Postoperative peritoneal adhesions are unsolved problem still. Currently, a thorough search of reliable postoperative adhesion prevention measures is going on a way of various adhesion barrier application due to the obvious advantages of the latter versus drugs. However, the adhesion formation is conditioned by a multitude of significant etiological and influencing factors, and adhesion barriers are enable to diminish only the effect of some of them. The authors consider the absence of the unified formal scale estimation system of adhesion extent classification as another essential obstacle to overcoming the present problem because the existing individual estimation methods do not admit the comparison of effectiveness indices between certain anti-adhesion methods. In the present review, advantages and limitations of some practically applied barriers were observed. According to the authors, the basis of the successful solution of the mentioned problem lies in the coupling of applied surgical intervention technique quality with anticipating methods of hidden peritoneum damages and with intra- operating poly-component anti-adhesion barrier gel instillation. The choice of that kind barrier gel is ought to be done on a base of rigorous clinical trials results of a high evidence level.

The article analyzes the experience of palliative treatment of 160 patients with dysphagia due to the obstruction of the esophagus. In 139 patients, stenting was performed in a planned manner, and 21 patients were operated on urgent indications due to progressive dysphagia. Based on the results of the treatment, complications were analyzed, also as the algorithm of patients selection for surgery and postoperative management. Based on our analysis, endoscopic stenting should be recognized as the leading method of palliative treatment of patients with esophageal cancer complicated by dysphagia. At present, there is a tendency to increase the median survival rate of patients with inoperable esophageal cancer who underwent endoscopic stenting of the tumor stricture.

Granulomatosis with polyangiitis (Wegener’s granulomatosis) (GPA) is a primary vasculitis of unknown origin characterised by granulomatous necrotising inflammation of small arteries and veins. The Chapel Hill Consensus classified GPA as small-vessel vasculitis with the presence of anti-neutrophil cytoplasmic antibodies (cANCA). Classical manifestation of the disease described by Wegener in 1936 includes upper and lower respiratory tract involvement and glomerulonephritis, it can affect every other organ. This results in heterogeneity of clinical manifestations. Although gastrointestinal tract involvement is rare, both the small and the large bowel may be involved, thus causing a serious complication of GPA

There are still a lot of surgical departments which are fully equipped with endoscopic devices underutilized due to medical personal preferences. The hypothesis is that for active involvement, before getting started working with laparoscopic equipment, a surgeon has to have got a number of special skills. In this study we assessed the efficiency and safety of clinical introduction of laparoscopic method into the surgical practice at the hospital where experienced “laparotomic” surgeons were employed. Twenty nine surgeons from The City Clinical Hospital №52 were involved into this study. Two thousand two hundred and thirteen lapsurgical protocols (except gynecological, urological and diagnostics) made since 2003 till 2009weanalyzed. We have studied any difficulties noted in the protocols, conversions and timing considered previous surgical experience, simulation training. We found out that unstructured experience in endoscopic surgery and basic laparoscopic manual skills impact to the speed of clinical laparoscopic introduction and total amount of steady surgical procedures performed. The results of this study showed that safe introduction of laparoscopy into the operating room should be started with training of basic laparoscopic surgical skills.

Basic laparoscopic surgical skills are an essential prerequisite for safe operation and further development of laparoscopic techniques in the operating room. The Department of Intermediate Level Surgery (Faculty surgery) No.1 of Moscow State University of Medicine and Dentistry came up with an method of basic laparoscopic skills simulation training with “training boxes” and elicited factors affecting the speed of skill formation. We have studied the skill level possessed by the surgeons that actively practice laparoscopic techniques and consider it as a reference standard. We have analyzed the speed and dynamics that 82 students demonstrated while moving towards the reference level and the impact their personality had on the progress. We found out that in our observation group an unstructured experience in endoscopic surgery, gender, personality of individual and temperament had little o no affect on the speed of basic laparoscopic manual skills formation. The results of the study proved that before beginning practicing laparoscopic techniques in the operating room to make them safe, all specialists should complete a standard training course on the development of basic laparoscopic skills. The Department of Intermediate Level Surgery No. 1 of Moscow State University of Medicine and Dentistry found an effective method of basic laparoscopic skills development with “training boxes”, gave scientific credence to its efficiency and elicited its optimal duration.

The article describes the system of training plastic surgeons in Canada. The positive features of the system of plastic surgeons training in Canada include a long training period, the size of the program, the interaction of residents and consultants, senior and junior residents with each other, the special status and functioning of committees, close continuous interaction of the professional community in the person of the Royal College of Physicians and Surgeons and future Specialists.