grekovВестник хирургии имени И.И. ГрековаGrekov's Bulletin of Surgery0042-46252686-7370Federal State Budgetary Educational Institution of Higher Education «Academician I.P. Pavlov First St. Petersburg State Medical University» of the Ministry of Healthcare of the Russion Federation, FSBEI HE I.P.Pavlov SPbSMU MOH Russia10.24884/0042-4625-2025-184-5-59-68grekov-2621Research ArticleОПЫТ РАБОТЫEXPERIENCE OF WORKМонопортальная эндоскопическая хирургия огнестрельных слепых ранений тазаMonoportal endoscopic surgery of blind pelvic gunshot woundshttps://orcid.org/0000-0003-2486-6995КравцовМ. Н.KravtsovM. N.

Кравцов Максим Николаевич, доктор медицинских наук, старший преподаватель кафедры нейрохирургии

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

Kravtsov Maxim N., Dr. of Sci. (Med.), Senior Lecturer of the Department of Neurosurgery

Saint Petersburg

neuromax@mal.ruhttps://orcid.org/0000-0002-1890-7546МирзаметовС. Д.MirzametovS. D.

Мирзаметов Саидмирзе Джамирзоевич, кандидат медицинских наук, начальник нейрохирургического отделения клиники нейрохирургии

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

Mirzametov Saidmirze D., Cand. of Sci. (Med.), Head of the Neurosurgical Department of the Neurosurgery Clinic

Saint Petersburg

said19mirze@mail.ruhttps://orcid.org/0000-0002-3922-9887СвистовД. В.SvistovD. V.

Свистов Дмитрий Владимирович, кандидат медицинских наук, доцент, начальник кафедры нейрохирургии

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

Svistov Dmitry V., Cand. of Sci. (Med.), Associate Professor, Head of the Department of Neurosurgery

Saint Petersburg

dvsvistov@mail.ruВоенно-медицинская академия имени С. М. КироваРоссияMilitary Medical AcademyRussian Federation20252412202518455968Copyright © Кравцов М.Н., Мирзаметов С.Д., Свистов Д.В., 20252025Кравцов М.Н., Мирзаметов С.Д., Свистов Д.В.Kravtsov M.N., Mirzametov S.D., Svistov D.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnik-grekova.ru/jour/article/view/2621

ВВЕДЕНИЕ. В статье приведено описание монопортальной эндоскопической техники хирургической обработки огнестрельных слепых ранений таза.ЦЕЛЬ – оценить возможности и эффективность монопортальной эндоскопической хирургии при слепых огнестрельных ранениях таза.МЕТОДЫ И МАТЕРИАЛЫ. Выборку составили 16 мужчин, 21–54 лет, со слепыми огнестрельными ранениями таза без повреждения органов и крупных сосудов, оперированных в 2022–2023 гг. в Военно-медицинской академии с применением монопортальной эндоскопической техники. Катамнез составил 12 месяцев.РЕЗУЛЬТАТЫ. Продемонстрирована оперативная техника монопортальной эндоскопии в жидкой среде физиологического раствора хлорида натрия с антисептиком, позволяющая удалить ранящий снаряд и осуществить санацию огнестрельной раны. У всех пациентов заживление ран наступило в сроки от 5 до 16 дней на фоне антибактериальной терапии. Инфекционных осложнений не отмечено. Во всех случаях достигнут удовлетворительный клинический результат. Предложена компьютерно-томографическая классификация огнестрельных слепых ранений таза для планирования эндоскопического доступа к инородному телу.ВЫВОД. Метод полностью эндоскопической интравульнарной санации огнестрельных ран позволяет эффективно удалять ранящие снаряды (пули, шрапнель, осколки) из костно-мышечных структур таза, обеспечивая удовлетворительные клинические исходы. Оптимальные условия к применению данной хирургии – наличие показаний к удалению глубоко локализованных небольших инородных тел в области таза. 

INTRODUCTION. This article describes a monoportal endoscopic technique for surgical treatment of blind pelvic gunshot wounds.The OBJECTIVE was to evaluate the possibilities and effectiveness of monoportal endoscopic surgery for blind pelvic gunshot wounds.METHODS AND MATERIALS. The sample consisted of 16 men, aged 21–54, with blind pelvic gunshot wounds without damage to organs and large vessels, operated in 2022–2023 at the Military Medical Academy using monoportal endoscopic technology. The catamnesis was 12 months.RESULTS. The operative technique of monoportal endoscopy in a liquid medium of sodium chloride saline solution with an antiseptic has been demonstrated, which makes it possible to remove a wounding projectile and clean a gunshot wound. In all patients, wound healing occurred within 5 to 16 days on the background of antibacterial therapy. There were no infectious complications. In all cases, a satisfactory clinical result was achieved. A computed tomographic classification of blind pelvic gunshot wounds is proposed for planning endoscopic access to a foreign body.CONCLUSION. The method of full-endoscopic intra-wound debridement of gunshot wounds makes it possible to effectively remove wounding projectiles (bullets, shrapnel, fragments) from the musculoskeletal structures of the pelvis, providing satisfactory clinical outcomes. The optimal conditions for the use of this surgery are the presence of indications for the removal of deeply localized small foreign bodies in the pelvic area.

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The authors declare that there are no conflicts of interest present.