Оглавление

Введение 1

Глава 1. Общие положения 7

1. История метода 7

2. Теоретические основы лапароскопической хирур­гии 9

1. Особенности практического применения

лапароскопических операций 16

1.3.1. Организационные вопросы 16

2. Подготовка больных 17

3. Методика лапароскопических операций 17

1.3.4. Послеоперационный период 27

Глава 2. Лапароскопические операции на желудке 29

1. Гастротомия 29

2.1.1, Лапароскопическая полипэктомия 30

2. Лапароскопическое удаление инородных тел 34

2. Гастростомия 34

1. Лапароскопическая гастростомия 35

1. Энтеральное питание 42

2.2.1.2. Внутрижелудочные манипуляции 45

Глава 3. Лапароскопические операции на желчных путях 50

1. Холецистотомия 51

1. Методика лапароскопической холецистолитотомии 53

2. Холецистостомия 60

1. Лапароскопическая холецистостомия 60

1. Лапароскопическая холецистостомия при ост­ром

холецистите 69

3.2.1.2. Лапароскопическая холецистостомия при

ме­ханической желтухе 80

3.3. Гепатохолангиостомия 85

3.3.1. Лапароскопическая гепатохолангиостомия 86

Глава 4. Лапароскопическая еюностомия 88

Глава 5. Лапароскопическая колостомия 100

Глава 6. Лапароскопические операции на сосудах 108

1. Катетеризация притоков воротной вены 110

6.1.1. Лапароскопическая катетеризация вен 111

1. Лапароскопическая катетеризация пупочной вены 111

6.1.1.2. Лапароскопическая катетеризация

желудочно-сальниковых вен 114

6.1.1.3. Лапароскопическая катетеризация вен

боль­шого сальника 117

6.1.2. Портография после лапароскопической катете­ризации вен 118

6.1.3. Внутрипортальная инфузионная терапия после

лапароскопической катетеризации вен 120

2. Катетеризация артерий бассейна чревного ствола 121

1. Лапароскопическая катетеризация артерий 121

6.2.2. Ангиография после лапароскопической катете­ризации

артерий 126

6.2.3. Регионарная внутриартериальная инфузия после

лапароскопической катетеризации артерий 128

Заключение 131

Список научных работ И. Д. Прудкова по

лапароскопической хирургии 133

Использованная литература 137

VDK 616-089

Ural's University Publishing House

Lenin Avenue, 13b Sverdlovsk, 620219

Prudkov I. D„ Hodakov V. V., Prudkov M. I.

ESSAYS ON LAPAROSCOPIC SURGERY a monograph, 1989

Prudkov Iosif Davidovich (1929—1984), DM, prof., head of chair of general surgery of Sverdlovsk Medical Institute, the founder of the original trend of laparoscopic surgery of digestive tract organs, which is widely used in the USSR and can be of great interest for foreign spe­cialists. He has published more than 150 scientific articles on the problems of surgery of heart, esophagus, stomach, intestine. He was working out the problems of laparoscopic surgery since 1968.

Hodakov Valeri Vasiljevich, candidate of medical sci­ences, assistant professor of the chair of general surgery of Sverdlovsk Medical Institute, the author of 50 scientific articles on the problems of abdominal surgery. He has been engaged in laparoscopic surgery since 1974.

Prudkov Mikhail Iosifovich, candidate of medical sci­ences, assistant professor of surgical chair N 2 of Sverd­lovsk Medical Institute, the author of 30 scientific articles including a monograph devoted to the problems of the bile ducts surgery. He deals with the problems of laparoscopic surgery since 1976.

The monograph is devoted to the highly original and perspective trend of laparoscopic surgery which is widely used in modern gastroentherology. The method of laparoscopic surgery of digestive tract has been worked out by I. D. Prudkov. This method versus other well-known va­riants of laparoscopic operations suggests the fulfilment of the essential stage of surgical operation on the parts of organs taken out of the abdominal cavity into the small­est possible cut on the abdominal wall and the use of the generally accepted technique of the operation.

The simplicity and the reliability as well as the high efficiency of this method are confirmed by the experience of many years of its application. The monograph generali­zes the 2000 operations experience of the clinic of general surgery of Sverdlovsk Medical Institute. The most frequent base for their application was the high risk or impossibility of applying traditional operations to the elderly or old patients with serious attendant diseases or hard complications of the main disease. The present monograph is the first one in the world literature devoted to the method of laparoscopic surgery worked out by I. D. Prudkov. It has been prepared for the publication by V. V. Hodakov and M. I. Prudkov after the death of prof. I. D. Prudkov.

The first chapter describes the history of the method and the theoretical fundamentals of laparoscopic surgery.

The second chapter deals with laparoscopic operations on stomach, i. e. gastrotomy, gastrostomy, intergastrical inteference. The results of the laparoscopic gastrostomy's use in radical and palliative treatment of cancer of eso­phagus and stomach, injuries of esophagus and its stric­tures and that of laparoscopic polipectomy are expounded in this chapter.

The third chapter discusses laparoscopic operations on bile ducts. It gives the results of the application of cholecystolithotomy, cholecystostomy and hepaticoholangiostomy to the high risk patients with acute cholecystitis, gall­stones, tumour occlusions of bile ducts. It also describes the possibilities of the subsequent transfistular sanation of biliary tract and radical surgical treatment performed under the most favourable conditions.

Method of laparoscopic eunostomy, its application and practical use is described in the fourth chapter.

The fifth chapter devoted to the laparoscopic kolostomy describes the methods of forming of ceco-, transverzostomy, the results of their application to the multi-step treat­ment of calonic tumour obstruction.

The laparoscopic catheterization's technique of abdo­minal cavity, vessels is described in the sixth chapter. The results of endovascular investigation and regional therapy in the treatment of some diseases are also discussed.

The book is intended for research workers of clinical establishments, doctors, etc., all those who are interested in the problems of laparoscopy, urgent surgery, geriatrics and oncology.

Иосиф Давидович Прудков,

Валерий Васильевич Ходаков,

Михаил Иосифович Прудков