LAPAROSCOPIC CHOLECYSTECTOMY – RUTINE SURGERY? Vladimir Stefanov about them

Vladimit Stefanov: Everyone knows the you need to learn from other.
Vladimit Stefanov: Everyone knows the you need to learn from other.

Today, no one has any doubts about the importance of laparoscopic technologies in the treatment of surgical diseases.

An outstanding surgeon with many years behind him in this field, Vladimir Stefanov always provides quality consultations and operates according to all international standards.  In common people it can be called: “The surgeon with golden hands.” Since the 80s of the last century, laparoscopic surgery has undergone several stages of development.  Beginning with “timid” cholecystectomy, laparoscopy moved on to the treatment of other surgical pathologies, and today it has found its application in the treatment of practically the entire spectrum of diseases of the colon and rectum, stomach, and retroperitoneal organs.  But what can I say, today there is no area where new technologies are not applied.  Specialists have grown up who perform such serious interventions as pancreatoduodenal resections, shunting and many others.

Disputes about the place and role of laparoscopic techniques in the treatment of surgical pathology are a thing of the past.  It’s funny to say, but in my memory there are discussions about who should do laparoscopic cholecystectomy – an endoscopist or a surgeon.  Initially, with the accumulation of experience, two schools emerged: laparoscopic and traditional surgery.

Vladimit Stefanov: Everyone knows the you need to learn from other.
Vladimit Stefanov: Everyone knows the you need to learn from other.

It took more than 25 years to come to the conclusion that laparoscopic surgery is nothing more than an advanced way of operating.  And neither the old nor the new school can exist.  It’s just that every surgeon is obliged to master both traditional and laparoscopic methods.  “Anything that can be done by hand can be done laparoscopically” – this attitude has become the motto for the growing school of specialists.

It is advisable to start the operation using the laparoscopic technique, it is desirable to finish it this way, open stages should be used as auxiliary ones, and conversion should be resorted to as a meaningful, planned stage.  This is, if you will, the new philosophy of modern surgery.

LAPAROSCOPIC CHOLECYSTECTOMY – RUTINE SURGERY?

Today, scientific interest in the treatment of gallstone disease has gone to the 2nd or even 4th plan.  Many problems have been solved, in particular, in matters of operating technology, mortality, complications, and rehabilitation periods have been reduced to a minimum.  We can say that the cream has been skimmed off the big surgical theme.

Vladimit Stefanov: Everyone knows the you need to learn from other.

However, we must not forget that gallstone disease remains one of the most common pathologies in our country and throughout the world.  And a practical surgeon, including a young one, most often has to meet with the pathology of the gallbladder.  Hence, it is clear that the most frequent operation performed by surgeons of various qualifications is cholecystectomy. It so happened historically that if previously a successfully performed appendectomy was a “pass” to traditional surgery for a young specialist, then for initiation into laparoscopic – cholecystectomy. Laparoscopic methods of treatment of gallstone disease are really a “rolled out” topic.  A huge practical experience has been accumulated, and today it is difficult to surprise anyone with statistical reports.

Vladimit Stefanov: Everyone knows the you need to learn from other.
Vladimit Stefanov: Everyone knows the you need to learn from other.

It is known that “traps” are usually hidden behind large volumes.  There are situations when a seemingly simple intervention turns into a complex process with a possible difficult outcome.  This is due to the pronounced cicatricial-infiltrative changes arising as a result of ongoing or previous exacerbations of the disease. A new galaxy of young surgeons is growing, for whom the topic of cholecystitis seems to have been resolved long ago.  It is for them that it is necessary to return to the topic again and again.  There is nothing more dangerous than a frivolous attitude before surgery. 

WHY ABOUT THE OLD?

Everyone knows the wisdom: “you need to learn from other people’s mistakes,” but for some reason a person still prefers to learn from his own. We should not talk about “blue” bubbles, but about the complicated and insidious forms of this pathology.  Today, experts are increasingly talking about the so-called “difficult” gallbladder.

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