Digestive Surgery Department

The Department of Digestive Surgery offers cooperation in developing diagnostic methods and methods of minimally invasive surgical treatment for digestive pathology, clinical testing of new drugs, new tools, sutures and sutures.

 

Researchers of the Department of Digestive Surgery:

Doctors of the surgical department of the digestive system:

Department of Anesthesiology with Intensive Care Beds (VALIT)

Development and clinical implementation of methods of diagnosis and surgical treatment of diseases of the digestive system

  1. Surgical treatment of refractory gastroesophageal reflux disease (GERD), and hernia of the esophageal orifice of the diaphragm (endolaparoscopic and endosurgical methods, including in the modification of the clinic).
  2. Surgical treatment of achalasia of the cardia by endolaparoscopic and endosurgical methods with the predominant use of balloon pneumocardiodilation and Geller’s operation, including in the modification of the clinic.
  3. Surgical treatment of complicated peptic ulcer disease (recurrent ulcerative bleeding, stenosis of the original stomach and duodenum) and tumors of the stomach with the use of traditional resection and organ-preserving surgery endolaparoscopically and openly.
  4. Surgical treatment of morbid obesity with the predominant use of laparoscopic hose resection of the stomach.
  5. Surgical treatment of calculous cholecystitis and gallbladder polyps – laparoscopic cholecystectomy.
  6. Diagnosis and surgical treatment of cholecystolithiasis, chronic calculous cholecystitis with single and numerous stones, gallbladder polyps with preservation of the gallbladder – endolaparoscopic cholecystolithotomy and endolaparoscopic cholecystopolypectomy.
  7. Surgical treatment of cholelithiasis (stones in the extrahepatic bile ducts) and its complications (mechanical jaundice, stenotic papillitis, etc.) with the use of endolaparoscopic and open technologies, endoscopic retrograde cholangiopancreatography (ERPP) and transparenic
  8. Surgical treatment of injuries and cicatricial strictures of the bile ducts in an open way
  9. Surgical treatment of complications of chronic pancreatitis and tumor lesions of the pancreas: duodenum-preserving resection and drainage interventions (Frey’s operation, Beger’s operation, Berne’s operation) and extended resections of the pancreas (pancreatoduodenal resection, central resection, central resection, W).
  10. Minimally invasive interventions for cystic lesions of the pancreas and liver, including puncture and drainage interventions under sonographic / radiographic control.
  11. Surgical treatment of anterior abdominal wall hernias of different localization (inguinal, umbilical, postoperative, including white line diastasis) using laparoscopic (TARR, IPOM) and open technologies using modern alloplastic materials.
  12. Surgical treatment of complicated forms of Crohn’s disease, nonspecific ulcerative colitis (NSAIDs) and intestinal tumors.
  13. Puncture biopsy of the liver and focal neoplasms of the abdominal cavity, including the pancreas, under sonographic control.

The topic of research work of the department for 2020-2022: “To study the peculiarities of complicated hernia of the esophageal orifice, gastroesophageal reflux disease, achalasia of the cardia, stenosis of the gastroduodenal zone of ulcerative origin and improve methods of surgical correction with the help of surgical correction.

In the Department of Digestive Surgery from 1970 to 2020. 10 doctoral and 17 candidate dissertations were completed, 41 diagnostic methods, 47 treatment methods were developed, more than 480 articles, 5 monographs, 7 reference books, 1 manual were published. 15 methodical recommendations, 2 textbooks, 3 departmental instructions were issued, more than 32 copyright certificates were received.

Sleeve gastrectomy

The operation is to remove part of the stomach along its longitudinal axis from the side of the large curvature, which helps to reduce the size of the stomach.

Currently, longitudinal (sleeve) gastrectomy is one of the most optimal and promising operations in the treatment of morbid obesity.

This operation is indicated for patients with a body mass index of 35-50 kg / m² and provides a loss of excess body weight up to 50-70%. In some cases, when the background of obesity is dominated by concomitant pathology (diabetes, hypertension), surgery is offered at a body mass index of 33-34 kg / m2.

How to determine if you are overweight?

  • 25-27.5 – normal weight
  • 27.5-29 – increased weight
  • 29-34 – 1st degree obesity
  • 35-40 – obesity 2 degrees
  • 40-50 – obesity 3 degrees
  • 50 and above – supermorbid obesity
  • Excess weight is determined by the following formula:
  • Weight (kg) / Height (m²)

For example:BMI = 120 kg / 2.89 (1m 70 cm • 1m 70cm) = 41.5

The operation is performed under endotracheal anesthesia by laparoscopic method (through punctures of 5-12-15 mm), using special suturing devices and other high-tech equipment, which causes rapid recovery of patients after surgery (average length of stay in hospital 5-7 days) Fig.1 .

Fig.1

The principle of longitudinal (sleeve) resection of the stomach is based on reducing the volume of the stomach, which leads to faster satiety and reduction of food volume. In addition, as the size of the stomach decreases, the part of the stomach that produces the hormone ghrelin, which is responsible for increasing appetite and thus completely disappears for a while and after a while the feeling of hunger after surgery, is removed.

At a sleeve resection of a stomach its lateral part on big curvature is removed, thus important physiological valves of a stomach (a cardiac sphincter and the gatekeeper) remain, and the stomach after such operation remains physiologically functional (fig. 2).

Fig. 2

Sleeve gastrectomy is the most promising operation, which since 1990 is used in combination with biopancreatic shunting (reconstruction of digestion in the small intestine), and since 2000 this operation is used in isolation using video laparoscopy.

The patient operated on by this technique can eat any food, but only in small amounts.

Patients operated on by this method have a sharp decrease in appetite. In the first months after surgery there is a total weight loss of one kilogram per day (Fig. 3 – our results)

Fig. 3

The Department of Gastroenterology Surgery of the Institute of Gastroenterology of the National Academy of Medical Sciences of Ukraine has been operating a bariatric club for several years, where overweight patients can actively communicate with patients who have already undergone bariatric surgery. and undergo all necessary examinations before surgery. We will be glad to help you!

 

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