Лапароскопия в диагностике и лечении послеоперационного перитонита

Endovideosurgical technologies are the most perspective direction in the diagnosis and treatment of postoperative peritonitis. Endoscopic reoperations are a new alternative of traditional relaparotomy which allow effectively with little trauma perform diagnosis and sanation of abdominal cavity in 75–85 % of patients with postoperative peritonitis. However, currently, the problems of method of the first trocar placement into the abdominal cavity reducing the risk of internal organs damage and formation of pneumoperitoneum in the presence of drainage counteraperturies are still debated. Another problem of the dynamic laparoscopy is the negative effect of tension pneumoperitoneum on the cardiovascular and pulmonary systems in this severe patients group, particularly in patients of elderly and senile age. Alternative of the tension pneumoperitoneum is laparolifting – mechanical lift-ing of the anterior abdominal wall using various devices in minipneumatical or isopneumatical modes. This meth-od eliminates some side effects of standard laparoscopy, but does not always provide adequate exposure and visu-alization of operational space and limits extracorporeal mobilities of laparoscopic tools. Thus, currently, each of these laparoscopic methods have several disadvantages that retains certain technical problems in its implementa-tion. This requires the necessity of discovering a new methods of laparoscopy for diagnosis and treatment of post-operative peritonitis, and determining of the indications criteria for relaparotomy or laparoscopic sanations.