THE ENDOSCOPIC METHODS IN TREATMENT OF PATIENTS WITH PELVIC INJURIES

Abstract

From the appearing of the first works of R. Judet, E. Letournel, M. Tile up to this day, the methods of pelvic surgery changed cardinally. These operations are technically complicated and accompanied by blood loss. That’s why the low-invasive surgical methods including endoscopic approach are perspective.

The endoscopic methods of reposition and osteosynthesis offer advantages which are expressed in increasing of injury visualization, reduction of surgical incisions and fast postoperative restoration. A surgeon using the method of osteosynthesis needs endoscopic skills and thorough knowledge of standard surgical approaches.

We have the experience of the treatment of 12 patients. We consider that the indications for these operations are not only a type of pelvic injury, but also anatomico-technical moment: an opportunity of creating of workspace.

We have 2 techniques:

1. endoscopic osteosynthesis with using of pelvioscope;

2. optical endoscopic osteosynthesis.

In any case, it is necessary to create the workspace from a small incision above the injury region by the method of tissue pneumotization. Fracture reposition is realized using a fracture table and reducing attachments. Osteosynthesis is immediately carried out with both standard and original steel constructions using the special tools that we developed and produced (ports, drill, screwdrivers etc.). The intraoperative blood loss was not more than 150 ml in all cases and in the postoperative period in drains–not more than 100 ml. The promotion of the patients was realized by the standard methods. There were no complications. The good functional result was in all cases.

We think that further development of such techniques will allow to activate pelvic surgery on the new qualitative level.