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Presented selected case reports are focused on the individual cases of patients suffering from functional anorectal disorders. During the examination algorithm, the emphasis is on 3D high-resolution anorectal manometry, which is a useful diagnostic technique and helps to understand the pathophysiological mechanisms in the field of functional anorectal disorders. Thanks to a comprehensive examination an individualized treatment plan can be determined for each patient.

The miniinvasive approach is atrend in pediatric surgery nowadays. The new surgical technique called percutaneous internal ring suturing (PIRS) is apromising method bringing all the benefits of miniinvasive surgery.

Prospective study of patients operated on using the PIRS technique from 01 January 2018 to 01 January 2020 at the Department of Pediatric Surgery, 2nd Faculty of Medicine, Charles University, University Hospital Motol.

73 patients (25 boys and 48 girls) were operated on using PIRS. The median age was 68 months. 90% of operations were performed by the same team of surgeons. During the procedure there were found 53 right-sided and 38 left-sided inguinal hernias. In 18 cases the hernia was bilateral, but only in 13 cases was this diagnosis made before the operation. Anon-absorbable stitch was used in 57 cases to close the internal ring of the inguinal canal, and anon-absorbable monofilament in 16. The median operating time was 34 minutes. There were 3 recurrences (3.3%) in our study. Conclusionefit of allowing to revise the contralateral inguinal canal as a prevention of a metachronous inguinal hernia. The cosmetic results were excellent.

Prevalence of obesity is 30% in the Czech Republic and is expected to increase further in the future. This disease complicates surgical procedures but also the postoperative period. The aim of our paper is to present the surgical technique called hand-assisted laparoscopic nephrectomy (HALS), used in surgical management of kidney cancer in morbid obese patients with BMI >40 kg/m2.

The basic cohort of seven patients with BMI >40 undergoing HALS nephrectomy was retrospectively evaluated. Demographic data were ana-lyzed (age, gender, body weight, height, BMI and comorbidities). The perioperative course (surgery time, blood loss, ICU time, hospital stay and early complications), tumor characteristics (histology, TNM classification, tumor size, removed kidney size) and postoperative follow-up were evaluated.

The patient age was 3867 years; the cohort included 2 females and 5 males, the body weight was 117155 kg and the BMI was 40.3501kg/m2. Surgery time was 7398 minutes, blood loss was 20450 mltatic disease; the tumor-free period in the other patients currently varies between 1 and 5 years. Conclusion HALS nephrectomy seems to be a suitable and safe surgical technique in complicated patients like these morbid obese patients. HALS nephrectomy provides acceptable surgical and oncological results.

The aim of our article is to present the results and experience with the method E.P.Si.T. - endoscopic pilonidal sinus treatment.

The operation is performed using aspecial endoscope - fistuloscope. In the first phase, we determine the extent and look for all the sinus tracts. In the second phase, the whole complex is treated with agrasper, abrush and an electrode from the inside.

Atotal of 21 operations were performed at our department from December 2018 through September 2019. In our sample, men predominated 61. Mean age of the patients was 27 years. Complete healing was achieved in 18 patients. Two patients were not healed primarily. One patient was lost to follow-up.

According to the first experience and results, the E.P.Si.T. seems to be avery good method for treating pilonidal sinus. Compared to open procedures, the length of hospitalization, the need for analgesics and antibiotics were significantly reduced. The period of convalescence was shortened and the return to normal life was faster. The size of the cohort and the duration of post-operative follow-up do not allow us yet to statistically evaluate the results.

According to the first experience and results, the E.P.Si.T. seems to be a very good method for treating pilonidal sinus. Compared to open procedures, the length of hospitalization, the need for analgesics and antibiotics were significantly reduced. The period of convalescence was shortened and the return to normal life was faster. Proteinase K manufacturer The size of the cohort and the duration of post-operative follow-up do not allow us yet to statistically evaluate the results.

An accurate histopathological diagnosis of indeterminate biliary strictures and pancreatic lesions is challenging because of insufficient quali-ty of tissue specimen taken during ERCP (brush cytology), cholangioscopy (biopsies) or endosonography (EUS, FNAB). Confocal laser endomicroscopy (CLE) allows virtual histopathological diagnosis with the potential to either replace or increase the diagnostic yield of standard histopathological diagnosis in patients presenting with biliary strictures and pancreatic lesions. The aims of our prospective pilot study were to 1. Assess the diagnostic yield of standard histopathology compared to CLE in patients referred for cholangioscopy or for EUS of the pancreas; 2. Evaluate the cost of CLE in these indications.

