Aim. To describe the experience of using augmented reality system in abdominal surgery at one clinical center.Materials and methods. In 2021–2022, five patients underwent laparoscopy with augmented reality technology. The interventions included echinococcectomy with resection of IV, V, VI liver segments, pancreaticoduodenal resection for pancreatic head cancer, excision of mesostenium cyst, resection of pancreas body and tail for neuroendocrine tumor.Results. Application of 3D models requires putting on glasses, scaling and setting a model on the screen image, which sometimes prolonged surgery time to 25 minutes. In a number of operations the use of augmented reality navigated the surgeon when working near vascular structures. After looking through the AR model, a surgeon felt more confident in terms of individual anatomy.Conclusion. Augmented reality can become a reliable and promising tool in abdominal surgery. However, further technological development in augmented reality systems is needed to increase their performance.

Purpose. To determine the frequency and risk factors for the development of internal spontaneous internal hemorrhage and clinical manifestations in patients with COVID-19 undergoing inpatient treatment. Material and methods. In the period from10.20 till 06.2021, 28 cases of spontaneous internal hemorrhage in patients with confi rmed COVID-19 complicated by bilateral interstitial polysegmental pneumonia were analyzed at the COVID-19 Clinical Center of Moscow State Medical University named after Evdokimov. Anamnesis, age, gender, objective examination data, concomitant diseases, laboratory blood counts, CT results, soft tissue ultrasound, treatment regimens, characteristics of hematomas (volume, localization) and hospitalization outcomes were analyzed. Results. Summarizing the results of our own observations, a low number (no more than 1%) of hemorrhagic complications in patients with coronavirus infection were noted. In more than half of the patients, spontaneous internal hemorrhages were detected during the 2^nd–3^rd weeks of treatment, for 17.4 ± 2.7 days on average. The main risk factors for the development of internal spontaneous hemorrhage with the formation of hematomas in patients with COVID-19 should be considered old age, female sex, and the presence of hypertension, diabetes mellitus, and anticoagulant therapy. Hemorrhages of any localization and intensity, both isolated and combined, can develop regardless of the severity of lung damage and respiratory failure. In case of a decrease in the level of hemoglobin in the dynamics of treatment, fi brinogen, hypotension, the appearance of pain syndromes of various localization (against the background of a decrease in C-reactive protein (CRP), and an increase in leukocytes in the blood), emergency computed tomography (CT) is indicated for timely diagnosis of hemorrhage and the formation of hematomas. Surgical treatment is indicated for hemodynamically stable patients with large-volume soft tissue hematomas (more than 500 ml) with signs of suppuration according to ultrasound or CT. The prescription of anticoagulants and antiplatelet agents, regardless of the dosage, can lead to hemorrhagic complications, which requires constant monitoring of coagulogram parameters in order to correct the dose.

Removal of epileptogenic lesions is an effective way to treat patients with drug-resistant epilepsy. The result of surgical treatment depends on the correct detection of pathology, definition of its boundaries. No lesion on magnetic resonance imaging is not a contraindication to surgical treatment, but requires a survey. Each of the additional methods has its advantages and disadvantages. С omprehensive examination, analysis and comparison of positron emission tomography, single-photon emission computed tomography, magnetoencephalography, scalp and invasive electroencephalography data can significantly improve the results of surgical treatment MRI-negative epilepsy patients. Clarification of the pre-surgical evaluation algorithm will allow to optimize the use of techniques.

The study objective is to analyze the results of surgical treatment of patients with endocrine ophthalmopathy using minimally invasive transorbital approaches and intraoperative frameless neuronavigation. Materials and methods. The study was based on the results of examination and surgical treatment of 9 patients with endocrine ophthalmopathy (17 orbits) in the period from 2015 to 2017. At the first stage the preoperative computed tomography images of the orbits was imported into the navigation software program, and then the area of the proposed resection of the orbit walls was marked. Further, in the operating room, the patient head position was registered in the navigation system. To perform bone decompression of the orbit and lipectomy, we used preseptal, transcaruncular and lateral retrocanthal approaches. These approaches are transconjunctival and do not leave postoperative scars. Upon completion of the orbitotomy, its accuracy and dimensions were determined by the intraoperative pointer of the neuronavigation system. Results. The postoperative period was uneventful. In all patients, according to clinical examination and computed tomography, good cosmetic and functional results were achieved. Only 1 patient developed a simblypharon after transconjunctival access, which required additional intervention to reconstruct the lower eyelid. There were no other complications of surgical treatment. The minimum degree of regression of exophthalmos was 3 mm, the maximum 7 mm. Diplopia completely regressed in 2 patients. The observation period was 6 months. Conclusion. Minimally invasive transorbital approaches allow the transconjunctival view of all orbital walls to perform decompression of the orbit and lipectomy without cutaneous incisions, to achieve good cosmetic and functional results. The intraoperative use of the neuronavigation system ensures the bone decompression of the orbit in full.