Vladimir Yanovich Hryschanovich
Head of the department, Doctor of Medical Sciences, Associate Professor
Telephone: (+375 17) 287-86-93
Staff of the department:
Clinical bases of the department: Minsk City Clinical Hospital of Emergency Medical Care, Minsk City Clinical Hospital №10, Minsk City Clinical Hospital №11.
Telephone: (+375 17) 287-86-27; (+375 17) 287-86-93
History of the Department of Emergency Surgery
Primary goal of the department is to provide advanced training courses for doctors and teaching staff working at higher medical educational establishments in the following branches:
- of emergency surgery (for surgeons working at outpatient clinics of the regional, provincial and republican levels, for heads of surgery divisions, deputy chief doctors in surgery, head doctors, junior doctors, clinical residents, including foreign ones, PhD students) and outpatient surgery;
- endoscopy (endoscopists and heads of the divisions in polyclinics and in-patient clinics of all levels); and also retraining of doctors on the specialty "Surgery".
The department consists of 32 specialists: head of the department, 2 professors of the department, 2 professors, 4 associate professors, 3 assistants (full-time shift), 2 PhD students of the extramural and intramural form of training, 8 foreign clinical residents (Georgia, Turkmenistan, Ukraine, Nepal), 4 clinical residents of extramural form of training (the Republic of Belarus), 1 laboratory assistant. The teaching staff includes 9 specialists.
Clinical bases of the department:
- Minsk Clinical Emergency Hospital, Kizhevatova Street, 58;
- 10th Minsk Clinical Hospital, Uborevicha Street, 73;
- 11th Minsk Clinical Hospital (courses of dispensary surgery), Minsk, Korzhenevskogo Street, 4;
Teaching and guiding activities
Lessons at the department of emergency surgery are given on a high theoretical and practical level, which is proved by the trainees after the courses on the basis of questionnaires. Practical classes are given in patient’ rooms by beds of the patients, in dressing rooms and endoscopic rooms. A part of the trainees participate in operations as assistants. The classes are given with the help of multimedia projector and computer technologies.
Educational videofilms are being demonstrated. Minsk Clinical Emergency Hospital has a system of real-time videotranslations of operations due to the telecommunication system which makes it possible to see the operation in the lecture room of the department.
Tests are widely used in the teaching process. For that purpose staff of the department has worked out test questions.
Treatment and consultation activities and assistance to healthcare establishments
The department of emergency surgery is situated on 3 clinical bases. The courses in emergency surgery are given at Minsk Clinical Emergency Hospital and10th Minsk Clinical Hospital (City Center of Gastroduodenal Hemorrhages), where daily staff of the department supervises 135 patients in 3 surgery divisions. The courses in outpatient surgery are given at City Center of Ambulatory and Minimally Invasive surgery (15 beds), which is situated on the basis of surgery division (60 beds) of the 11th Minsk Clinical Hospital (daily follow-up of 60 patients). Totally there are 320 patients at all the clinical bases who are followed by the staff of the department per day.
Specialists of the department are on duty and render treatment and consultation work at the Republican Center of Emergency Medicine.
Logistic supplies in Minsk clinics, where practical and theoretical lessons are given for trainees of all the courses, have all its necessary elements and are considered to be good enough to fulfil the training programs and curriculum approved by the Ministry of Health of the Republic.
