Report from the ‘Basics of Laparoscopy’ 4th edition and 1st Nursing Workshop organized by the Section of Videosurgery of the Polish Surgeons’ Society, Słok/Bełchatów, 5-6 December 2009

Report from the ‘Basics of Laparoscopy’ 4th edition and 1st Nursing Workshop organized by the Section of Videosurgery of the Polish Surgeons’ Society, Słok/Bełchatów, 5-6 December 2009 Michał Skalski, Tadeusz Wróblewski Department of General, Transplantation and Liver Surgery, Medical University of Warsaw, Poland Videosurgery and other miniinvasive techniques 2010; 5 (2): 82-85 Address for correspondence: Prof. Tadeusz Wróblewski, MD, PhD, Department of General, Transplantation and Liver Surgery, Medical University of Warsaw, Poland



On 5-6 December 2009 the 1st edition of the ‘Nursing Workshop’ was held in Słok near Bełchatów, together with the 4th edition of the ‘Basics of Laparoscopy’ course for physicians. Apart from 70 physicians, surgical residents mostly, 25 nurses from surgical departments participated in the workshop. The programme covered participation in lectures delivered by laparoscopic surgery experts and oral presentation of studies performed by participants of the workshop and sent for acceptance in abstract form. The topics of nurses’ presentations included treatment of patients with liver insufficiency with albumin dialysis, application of cochlear implants, and minimally invasive techniques in treatment of intracranial aneurisms. Lectures were delivered by 17 speakers, all accepted authorities in the field of laparoscopic surgery. The lectures were met with interest and were highly valued by the audience. The latest achievements and progress in minimally invasive techniques in the treatment of diseases of the biliary tree, oesophagus, stomach, large intestine, hernias and hormonal glands were presented. Films from videoscopic surgical procedures were shown. Each lecture was followed by a vivid discussion. At the end of the course for physicians, a short competition test was conducted to assess the level of new skills acquired during the training.

Additionally, participants had an opportunity to see the latest technological accomplishments in videosurgery, presented in industry stands and brief expert communications. Nurses actively participating in the Workshop could gain additional points necessary for enrolment in master degree studies at various medical universities.

Those interested in the forthcoming 5th edition of the ‘Basics of Laparoscopy’ course and the 2nd edition of the ‘Nursing Workshop’ are invited to the Wodnik Hotel in Słok near Bełchatów on 4-5 December 2010. Information can be found on our webpage: www.wideochirurgia.pl/.



Nursing session

1. Katarzyna Prus, Marzena Karaban, Mariusz Grodzi­cki

“Zadania pielęgniarki podczas wykonywania zabiegu dializy albuminowej u chorych z niewydolnością wątroby” (Role of the nurse during albumin dialysis in patients with liver failure)

2. Helena Kamińska, Arkadiusz Paprocki

“Implanty ślimakowe – kierunki rozwoju i ich znaczenie dla pacjentów” (Cochlear implants – directions of progress and significance for the patient)

3. Mariola Rodowicz, Marek Prokopienko

“Zastosowania toru wizyjnego przy mikrochirurgicznych operacjach tętniaków wewnątrzczaszko­wych” (Application of video in microsurgical procedures of intracranial aneurysms)

4. Elżbieta Adrian, Maciej Śmietański

“Znaczenie wprowadzenia programu Szpital bez bólu dla opanowania dolegliwości pooperacyjnych u chorych poddanych plastyce przepukliny” (Role of the “Hospital free from pain” programme in control of postoperative discomfort in patients after hernia repair)

5. Tadeusz Wróblewski

“Zapobieganie zakażeniom wewnątrzszpitalnym w warunkach oddziału chirurgicznego” (Prevention of nosocomial infections in the surgical ward)



Scientific Committee:

Wiesław Tarnowski – President

Andrzej Budzyński

Stanisław Głuszek

Marek Jackowski

Krzysztof Kołomecki

Krzysztof Leksowski

Maciej Michalik

Maciej Otto

Krzysztof Paśnik

Wiesław Pesta

Piotr Richter

Edward Stanowski

Maciej Śmietański

Tadeusz Wróblewski

Mariusz Wyleżoł



Organizing Committee:

