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Volume 8 J Community Med Health Educ, an open access journal
ISSN: 2161-0711 Public Health 2018
February 26-28, 2018
PUBLIC HEALTH AND NUTRITION
3rd World Congress on
February 26-28, 2018 London, UK
THE SIGNIFICANCE OF HYDROJET SCALPEL IN THE SURGICAL TREATMENT OF
INFILTRATIVE INFLAMMATORY AND ADHESIVE PROCESSES OF THE ABDOMINAL
CAVITY
V.F.Rybalchenkoa, V.V.Skybac,d, A.V.Ivanko c,d, V.M.Badakhb and V.P.Bocharovb
aNational Medical Academy of Postgraduate Education, Ukraine.
bNational Aviation University, Ukraine.
cKyivsky Medical University of Ukrainian Academy of Medical Sciences, Ukraine.
dKyivska City Clinical Hospital N1, Ukraine.
Aim: To improve the results of surgical treatment by using a hydrojet scalpel in inflammatory and adhesive processes of the
abdominal cavity.
Materials Required: In the surgery clinic, 72 adolescents aged 17-18 years were treated. Male patients had 41 (56.9%), female
- 31 (43.1%). Infiltration of the abdominal cavity was established in 54 (75.0%) patients, and obstruction of the intestine of a
commissural nature in 18 (25.0%). All patients had a full examination.
Result: It was established that the causes of the infiltrative inflammatory process were the inflammation of the appendicular
process in 50 (69.4%) and Meckel's diverticulum in 4 (5.5%) patients, and the adhesion process: the transferred laparotomy due
to appendectomy. According to the clinic, vomiting syndrome in 59 (81.9%), abdominal pain syndrome in 65 (90.3%) patients,
asymptomatic anterior abdominal wall in 63 (87.5%), hyperthermia in 28 (38.8% ). Radiographically - the bowl of Kloyberg
in 32 (44.4%) patients. According to ultrasound, abdominal infiltrates in 54 (75.0%) patients, and free fluid in the abdominal
cavity in 58 (80.5%), and signs of abscessing in 38 (52.7%) patients. Studies found that 22 (30.5%) patients had atypical clinical
symptoms of the course of the disease. After preoperative preparation, all patients were operated using a hydrojet scalpel. For
the first time in the clinical work, the domestic apparatus "Hydrojet scalpel" was used, which was developed at the Aerospace
Institute of the National Aviation University of Ukraine. It is established that a jet of physiological solution separates living
tissues, which have different density and different cellular structure. The essence of the anatomical method of separation of
tissues by a hydrojet scalpel consists in the possibility of dosed pressure of a stream of physiological solution, which allows the
separation of tissue layers of various elasticity and strength. Thus, due to the selectivity of the action, it is possible to conduct
a gentle, precise anatomical dissection of tissues in their border zone, taking into account the specific anatomical and physical
properties of the tissues. It is established that the water flow of the physiological solution forms an expansion space, a liquid
medium that enters this space, spreads the tissue, that is, dissects it.
Treatment of infiltrative inflammatory processes of the abdominal cavity in 54 (75.0%), which prevented traumatization when
separating the spike from the intestine and the peritoneum to approach the focus of inflammation with minimal loss of blood.
It was established that the cause was the inflammation of the appendicular process in 50 (69.4%) and Meckel's diverticulum in
4 (5.5%) patients. The use of a hydrojet scalpel allowed to separate all the components of the infiltrative - inflammatory process,
namely the large omentum and its resection: limited in 16 (22.2%), subtotal in 30 (41.6%), total in 8 (11.1%) patients. Treatment
of adhesive obstruction of the abdominal cavity was carried out by all patients, and appendectomy and genologic diseases
were transferred from the causes of development, of which 10 (13.8%) were male and 8 (11.1%) female. With laparotomy, the
following adhesions were established: multiple planar joints in all 18 patients, of which, in the face of planar ones, cordlike
ones also took place in 8 (11.1%), and in the form of chain mail with full coverage and turn in 4 (5.5%) patients. Adhesiolysis
is the main stage of the operation in which a hydrojet scalpel was used. There were no complications during the separation of
adhesions.
Thus, surgical treatment using a hydrojet scalpel for the separation of the inflammatory or adhesive process has a gentle,
non-traumatic effect on the vessels, the intestinal wall and the peritoneum in the separation of the inflammatory process and
adhesions, contributes to the reduction of edema, and as a consequence, early recovery of peristalsis, and further absence of
abdominal discomfort manifestations of the disease. Intestinal resection performed in 6 (8.3%) patients, of which 4 (5.5%) due
V.F.Rybalchenko et al., J Community Med Health Educ 2018, Vol 8
DOI: 10.4172/2161-0711-C1-032