CLE was performed (during cholangioscopy or EUS), followed by standard tissue sampling. CLE-based diagnosis was compared with standard histopathology/cytology. CLE probe was introduced through the working channel of the cholangioscope or through the FNAB needle, therefore, might improve diagnostic accuracy or even replace standard histopathology in these indications.Complex anorectal examination including a detailed medical history, physical proctological examination and evaluation of the sensorimotor and structural function of the anorectum is essential for the diagnosis and therapeutic management of functional anorectal dysfunction. The aim of the work is to provide an overview of diagnosing functional anorectal disorders according to the new update and consensus statement of the International Anorectal Physiology Working Group (IAPWG) with a focus on indications, a standardized examination protocol and introduction of the new London classification of anorectal dysfunction. The indications are fecal incontinence, defecation disorders, functional pelvic (anorectal) pain, evaluation before an anorectal intervention and before planned delivery to assess the function of a previously traumatized anal sphincter. Standardization of the diagnosis and the evaluated data are the basis for multidisciplinary cooperation and determination of a treatment plan for each patient individually.Zenkers diverticulum is the most common type of esophageal diverticulum with a prevalence of 0.01 to 0.11 %, usually found in middle-aged and older patients. The prevalent symptoms are dysphagia and regurgitation. Treatment is recommended in symptomatic patients and consists of myotomy of the cricopharyngeal muscle. Both surgical and endoscopic methods are used in the treatment of Zenkers diverticulum. With technical advances, flexible endoscopy has come to the forefront in the treatment of Zenkers diverticulum, especially in older polymorbid patients. Its advantages include lower morbidity and mortality, shorter surgery time, the possibility of performing the procedure without general anesthesia, and a shorter hospital stay, including early oral food intake. In this paper we present our own experience with endoscopic treatment of Zenkers diverticulum and at the same time we provide a review of effectiveness with other methods of treatment.In this study, the structure, adhesion, and cell viability characteristics of silicon-incorporated diamond-like carbon (Si-DLC) coatings on fused silica substrates were investigated. The effects of argon and oxygen postprocessing plasma treatments on the Si-DLC coatings were also studied. The contact angle results showed that the Si-DLC coatings were more hydrophilic than the uncoated surfaces, and postprocessing plasma treatment increased the hydrophilicity of the Si-DLC coatings. Atomic force microscopy and profilometry confirmed that postprocessing plasma treatment increased the thickness and roughness of the Si-DLC coatings. The results of microscratch testing indicated that the plasma treatments reduced the adhesion of the coatings. The x-ray photoelectron spectroscopy (XPS) showed the presence of carbon, oxygen, and silicon in the Si-DLC coatings before and after the plasma treatments. These results show that the postprocessing plasma treatment significantly reduced the atomic percentage of the carbon in the Si-DLC coatings. XPS also confirmed the presence of carbon in the form of sp3(C-C), sp2(C=C), C-O, and C=O bonds in the Si-DLC coatings; it showed that postprocessing treatments significantly increased the percentage of oxygen in the Si-DLC coatings. Fourier transform infrared spectroscopy (FTIR) analysis showed features associated with C-OH stretching, C-H bending, as well as Si-CH2 and C-H bending in the Si-DLC coating. The XPS and FTIR results confirmed that the plasma treatment caused dissociation of the sp2 and sp3 bonds and formation of C-OH bonds. The contact angle data indicated that postprocessing treatment increased the hydrophilicity of the Si-DLC coating. Similar to the uncoated substrates, L929 cells showed no change in cell viability when cultured on Si-DLC coatings. These results of the study indicate the suitability of Si-DLC coatings as inert coatings for medical and biotechnology applications.June 20, 2020 marked the 70th anniversary of the birth of Sergei Alexandrovich Sovtsov - a prominent Russian surgeon, Doctor of Medical Sciences, Professor, Honored Doctor of Russia, Vice-President of the Russian Society of Surgeons.The researches devoted to blood-saving technologies in extensive liver resections are analyzed in the manuscript. Resection of three and more liver segments is effective method of surgical treatment of various focal liver lesions. Surgical (anatomical resection with hilar glissonean access, Pringle maneuver, modern technical equipment, etc.), anesthesiological (reduction of central venous pressure, hemostatic agents) and transfusion (autologous blood donation, transfusion, cell saver, etc.) methods contribute to prevention and reduction of blood loss. Intraoperative measures for blood loss prevention should include adequate surgical incision and liver mobilization, precise techniques of parenchymal dissection (for example, cavitation surgical aspirator-destructor), use of clip applicators and local or systemic hemostatic agents.Exocrine drainage is an Achilles heel of pancreas transplantation. The author analyzed the outcomes of pancreas transplantations with different types of exocrine drainage in various centers (n=93). The manuscript ensures insight on the evolution and progress of exocrine drainage techniques in pancreas transplantation within the historical context and current state of the problem.

Analysis of national and foreign trials investigating accumulation of experience in innovative technologies using the learning curves.

Earching for Russian-language manuscripts was carried out within the references of the articles and in the ELIBRARY database. Foreign trials were selected from the PubMed database according to the keywords «learning curves in surgical practice». The discovered publications were studied for accordance with the objectives of this study.

Accumulation of experience in new technologies by using of learning curves is valuable to improve the training, determine duration of development of new technology and the factors affecting its characteristics.

The method is high-quality for comprehensive analysis of experience accumulation in new surgical technologies.

The method is high-quality for comprehensive analysis of experience accumulation in new surgical technologies.