Emergency laparoscopic surgery in Russia: a current state

Revishvili A.Sh.; Olovyanniy V.E.; Kuznetsov A.V.

doi:https://doi.org/10.17116/hirurgia20240915

Revishvili A.Sh.

Vishnevsky National Medical Research Center of Surgery of the Ministry of Health of Russia

ORCID: 0000-0003-1791-9163

Olovyanniy V.E.

Vishnevsky National Medical Research Center of Surgery of the Ministry of Health of Russia

ORCID: 0000-0001-9670-3429

Kuznetsov A.V.

Vishnevsky National Medical Research Center of Surgery

ORCID: 0000-0002-6696-0499

Emergency laparoscopic surgery in Russia: a current state

Authors:

Revishvili A.Sh., Olovyanniy V.E., Kuznetsov A.V.

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Journal: Pirogov Russian Journal of Surgery. 2024;(9): 5‑15

DOI: 10.17116/hirurgia20240915

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To cite this article:

Revishvili ASh, Olovyanniy VE, Kuznetsov AV. Emergency laparoscopic surgery in Russia: a current state. Pirogov Russian Journal of Surgery. 2024;(9):5‑15. (In Russ.)
https://doi.org/10.17116/hirurgia20240915

Подписка 2026 Хирургия. Журнал им. Н.И. Пирогова (Pirogov Russian Journal of Surgery)

Использование инфографики авторами научных работ

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Abstract:

OBJECTIVE

To determine the current status and main factors influencing the level of emergency laparoscopic surgery in the Russian Federation.

MATERIAL AND METHODS

A retrospective nationwide analysis included patients ≥18 years old undergoing surgery for acute cholecystitis (AC), acute appendicitis (AA), perforated ulcer (PU) and ileus. The database of the chief surgeon of the Russian Ministry of Health for 2018 — 2022 was used. To investigate possible reasons influencing the level of emergency laparoscopic surgeries, we performed online survey of medical organizations connected to the electronic reporting system.

RESULTS

Over five years, the incidence of laparoscopic surgeries for AC increased from 52.6% to 70.5% (p<0.001), for AA from 25.1% to 41.0% (p<0.001), for PU from 9.4% to 13.2% (p<0.001) and for ileus from 5.9% to 8.5% (p<0.001). The percentage of emergency laparoscopic surgeries in rural hospitals (level I) was 14.8%, level II hospitals — 40.2%, level III — 67.7% (p<0.001). We obtained responses from 1.982 (84.9%) out of 2.335 hospitals included in the database. Significant differences were revealed in equipment of hospitals of different levels with laparoscopic surgical systems and proportion of surgeons proficient in laparoscopic techniques (p<0.001). The same factors influence laparoscopy in different federal districts to a greater extent than their geographic and demographic characteristics.

CONCLUSION

Laparoscopic emergency procedures became more widespread, but vary widely between regions, urban and rural. Availability of laparoscopic surgery is influenced by availability of equipment and trained surgeons, geographic distance and population density, level of hospital and ability to maintain acquired skills and increase experience in appropriate surgeries.

Keywords:

emergency laparoscopic surgeries

equipping hospitals with laparoscopic equipment

training of surgeons

Authors:

Revishvili A.Sh.

Vishnevsky National Medical Research Center of Surgery of the Ministry of Health of Russia

ORCID: 0000-0003-1791-9163

Olovyanniy V.E.

Vishnevsky National Medical Research Center of Surgery of the Ministry of Health of Russia

ORCID: 0000-0001-9670-3429

Kuznetsov A.V.

Vishnevsky National Medical Research Center of Surgery

ORCID: 0000-0002-6696-0499

Received:

07.03.2024

Accepted:

20.04.2024

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