The laparoscopic rating scale for the evaluation of working conditions for surgical treatment of super-obesity

In this technical note,a novel rating scale(abdominal integral index)was introduced for assessing the conditions of the working laparoscopic space based on linear measurements to select the optimal one or two-stage surgical treatment for super-obesity.Patients with the same height and similar BMI values had different rating scale scores,reflecting different conditions of laparoscopic bariatric surgery.The rating scale helps surgeons and patients make a safe option for surgery,depending on the experience of the surgeon and technical laparoscopic conditions.

A New Three-Dimensional(3D)Printing Prepress Algorithm for Simulation of Planned Surgery for Congenital Heart Disease

Background:Three-dimensional printing technology may become a key factor in transforming clinical practice and in significant improvement of treatment outcomes.The introduction of this technique into pediatric cardiac surgery will allow us to study features of the anatomy and spatial relations of a defect and to simulate the optimal surgical repair on a printed model in every individual case.Methods:We performed the prospective cohort study which included 29 children with congenital heart defects.The hearts and the great vessels were modeled and printed out.Measurements of the same cardiac areas were taken in the same planes and points at multislice computed tomography images(group 1)and on printed 3D models of the hearts(group 2).Pre-printing treatment of the multislice computed tomography data and 3D model preparation were performed according to a newly developed algorithm.Results:The measurements taken on the 3D-printed cardiac models and the tomographic images did not differ significantly,which allowed us to conclude that the models were highly accurate and informative.The new algorithm greatly simplifies and speeds up the preparation of a 3D model for printing,while maintaining high accuracy and level of detail.Conclusions:The 3D-printed models provide an accurate preoperative assessment of the anatomy of a defect in each case.The new algorithm has several important advantages over other available programs.They enable the development of customized preliminary plans for surgical repair of each specific complex congenital heart disease,predict possible issues,determine the optimal surgical tactics,and significantly improve surgical outcomes.

Mortality Rates of Ventricular Septal Defect for Children in Kazakhstan: Spatio-Temporal Epidemiological Appraisal

Objective: The aim is to study the trends in ventricular septal defect (VSD) mortality in children in Kazakhstan.Methods: The retrospective study was done for the period 2011–2020. Descriptive and analytical methods of epidemiologywere applied. The universally acknowledged methodology used in sanitary statistics is used to calculatethe extensive, crude, and age-specific mortality rates. Results: Kazakhstan is thought to be seeing an increase inmortality from VSDs in children. As a result, this study for the years 2011 to 2020 was conducted to retrospectivelyassess data from the central registration of the Bureau of National Statistics that was available throughoutthe nation. Age-standardized mortality data were obtained and compared between age categories. It was shownthat 507 children died from this condition throughout the time period under study. The average annual standardizedmortality rate was 1.88 per 100,000 population and tended to decrease over time. The peak of mortality wasnoted at the age of up to 1 year, namely the neonatal period. Cartogram mortality rates were calculated usingstandardized indicators. Additionally, age-sex variations were taken into account when performing all calculations.Conclusion: In recent years, the death rate from VSD has declined from 1.5 to 0.6 per 100,000 people, withthe trend remaining constant (T = 1.4%, R^(2) = 0.5825). The analysis of mortality trends related to VSD is crucial inboth theoretical and practical aspects, as it enables early detection and treatment of VSDs. The findings of thisstudy will be valuable to public health authorities in developing a strategy to treat VSDs effectively.

Anesthetic Treatment in Operations of Small Pelvic Organs Pathology

The article presents data on the surgical treatment of 405 patients with pelvic organ surgical and gynecological diseases. When using regional anesthesia during operations in the lower abdominal cavity of patients with pelvic pathology, a smoother operation course and early postoperative period were observed compared with general anesthesia use. In this work, 405 patients with surgical and gynecological diseases of pelvic organs, operated in the surgical and gynecological departments were analyzed. When using regional anesthesia, it was observed that intraoperative blood loss in patients and consumption of narcotic analgesics in the postoperative period decreases.