ALMATY – The recent fifth Congress of Kazakh Surgeons demonstrated new possibilities in transplantology.
The surgeons, together with their colleagues from Tomsk University, first replaced a damaged joint in a hand with an artificial, ceramic one. This operation was conducted by Mismil Muradov D, Head of the Department of Reconstructive and Plastic Microsurgery of Syzganov National Scientific Centre of Surgery (NSCS). He shared his views on the development of microsurgery in the republic.
Microsurgery today can do a lot, for example, such as transplant fingers or joints, thus maintaining the functions of the hand. After such an operation, a person can write, sew and draw. We can restore movements of the hand which were lost due to improperly united fractures or correct a birth defect, for example to set webbed fingers apart. Our centre performs practically all types of microsurgical operations – aesthetic and reconstructive operations on limbs – using the most advanced microsurgery technologies.
Certainly, there can be problems and they depend on many factors. For a successful operation, for example, it is necessary to deliver the patient and the cut-off segment of his body to a hospital in a timely fashion. Moreover, this segment must be properly transported.
The time factor is also of special importance – the assistance should be provided within the first two to three hours. Of course in such a short period of time it is almost impossible to deliver a patient from remote areas; therefore it is very important to have such experts there.
I must say that reconstructive plastic microsurgery is a young direction and it has been developed in our centre since 1983. Then the priority was limb replantation.
Until recently, there was no reconstructive and plastic microsurgery in the list of medical specialties. It was introduced in 2010, when Kazakhstan started fulfillment of the state programmes, including in the area of healthcare development. Over the last two or three years, we have been working on the creation of innovative platforms in the regions. We have supervised the region in southern Kazakhstan over the past two years, for example, and have conducted about 30 master classes and trained 22 specialists.
In addition to southern Kazakhstan, microsurgery operations can be carried out in Astana and Karaganda. We also provided training for doctors from Taraz, Kyzylorda. The work is going dynamically and it is an encouraging fact that young professionals’ interest in this specialty is growing, though unfortunately, Kazakhstan is short on microsurgery specialists.
Our medical universities do not train such specialists, but we are working on it. We were offered an opportunity to organise a kind of master class at the Kazakh National Medical University.
I’ve been on practical trainings in European clinics and in America as it is impossible to monitor the dynamics of microsurgery’s development without communicating with foreign colleagues and without studying the international experience.
In Kazakhstan microsurgery operations are performed due to the state grants and they are very expensive – about half a million tenge (US$2,722).
We have carried out over 5,000 operations. For example, in our department we perform about 500 operations per year in hand and foot surgery. Our surgeons have a very high physical load; they practically don’t move during the operation, about six-eight hours. Besides, surgical instruments and suture materials are very small in size. Therefore, the operation is performed with the use of a special surgical microscope, which zooms in eight-40 times.
Certainly over the last ten years, the progress in microsurgery is obvious. At present we are able to perform multi-microsurgery operations.
This branch of medicine is able to reduce the level of traumatisation in the country and it is one of the main tasks of well-developed microsurgery. It should be noted that in addition to the ruined lives and injuries, traumatism causes very tangible damage to the economy of the state. According to statistics, the total economic losses in the country over the last five years exceeded 960 billion tenge (US$5.2 billion). These are huge figures! Therefore, we believe that the state should create a special training programme for such specialists, taking into account their importance for the country’s economy. After all, the state’s expenditures on disability benefits and long-term medical treatment of such patients cost more than a billion tenge (US$5.4 million) a year.
Microsurgery can be of great help, because it is truly a unique branch of medicine that can do if not all, but many things.