Tadeusz Wróblewski

Michał Skalski

Jolanta Budny

Marzena Karaban

Mariola Rodowicz

Katarzyna Prus

Helena Kamińska

Abstracts of oral presentations for 1st Nursing Workshop

Assessment of visual tract use in microsurgical treatment of intracranial aneurysms Mariola Rodowicz1, Marek Prokopienko2 1SPCSK Warszawa, ul. Banacha 1a 2Department of Neurosurgery, Warsaw Medical University, Banacha 1a Introduction: The aim of the study was to assess the applicability of a videosurgery unit during microsurgery for intracranial aneurysm. Material and methods: Use of an external video monitor connected to an operating microscope during intracranial aneurysm clipping was compared to no visualization available for the scrub nurse. The observations were carried out at the operating theatre of SPCSK in the operating rooms of the Department of Neurosurgery. Results: Better cooperation between the surgeon and the scrub nurse and improved safety during surgery were noted. Direct visualization of the operating field and shortened reaction time of the scrub nurse minimize the duration of any intraoperative bleeding. The temporary or permanent clip is placed without delay and increases the safety of the procedure. Conclusions: Use of video monitoring during microsurgery is a method of intraoperative control necessary to maximize the safety of the procedure. Author’s e-mail: mariolarodowicz@vp.pl, author’s phone number: 509400538. The role of the nurse during albumin dialysis in patients with liver failure Katarzyna Prus, Marzena Karaban, Mariusz Grodzicki Department of General, Transplant and Liver Surgery, Medical University of Warsaw, Banacha 1a Introduction: Procedures of albumin dialysis are performed as a liver support in acute or decompensated chronic liver failure in patients who qualify for liver transplantation. Adsorbent columns filter blood and remove metabolites that cannot be metabolized in the liver to compounds excreted by the kidneys. The FPSA-Prometheus system of albumin dialysis is used in the Department of General, Transplant and Liver Surgery. Material and methods: Data gathered in dialysis protocols of patients treated in the Department of General, Transplant and Liver Surgery in 2003-2009 were analysed. Two hundred and seventy-eight albumin dialysis procedures were performed in 114 patients with liver failure of various origin. Acute liver failure was an indication for dialysis in 52 patients and decompensation of chronic liver failure in 62 patients. Results: Present standards of treatment include three 6-h long dialyses repeated every 24 h in one patient. The whole procedure lasts about 8.5 h. The first step is a 1 h calibration of the water treatment system that treats tap water. The next step is a test of the Prometheus system and filling of two sets of adsorbent columns and cannulas with 0.9% saline and 5000 U/l of unfractionated heparin, which lasts about 1 h. After dialysis the system is cleaned for 0.5 h. During the dialysis, vital patient’s parameters are monitored including the pressure at the entry and at the exit of the circuit (suction and pumping pressure at a central venous cannula) and at the entry and the exit of adsorbent columns; heparin flow in the integrated pump and flow rate of blood and plasma. Data regarding bilirubin, ammonia, urea and creatinine plasma concentration and transaminase activity and pH were gathered before and after dialysis. Mean number of dialysis procedures per patient in the study group was 2.41. Mean heparin dose administered during dialysis was 750 U/h. Mean dialysis time was 6.3 h. Statistically significant improvement in laboratory values was observed. Conclusions: The duties of the nurse include: 1) conducting the albumin dialysis, preparing and operating the dialysis equipment, 2) preparing the patient for dialysis, 3) monitoring essential vital parameters during the dialysis: heart rate, blood pressure, central venous pressure, saturation, body temperature and diuresis. Cochlear implants – directions for development and their importance to patients Kamińska Helena1, Arkadiusz Paprocki2 1SPCSK Warszawa, ul. Banacha 1a, operating theatre 2Chair and Department of Otolaryngology, Medical University of Warsaw Introduction: In 1972, the first implantation of one electrode, the standard produced cochlear system, was done. However, it was insufficient for satisfactory speech understanding. That led to the construction of multichannel systems. In 1992 the first surgical treatment of deafness using cochlear systems was done in Poland in the Department of Otolaryngology, Medical University of Warsaw. Aim of study: To present the equipment, operative technique and educational-therapeutic process employed for treatment of sensorineural hearing impairment with cochlear system implants. Material and methods: Seventy patients with bilateral deafness were qualified for cochlear implants. Results: Three types of cochlear systems were implanted – MXM in 12, Advanced Bionic in 26 and Nucleus Freedom in 32 patients – without any major intra- or perioperative complications. Based on audiological and psychoneurological control tests, good clinical results of surgical treatment were confirmed in nearly all of these patients. Conclusions: Cochlear implants are the most effective treatment of bilateral and deep sensorineural hearing impairment. The success of the treatment depends on a properly qualified group of patients, excellent surgical technique, postoperative course and long-term speech and hearing rehabilitation. Author’s e-mail: kaminskahelena@vp.pl, author’s phone number: 0605292151.