Кочкин А.Д.

Introduction. Urolithiasis is a disease whose etiology and pathogenesis have not been fully elucidated. However, studies of recent decades indicate the presence of an organic matrix in the composition of all urinary stone.

Materials and methods. A white substance of the consistency of «soft plasticine» was extracted from the pelvis of the right kidney. The sample was examined for elementary composition, molecular weight characteristics and structure.

This paper presents the results of a series tansmezenteriс kidney resection and compares to standard laparoscopic technique. The basis of the study served as a retrospective analysis of the results of surgical treatment of 61 patients with tumors in the left kidney T1NoMo stage, subjected to laparoscopic partial nephrectomy in the period 2012-2015 years. 

This case report describes the first experience of laparoscopic transmesenterial resection of the lower segment of horseshoe kidney due to renal cell carcinoma. All stages were performed using the “window” in the mesenterium of the colon. The size of the “window” provided optimal ergonomics at all stages of the intervention. We consider that during isthmus dissection transmesenterial access provides more freedom compared to conventional techniques.

In the west countries only 2 cases of the upper urinary tract urothelial cancer (UUTUC) are registered for 100 000 individuals. The anomalic doubling of the kidney is accounted for no more as 0.8% of cases. Therefore, UUTUC of one part of the doubled kidney is extremely rare to happen. PubMed search revealed single case reports of the UUTUC located in ureter of doubled kidney. Of 11 cases 10 have received the total nephroureterectomy with bladder wall resection, in only one case – ureter was resected with the formation of the uretero-ureteral anastomosis.

For a quarter of the century since Ralph Clayman performed the first laparoscopic nephrectomy, technique of the operation has developed and was standardized to details: from the placing of the patient on the operation table to the evacuation of the specimen. The algorithm of every standard laparoscopic operation on the upper urinary tract suggests wide mobilization of colon with the aim to access the retroperitoneum. This stage is almost always lasts more than one third of the operation time and coupled with certain risks of iatrogenic injuries.

For a quarter of the century since Ralph Clayman performed the first laparoscopic nephrectomy, technique of the operation has developed and was standardized to details: from the placing of the patient on the operation table to the evacuation of the specimen. The algorithm of every standard laparoscopic operation on the upper urinary tract suggests wide mobilization of colon with the aim to access the retroperitoneum.

Benign prostatic hyperplasia (BPH) is one of the commonest diseases in older men. Operation is the most effective treatment modality. Monopolar surgery is slowly retracting itself, giving the way to the bipolar surgery. Bipolar transurethral vaporesection of prostate (TUVRB) is similar to the standard TURis with regard to the mechanism of action, but has some constructive peculiarities in the form of the loop electrode.

In spite of significant success in treatment of the urolithiasis, extraction of the staghorn stones in obese patients is a major clinical problem. Role of the laparoscopic approach in operative treatment of these patients is not clear. The aim of this work was to analyze retrospectively our first experience in treatment of obese patients with staghorn kidney stones using the laparoscopic pyelolithotomy. The analysis was performed in 15 patients. No intraoperative complications were registered. There was no need in blood transfusion.

Problems of the surgical treatment in patients with multiple diseases are discussed for more than half of a century. Besides the minimal invasiveness and rapid rehabilitation of the patients, laparoscopy has one more advantage to denote – the ability to conduct the simultaneous operations, i.e. operations aimed at the correction of the diseases of 2 or more organs at the same time. Given the proper selection of the operation type and patients, the efficacy of the simultaneous operations is beyond any doubts.

This article contains the results of the dynamics investigation for the adult patients morbidity from the benign prostatic hyperplasia (BPH) according to the ambulatory medical aid appealability and admission rates.