Methods of simultaneous laparoscopic treatment of gallstone disease with inguinal hernia and their effectiveness
Annotation. Aim of work – to define and evaluate visualization and ergonomics during single laparoscopic operations and simultaneous laparoscopic operations for gallstone disease and inguinal hernia. Identify the advantages and disadvantages of techniques. Assess whether our method affects ergonomics during surgery. The design of the study formed as retrospective comparative study with the control and research groups was used for evaluation and analysis. To form groups, a statistical database was used, which included 411 patients treated in VRSH MISD. Ergonomic parameters were analyzed and compared, such as the distance between the surgeon's hands, deviations depending on the patient's physique, the angle between the manipulators, the distance of approach to the target. Null hypothesis technique used, Pearson analysis, Tukey, Mann-Whitney. It is established that the angle between the main working tools 68.64±4.68o [64–73o] against 57.29±6.764o [44–65o] (p <0.001); the visualization area was 12.17±4.43 cm2 against 9.54±2.27 cm2 (p<0.001*); in the first and second groups, respectively; the average distance of the laparoscope approaching the operating area is greater when using a laparoscope with a 30o – viewing angle which is 3.84±0.37 cm [3.4–4.2] and 3.34±0.728 cm [2.5–4.5] for our own and French methods 3.21±0.24 cm [3.0–3.5] vs. 3.41±0.478 cm [2.7–4.1] at an angle of 0o). Performing a simultaneous laparoscopic intervention does not have any significant effect on the imaging and ergonomics during surgery. The technique allows to perform surgical treatment of inguinal hernia and cholecystolithiasis at one time without worsening of ergonomics. The technique found out in VRSH MISD is sufficiently effective and usable.
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