: This article analyses the treatment of 198 patients with different stages of slipped caput femoral epiphysis.

Results: due to the high rate of disability in patients with slipped caput femoral epiphysis and the variety of methods of surgical treatment of this pathology, the analysis of the most common treatment options for slipped caput femoral epiphysis, depending on the stage of the disease, was carried out and the algorithm to determine the most appropriate surgical treatment option was developed.

Conclusions: The developed algorithm for surgical treatment choice in juvenile slipped caput femoral epiphysis makes it possible to decide on the treatment of slipped caput femoral epiphysis as quickly as possible and to perform surgical treatment at an early stage, immediately after the pathology is identified.

The treatment methods used in the development of the algorithm are for the most part technically simple to perform. The fixation methods make it possible to carry out early activation and rehabilitation of the patient, which considerably improves the patient's quality of life.

The use of shoulder joint replacement has increased significantly since the early 2000s. The method, initially used as the gold standard for the treatment of osteoarthritis, has long gone beyond the generally accepted indications, expanding its use for the treatment of shoulder joint injuries and their consequences. The new generation of implants has led to improved outcomes such as functionality, range of motion in the shoulder joint and patient satisfaction. The decision to perform anatomical endoprosthetics (hemiarthroplasty, total shoulder joint replacement) depends on the degree of osteopenia, the viability of the humerus head, the integrity of the tubercles or the functional state of the rotator cuff of the shoulder. This type of arthroplasty remains for patients with a functional rotator cuff. Reversible endoprosthetics is today the preferred treatment option for non-fusion or improper fusion of the proximal humerus with a collapse of the humerus head or a non-functioning rotator cuff. Despite the limitations and complications reported in the literature, revision arthroplasty has a good potential for functional improvement in patients with the consequences of injuries of the proximal humerus. This is a group of patients, which is a difficult task for a surgeon. As further research is carried out, implant designs and their clinical application will continue to evolve.

The article presents the review of the literature data covering the most common causes of obstructive jaundice, methods for its differential diagnosis, as well as sonographic criteria for making a diagnosis. Based on the review, it was found that in practical surgery, ultrasound has a number of advantages in the differential diagnosis of obstructive jaundice. Sonography is an affordable, non-invasive method with high information content, allowing to make a diagnosis in the shortest possible time. The main reliable sonographic criteria for the obstructive genesis of icterus is prestenotic dilatation of the bile ducts. However, since the interpretation of ultrasound results is subjective and depends on the qualifications of the ultrasound specialist, verification of sonographic information by other research methods is necessary.

The development of bronchopleural fistula (BPS) against the background of advanced pleural empyema, as a result of severe pneumonia, is a formidable complication. The most significant obstacle in the surgical treatment of this group of patients is: a pronounced comorbid background, low functional indicators of patients, high requirements for surgical technique when performing reconstructive plastic interventions in BPS. Multiple surgical methods for treating bronchopleural fistulas are suggested. The first of these were to suture the defect. However, access through the infected pleural cavity leads to suture eruption and recurrence of the fistula, despite the fact that some authors have proposed combining these operations with various variants of myoplasty, thoracoplasty, removal of the fibrous capsule of empyema. Unsatisfactory functional and cosmetic outcomes during these surgical interventions led to the development of endoscopic, minimally invasive surgical interventions. Modern technologies allow temporary endoscopic bronchiococclusion, which stops the release of air from the defect. However, at the same time, she "turns off " part of the lung tissue from the gas exchange. Prolonged bronchial occlusion leads to the development of pneumonia with an outcome in the destruction of lung tissue. Our team of authors treatment of bronchopleural fistula with xenopericardium in combination with negative pressure therapy. This area seems to us very promising, and in this work we would like to share our first experience.

Background: According to current literature, anastomosis leakage holds a leading position among all complications of colorectal surgery. A particular area of prevention of this complication in colorectal oncology is the research of the possibilities of using biological adhesive compounds as a universal biological and mechanical barrier to the spread of intraluminal microflora and tumor cells.

Clinical case: A 65-year-old patient (female) was hospitalized with a diagnosis of rectal cancer cT3cN1cM0 (stage III) after neoadjuvant chemoradiotherapy. Surgical treatment was performed: the laparoscopic low anterior resection of the rectum with expanded lymphodissection, protective loop ileostomy. The anastomosis was formed at a height of 4 cm from the anus. Intraoperatively, the anastomosis line was strengthened using the Vivostat R system product. The technology of on-site preparation and application of the compound is described in the paper.. The postoperative period passed without complications.

Conclusion: Due to the possible economic, oncological and postoperative advantages, the use of modern fibrin adhesive compositions is quite promising for introduction into surgical practice. It is required to conduct research aimed at studying the effectiveness of this method of preventing the leakage of colorectal anastomoses.