Experience of Using Videolaparoscopic in the Treatment of Liver Echinococcosis of Using Videolaparoscopic in

period, which dictates the need to improve old and search for new methods of surgical treatment of echinococcosis. Outcomes To show the possibilities and effectiveness of video-laparoscopic technologies in the surgical treatment of liver echinococcosis in comparison with laparotomic liver echinococcectomy. Experience the Treatment of Liver Echinococcosis. The article presents the results of video laparoscopic liver echinococcectomy (LEP) in 32 patients in comparison with the results of laparotomic liver echinococcectomy in 28 patients. The diagnosis was confirmed by laboratory and instrumental examination methods. The main indications for the operation are determined, the features of the operative technique are described in detail with an analysis of possible options. Much attention is paid to preventing the spread of the parasite during the operation. The advantages of VLEP in comparison with laparotomic echinococcectomy of the liver are indicated. Evaluation of immediate and long-term results showed that the use of endovideosurgical interventions can reduce the number of complications, shorten the length of hospital stay and accelerate their rehabilitation. Some VLEP issues are also listed.


Results and Their Discussion
The variant of the operative technique was based on the use of 3 trocars, as shown in (Figure 3):

2.
Epigastric, 10mm -for the introduction and removal of a rubber bag with a chitinous sheath;

Access
The first trocar is placed on the superior paraumbilical point.
Depending on the localization of the cyst, the rest of the trocars were imposed as follows: for the right-sided one, they were placed in the epigastrium and the right hypochondrium, and for the left-sided one, in the left hypochondrium along the midclavicular line and the epigastric point below the xiphoid process with its conduction to the left of the round ligament of the liver.

The Course of the Operation
Before the puncture, the place of the proposed puncture was covered with a napkin moistened with Decasan solution. Then the cyst was punctured with a special puncture needle with a terminal extension, shown in Figure 3, the contents were aspirated as much as possible, and a 25% hypertonic sodium chloride solution was injected for 4-5 minutes. After exposure, the hypertonic solution was aspirated, then the cyst was opened and the chitinous membrane was removed in a homemade rubber bag (made from a sterile glove). ( Figure 5) To detect biliary fistulas, the cavity was examined with a laparoscope and a dry sterile tissue was pressed to the floor of the cavity for several minutes. A partial pericystectomy was performed in 6 cases of superficial localization of the echinococcal cyst. In 7 cases the cavity was tamponized with a strand of the greater omentum, in 16 the cavity was removed by abdominalization, and in 3 patients the cavity was removed by invagination. The duration of the operation was 60 ± 5 minutes.
Abdominal drainage was placed relative to the location of the cavity and removed on the 2nd or 3rd day. The conditions of the VL before commissioning were as follows:

1.
Careful selection of patients with regard to location and size of cysts -superficially located cysts on the diaphragmatic and visceral surfaces of the liver measuring from 5 cm in diameter -for successful aspiration of the contents

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Performing all phases of surgery in a parasitic and antiparasitic manner.

3.
Patients with the following indications were not included in the group.

4.
Patients whose echinococcal cyst location was inaccessible to VL in segment VII and posterior diaphragmatic surface of segment VIII liver.

6.
Echinococcosis of the liver with various severe

1.
Laparoscopic methods of treatment of liver echinococcosis can be carried out, but with mandatory consideration of the size and location of cysts.

2.
When performing laparoscopic echinococcectomy with even greater care and caution, the rules of aparasitism and antiparasitism should be observed in order to prevent infection of neighboring organs and the abdominal cavity.
Thus, VL is the most effective treatment of liver echinococcosis with suitable sizes and location in available segments.