Electric welding of living soft tissues in paediatric surgery: experience and development prospects
DOI:
https://doi.org/10.15574/PS.2018.58.28Keywords:
electric welding of living soft tissues, paediatric surgery, modern stage, prospectAbstract
Objective: to conduct an analysis of the results of biowelding method application in paediatric surgery, to study the physical parameters of current in electric welding. Outline new trends for the development of this method.Material and methods: The electric welding of living soft tissues (EWLST) has been used in the CI «Zhytomyr Oblast Children’s Clinical Hospital» of Zhytomyr Oblast Council since 2006. The specialists of the clinic have passed practical and theoretical training at the B.O. Paton Electric Welding Instituteof NAS of Ukraine and the National Academy of Agrarian Sciences of Ukraine under the aegis of the international association «Welding». During the cooperation, the electric welding complexes EK300 M1 and Patonmed EKVZ-300 M1 were used. In addition to the standard set of electrosurgical tools, several special, including laparoscopic, welding keying devices have been developed.
Results. During 11 years 1,285 surgeries were performed in the surgical departments of the clinic by using EWLST. The structure of the surgical interventions is as follows: 617 (48.0%) operations on the skin and subcutaneous tissue, 301 (23.5%) interventions on the open abdominal cavity, 88 (6.8%) – open thoracic cavity, 225 (17.5 %) laparoscopic and thoracoscopic interventions, and 54 (4.2%) operations in newborns.
Conclusions. The obtained results of research and practical use allow advocating a large-scale implementation of the biowelding in paediatric surgery. Special mention should be made of the operations in children with haemophilia and other blood clotting disorders, as well as in cases when blood transfusions are limited to religious beliefs and faith; future-oriented is its use in paediatric oncosurgery. The biowelding allows operating on parenchymatous organs, performing organ-conserving surgery. In haemangiomas of critical localizations treatment in children it has good cosmetic results, allows avoiding hormone therapy and long-term dangerous treatment with B-blockers; and in many cases, it is an efficient treatment option to laser therapy as well as more accessible. In treatment of spontaneous pneumothorax, the method of thoracoscopic electric welding of pulmonary bullas and pleurobrasia can be a method of choice. It is reasonable to provide the extension study of the soft tissues biowelding characteristics in children of different age groups.
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