New types of operative interventions have been implemented:
- Pylorus-retaining and other types of pancreatoduodenal exsection, lateral pancreaticojejunostomy, exsection of body and tail of pancreas using the device LigaShu and ultrasound technologies, modern types of hemostasis and machine stitch (professor N.Zavada);
- reconstructive operations on stomach, small and large intestinal tract (professor N.Zavada, associate professor I.M.Ladutko, assistant A.G.Piluschenok);
- laparoscopic cholecystectomy after stomach exsection and other operations over the upper part of abdominal cavity (professor N. Zavada);
- single-stage laparoscopic cholecystectomy, tension-free hernioplasty and abdominoplasty at calculous cholecystitis, ventral hernia and obesity of 2-4 stage (professor N.V.Zavada);
- new methods of ulcer extraduonization of posterior wall of dodecadactylon (patents of the Republic of Belarus for two inventions – professor Zavada N., surgeon at Minsk Clinical Emergency Hospital Solomonova G.);
- new method of laparoscopic cholecystectomy with the application of harmonic scalpel at acute cholecystitis (patents of the Republic of Belarus for the invention - professor N.V.Zavada, assistant A.Ch.Chasnoit);
- operative interventions with the application of argon-plazma coagulator (patent of the Republic of Belarus for invention - professor Zavada N., assistant Sedun V. etc.);
- laparoscopic appendectomy with a new way of manipulation of cecal appendage stump (patent of the Republic of Belarus for the invention - professor Zavada N., Nalbandyan T.);
- new method of endoscopic hemostasis at gastroduodenal bleedings (patent - assistant Sedun V., head of the department at Minsk Clinical Emergency Hospital Sologub I., professor Zavada N.);
- operative interventions over stomach using new bougie for enteroalimentation (patent of the Republic of Belarus for invention - professor Zavada N., assistant Sedun V. etc.);
- method of tube feeding of patients operated because of acute billiar pathology and complicated ulcer of stomach and duodenum (professor N.V.Zavada, assistant V.V.Sedun, Associate Professor I.I.Pikirenya, Candidate of Medical Sciences O.S.Bogushevich);
- endoscopic clipping of vessels at bleeding ulcer (assistant Sedun V., head of the department of Minsk Clinical Emergency Hospital, Sologub I., professor Zavada N.);
- endoscopic stenting and balloon dilatation of strictures of extrahepatic bile ducts (assistant V.V.Sedun);
- endoscopic transpapillary interventions in the treatment of cholangiolithiasis (assistant V.V.Sedun);
- roentgenendovascular methods of diagnostics and treatment of mesenteric vessels thrombosis.
- system thrombosis therapy at this pathology (A.E.Beimanov, head of the division of roentgen-endovascular surgery of Minsk City Clinical Hospital of Emergency Medicine, professor N.V.Zavada, associate professor I.M.Ladutko, assistant A.G.Pischulenok, D.V.Yushkevich, vice head of the 1st surgical division of Minsk City Clinical Hospital of Emergency Medicine - N.A.Lazarevich, A.V.Zhukov - surgeon of the 1st surgical division);
- laparoscopic operations at pancreatolysis (professor Zavada N., head of 1st surgery department of Minsk Minsk Clinical Emergency Hospital, Lazarevich N., surgeon of the 1st surgery department Zhukov A.);
- drainage of liquid masses of abdominal cavity under ultrasound control (head of the department of Minsk Clinical Emergency Hospital, Sologub M., head of the 1st surgery department of Minsk Clinical Emergency Hospital, Lazarevich N., professor Zavada N., Deputy Chief Doctor in surgery of Minsk Clinical Emergency Hospital, Shimansky I.).
- surgical cell transplantation (professor Y.M.gain, S.V.Shahray, associate professor);
- application of laser medical device in proctology and in complex treatment of infected trophic ulcers (professor Y.M.Gain, associate professor S.V.Shahray, M.Y.Gain);
- transplantation of culture of autologous mesenchimal stem cells of adipose tissue in complex surgical treatment of extra- and transconstrictor perianal fistula (professor Y.M.Gain, associate professor S.V.Shahray, M.Y.Gain);
- application of multiagent biological transplant with autologous mesenchymal stem cells from adipose tissue in surgical treatment of patients with postoperative large and huge hernias (associate professor V.G.Bogdan, professor Y.M.Gain, professor Y.E.Demidchik);
- application of complex transplant on the basis of mesenchymal stem cells from fat tissue and application of hydrogel for restoration of the skin cover continuity (professor Y.M.Gain, E.P.Kisileva, Associate Professor S.V.Shahray);
- two-stage treatment of patients with postoperative ventral herniae of large and huge dimensions (Associate Professor V.G.Bogdan, professor Y.M.Gain, Associate Professor N.N.Dorokh etc.);
