Videotoracoscopy and videolaparoscopy in large trauma tactic protocols

The work was carried out to determine the prospects for the use of videotoracoscopy (VTS) and videolaparoscopy (VLS) in the diagnosis and treatment of victims with large trauma. The article presents the results of management of 456 cases with a closed combined trauma of the chest and abdo- men, who were treated in the Ivanovo regional clinical hospital. The cases in the control groups demonstrate a tactic with the traditional approach, based on the use of non-invasive diagnostics and open surgery without taking into account the morphology and severity of injuries. The general samples show the ex- perience of videotoracoscopy and videolaparoscopy application for diagnosis and simultaneous surgical correction of identified pathology, including their consistent sequenced use. After a comparative observation, the indications for videotoracoscopy and videolaparoscopy, depending on the presence and severity of shock, as well as indications for a one-time minimally invasive intervention, depending on the video audit data, are proposed. Minimally invasive technologies in 2/3 of the victims were the comprehensive type of intervention. At the same time, low traumaticity and shortened time of videoendoscopic operations are indispensable in cases of traumatic shock. An approximate tac-tical algorithm based on the active use of endovideosurgical technologies in patients with combined trauma is presented.