[The operative videothoracosopy in rendering emergency surgical care in penetrating gunshot chest wounds].

The modern doctrine of military surgery is based on the concept of maximal and, if possible, simultaneous surgical aid to the wounded in the shortest period of time after the injury. It could be achieved by approximation of specialized surgical section to the zone of fighting and improvement of medical evaluation. These are conditions for applicability of modern methods of treatment and for perfecting of surgical strategies to the wounded, such as videothoracoscopy. To report the experience of the usage of videothoracoscopy in the treatment of the wounded with penetrating gunshot wounds of chest (PFAWT) in military hospital. 23 patients with PFWAT was administer surgical therapy: 19 patients had pleural draining at previous stages of medical evacuation, 4 patients were delivered directly from the battle Geld 1.5 hours after the injury. 11 patients with pleural drains and 4 patients, delivered from battle Geld, had indications for videothoracoscopy. These indications included ongoing intrapleural bleeding, clotted hemothorax and prolonged leakage of the air through the drain. Suturing of the lung wounds was performed by Endo-GIA-30 stapler. If it was impossible, manual suture EndoStitch USSC was used. In 2 cases was performed wedge-like resection by EndoGIA-30. The bleeding from the thoracic wall wounds was controlled by electrocautery. The clotted hemothorax was removed by fragmentation with EndoBabcock, washing out and aspiration through large diameter tubes. The duration of the procedure ranged from 40 to 90 minutes. None had suppurative complications. All patients was survived. The mean duration of inpatient period was 20 days, rehabilitation period-14 days.