- deligation of hemorrhoid by latex anulus; laser destruction of hemorrhoid; method of treatment of perianal itch induced by subclinical form of genital herpes; treatment method of chronic anal fissure; prevention method of purulent postoperative wound complications at proctology operations; (professor Y.M.Gain, Associate Professor S.V.Shahray, Y.M.Gain);
- surgical treatment of acute complications of colorectal cancer (professor Y.M.Gain, Associate Professor S.V.Shahray, V.L.Denisenko);
- new technologies and types of operative interventions in the treatment of bleeding gastric ulcers and duodenum ulcers (Associate Professor S.G.Shorokh, assistant L.V.Tarasik, S.A.Paleev);
- single-step curative operations in the surgery of pancreatogenic bleeding (assistant L.V.Tarasik, Associate Professor S.G.Shorokh);
- surgical treatment of para- and transpapillary ulcers of duodenum complicated by bleeding (S.A.Paleev, Associate Professor S.G.Shorokh, assistant L.V.Tarasik);
- laparoscopic operations in the treatment of ezophagogastroduodenal bleeding (Associate Professor S.G.Shorokh, I.S.Yakuta);
New standards of medical care rendered for patients with urgent surgical diseases of abdominal cavity organs have been developed by professor N.V.Zavada and approved by the Ministry of Health of the Republic of Belarus in 2005. These standards have been implemented into the work of Emergency Surgery Divisions of Minsk City Clinical Hospital of Emergency Care. Besides, specialists of the Department of Emergency Surgery and the Department of Emergency Medical Care of BelMAPE together with specialists of the 1st Trauma Division of Minsk City Clinical Hospital of Emergency Care have developed and implemented algorithm of emergency medical care rendered to casualties with concomitant injury into medical practice at this Division.
For the whole period of work the department has prepared 7 Doctors of Medical Sciences and 16 Candidates of Medical Sciences, 9 of them - for the last 5 years. From 2005 to 2015 the department has published more than 510 scientific works, among which there are 19 monographs and instructions.
36 invention patents have been received.
Main directions of scientific work at the department:
- Scientific justification of diagnostic and treatment methods of acute surgery diseases and abdominal cavity injuries.
- Endovideosurgical technologies in treatment of urgent diseases of abdominal cavity organs.
- Minimally invasive interventions in emergency surgery.
- Development of new technologies and types of operative interventions in the treatment of bleeding gastric ulcers and duodenum ulcers.
- Endovideosurgical operations at ulcerous gastroduodenal hemorrhages.
- Endoscopic technologies of local homeostasis in patients with gastroduodenal hemorrhages of ulcerous etiology.
- New approaches to surgical treatment of parapapillary ulcers in emergency surgery.
- Treatment of destructive pancreatitis complicated by arrosive hemorrhages.
- Comparative evaluation of different methods of physical hemostasis in abdominal surgery.
- Justification of diagnostic and treatment methods of small bowel and large bowel damages.
- Methods improvement of surgical treatment of acute adhensive intestinal obstruction.
- Development of new minimally invasive technologies with the application of ultrasound navigation.
- Roentgen-endovascular methods of diagnostics and treatment of emergency surgical diseases of abdominal cavity organs.
- Laparoscopy in diagnostics and treatment of necrotizing pancreatitis.
- Development of new methods and technologies with the application of stem cells.
- Justification of the method of cell transplantation in restoration of large defects of soft tissues.
- Development of new methods of cell transplantation in the treatment of anal fistula.
- Laser technologies in complex surgical treatment of diseases of anorectal area.
- Minimally invasive surgery of chronic hemorrhoid.
- Preventive care of purulent postoperative wound complications at proctologic operations.
- Surgery of short-term patient's stay in hospital.
- Daycare clinic saving technologies in the treatment of surgical infection.
- Laser technologies in abdominal surgery.
- Medical care rendered to patients with multisystem injuries in conditions of multifield hospital.
Preparation of scientific staff
There are 2 PhD students who undergo training at the department (extra-intramural form of training). 7 seekers for Candidate's degree are carrying out their theses.
For the last several years physicians from the Russian Federation, Kazakhstan, Georgia, Ukraine and other countries have undergone advanced training at the department. At present there are a lot of foreign clinical residents from Georgia, Turkmenistan, Iran, Ukraine, who undergo training at the department.
S.G.Shorokh, Associate Professor, Candidate of Medical Sciences, is an active member of the Association of Surgeons-Hepatologists.
S.V.Shahray, Candidate of Medical Sciences, Associate Professor, if an active member of the Association of Outpatient Surgeons of Russia and CIS-countries.