The Clinic of Gynaecology and Obstetrics of the Clinical Centre Banja Luka introduced several new and modern procedures and accordingly, with its continuous activities, improved treatments of patients in the Clinical Centre Banja Luka.
LAVH- laparoscopically assisted vaginal hysterectomy is the first and the most significant procedure which is performed in the Clinic of Gynaecology and Obstetrics, as a routine surgical method. It is an endoscopic method which is performed exclusively in the most modern international centres which employ fully qualified staff for this type of procedure.
These highly sophisticated surgical techniques are rarely performed in the health care institutions in the region, except in Slovenia. In 2013, nine procedures were performed and twenty-two procedures were performed in 2014. The significance of these surgeries is multiple, because morbidity and mortality are decreased and occurrence of postsurgical complications is reduced. Patients’ hospital stay is significantly shorter (3-4 days maximum) and usage of medications, sanitary material and transfusion is also reduced. Obese female patients have a special advantage because of application of minimally invasive procedures. In those cases, surgical opening of front abdomen wall is avoided, because it leads to significant morbidity. Examples of successful performing of surgery in extremely obese female patients are multiple. Weight of a female patient diagnosed with endometrial cancer who underwent this procedure is 219 kg, BMI is 71,50 kg /m2 and height is 175 cm. At the same time she is the heaviest patient that underwent a surgery in the Clinical Centre Banja Luka since its establishment. The complex surgical procedure was performed by Miroslav Popović MD, Rosanda Jevtović MD, C. Lazikić MD and anaesthesia was performed by Darko Golić MD.
The second very significant and new procedure is radical trachelectomy which was successfully performed for the first time in the Clinic of Gynaecology and Obstetrics in April 2014 in a female patient that was diagnosed with cervical cancer. The specificity of this procedure is the fact that the female patient never gave birth. Therefore, it was necessary to preserve her reproductive ability. Only cancer tissue of cervix was removed as well as regional lymph nodes. At the same time, body of uterus with adnexa was not removed and anastomosis of healthy part of uterus with healthy part of vagina was performed. The surgery is very rare and technically demanding since it lasts 6-7 hours. The complex surgical procedure was performed by: M. Popović MD, A. Baničević MD, C. Lazikić MD and anaesthesia was performed by M. Hadžibegović, MD.
The third very significant surgery which was performed in the Clinic of Gynaecology and Obstetrics is Fistulectomia sec. Martzius. It is gynaecological and urological surgery by which the cavity between bladder and birth canal occurring as a consequence of radiation therapy is closed. The surgery was performed in December 2013 in a female patient named M.D. The complex surgical procedure was performed by Miroslav Popović M.D., Vladimir Krivokuća M.D. and Slobodan Grahovac M.D.
All three procedures are part of standard services which are performed in the Department of Surgical Oncology of the Clinic of Gynaecology and Obstetrics of the Clinical Centre Banja Luka. Besides the described procedures, there are several simpler endoscopic procedures which are not less significant and which are introduced into routine practice. By introducing minimally invasive procedures into gynaecological surgical practice, the Clinical Centre Banja Luka became one of the biggest health care institutions in the region. Treatment of patients was improved, the range of services was extended and at the same time significant savings in the Clinical Centre Banja Luka and the Health Insurance Fund of the Republic of Srpska were made.
Standard procedure for work of the ethical committee of the clinical center (kc)