[Using various methods of intraoperative hemostasis in laparoscopic genitourinary surgery in children].

AIM: To improve treatment results of children undergoing laparoscopic genitourinary surgery by optimizing intraoperative hemostasis. MATERIALS AND METHODS: The study comprised 110 children with various genitourinary diseases. The study group included 70 children who underwent laparoscopic surgery with optimized hemostasis with the use of an automated electrosurgical vessels ligation device LigaSure. Forty children who received standard intraoperative hemostasis with mono- or bipolar coagulation made up a control group. RESULTS: The operative time was significantly shorter with the optimized method of hemostasis than when using mono- and bipolar coagulation [77.02 min versus 112.5 min (p<0.05)]. The blood loss in the study group was also significantly lower than in the control group [17.9 and 34.2 ml, respectively (p<0.05)] due to precise control and final hemostasis. There were no intraoperative complications and conversion to open surgery in patients in the optimized hemostasis group, whereas in the control group two complications were observed. CONCLUSION: Laparoscopic urogenital surgery with the optimized hemostasis using the automated electrosurgical vessels ligation device LigaSure in children is optimal due to the minimal injury to the coagulated tissues, the ability to forgo clipping and ligation of the vessels, which results in shorter operative time and reduced intraoperative blood loss.

[Use of a laryngeal mask during combined regional anesthesia in children].

For intraoperative anesthesia, the authors applied central regional blocks. A laryngeal mask was used to maintain free airways patency. The purpose of this study was to provide evidence for the effectiveness of a laryngeal mask used under combined regional anesthesia and to establish whether the mask could be employed for artificial ventilation during laparoscopy in children.

[Rectosigmoid vaginoplasty in children and adolescents]. / Rektosigmoidnaia vaginoplastika u detei i podrostkov.

The authors analyze the results of vaginal plasty with grafts from the rectosigmoid portion of the large intestine, carried out in 279 girls aged 3 to 18 with abnormalities of the genitals and vaginal aplasia, including that with a functioning uterus. They have developed new modifications of such surgery, that facilitate sexual social adaptation of the patients when they reach puberty.

[Possibilities of surgical treatment of lesions of the organs of the reproductive system and disorders of sexual development]. / Vozmozhnosti khirurgicheskogo lecheniia porazhenii organov reproduktivnoi sistemy i narushenii polovogo razvitiia.

The authors describe the data on clinico-laboratory and instrumental examinations and surgical treatment of about 5,000 children with different reproductive organ injuries including complex patterns of abnormal sexual differentiation. The designed diagnostic programs made it possible to distribute patients into groups and according to the disease entities in conformity with the classification suggested. It is emphasized that in the developing science concerned with sex, it is necessary to distinguish an area pertaining to childhood, namely pediatric andrology, and to delineate its subject matter and tasks. Skilled assistance can be rendered by a specialized center. A broad spectrum of improved masculinizing (including the design of an artificial phallus) and feminizing (including the design of an artificial vagina from the rectosigmoid segment of the colon) is provided. The catamnestic data are evaluated.