The review presents a comprehensive analysis of the current state and prospects for the use of artificial intelligence (AI) technologies in endoscopy of the digestive system. The research covers the main areas of AI implementation in endoscopic practice, including CADe and CADx computer vision systems, machine learning methods and deep learning algorithms. The paper examines the features of endoscopic procedures that affect the effectiveness of AI technologies: patient preparation, imaging quality depending on the skills of the endoscopist, and the multimodality of modern endoscopic methods. The results demonstrate the active development of AI technologies in endoscopy, especially in the field of detecting pathological changes in the gastrointestinal tract. Key applications of AI include cancer detection, diagnosis of Helicobacter pylori, assessment of inflammatory diseases, and quality control of research. The analysis shows that despite significant advances in the development of AI systems for endoscopy, their implementation is limited by a number of factors, including dependence on the operator and the complexity of standardization. In the near future, new approaches will be introduced to train AI models, including recurrent neural networks and multimodal AI systems that combine visual data with other patient information.

Robot-assisted surgery is an innovative, minimally invasive approach widely applied in modern clinical practice. This study summarizes the experience of the Moscow Multidisciplinary Scientific and Clinical Center named after S.P. Botkin in performing more than 9,000 robot-assisted operations since 2008. A retrospective analysis included data from 9,133 patients who underwent robot-assisted surgery using the da Vinci S/Si/Xi platforms in urology, abdominal surgery, and gynecology. Outcomes were assessed using the Clavien – Dindo classification, ISGPS classifications (for pancreatic surgery), and validated questionnaires. In abdominal surgery, 1,642 procedures were performed (45.2 % – on the colon, 19.8 % – on the stomach, 15 % – on the pancreas); the incidence of grade III–V complications ranged from 4.2 (colon) to 19.7 % for pancreatoduodenectomies. In thoracic surgery, 330 procedures were performed, with grade III–V complications occurring in 2.6–17.1 % of cases. In urology, radical prostatectomy predominated (n = 5,253), followed by partial nephrectomy (n = 934) and adenomectomy (n = 558). In gynecology, 416 procedures were performed; grade III– V complications occurred in 0–20.9 % of oncogynecology cases and 3.8 % in general gynecology. The experience of a multidisciplinary center demonstrates that robot-assisted surgery is safe and effective in urology, abdominal, thoracic surgery, and gynecology, providing comparable oncological radicality with lower invasiveness and faster recovery.

Various aspects of surgical treatment of hiatal hernias and gastroesophageal reflux, despite the differrences in these nosologies, are traditionally considered in a complex. In addition to the general historical stages of studying these pathological conditions, they are largely united by interrelated mechanisms of development and approaches to treatment. As is often the case in medical science, understanding of many theoretical components of the problem followed the development of its purely applied side. Questions that initially seemed obvious and simple acquired a different meaning and significance. The article in discussion form presents current views on the problem of surgical treatment of hiatal hernias and gastroesophageal reflux. The main stages of development of this area of clinical medicine are noted in chronological order. Controversial issues of surgery of hiatal hernias and gastroesophageal reflux are considered in detail from the stand-point of functional anatomy and physiology. The fallacy of dominating technology over ideology, forgetting the experience of the founders and pioneers of this field of knowledge is shown. The theoretical and practical approaches to their solution, the advantages and disadvantages of various methods of operations, which are available to date, are presented.

In the next 25 years, medicine, and surgery in particular, will undergo revolutionary changes, mainly due to a combination of biotechnology, artificial intelligence and the emergence of new materials. With a high degree of probability, the focus of surgical science will be on biocompatible materials, personalization of treatment using artificial intelligence algorithms, as well as the development of fully automated robotic systems. Based on existing experimental and preclinical studies, it is possible to get an idea of current trends that can be guessed in existing and emerging technologies, which allows us to describe the outlines of the near future with a high degree of probability and, based on a detailed analysis, describe the expected, and possibly desired, technologies.

The article presents the results of an analysis of the experience of using augmented reality (AR technology) by the staff of a multidisciplinary surgical clinic in various branches of surgery. 151 patients were included in the study, which was conducted from 2021 to 2025 at the Department of Naval Surgery of the Kirov Military Medical Academy and at its clinical base at the I.I. Dzhanelidze Research Institute of Emergency Medicine. All patients underwent surgery for various diseases of the chest, abdomen, pelvis, and extremities, the structure of which was represented by malignant locally spread tumors of the abdomen and pelvis (n=31), benign diseases of the biliopancreatoduodenal zone and chest (n=14), as well as foreign bodies (fragments) of the chest, abdomen, and extremities (n=106). The perioperative application of augmented reality technology included five main stages: patient selection, spiral computed tomography, the construction of a topographic and anatomical model (TAM) of the patient, the choice of a method for combining (linking) the model and the area of surgical intervention, and the intraoperative use of technology. The medical and technical support of AR technology is represented by a hardware and software complex – a navigation system based on augmented reality "Medical Vision", including a personal computer and augmented reality glasses "Microsoft Hololens II". The evaluation of AR technology was carried out in two directions. The first direction is an objective and subjective study of the accuracy of intraoperative comparison of TAM, the second is a comprehensive assessment of the degree of satisfaction of the surgical team with various aspects of the technology used. The average deviation of the topographic and anatomical model was the lowest when using AR technology for surgical removal of foreign bodies (fragments), unlike other types of surgical interventions, the same dynamics was demonstrated by the results of a subjective assessment. A comprehensive subjective assessment of AR technology satisfaction among surgeons, in general, indicates its positive perception. It was found that experienced surgeons (with more than 15 years of experience) attach more importance to the role of augmented reality technology at the planning stage, in contrast to less experienced surgeons who rated its intraoperative use higher. In addition, less experienced specialists speak better about the ergonomics of using AR technology during surgical interventions. The study shows that augmented reality technology in surgery is undoubtedly necessary in preoperative planning to increase the confidence of the surgical team and prepare it for the upcoming surgical intervention. A direct comparison TAM with the field of surgical intervention at this stage of the development of engineering support for AR technology is justified when removing foreign bodies (fragments). The results obtained in the study made it possible to formulate and substantiate a multimodal concept of planning and perioperative safety of surgical intervention based on augmented reality.

Personalization of the choice of hernioplasty technique in patients with inguinal hernias remains an urgent problem of modern herniology. Performing "embryo-oriented operations" in the treatment of patients with inguinal hernias and difficulties in perceiving the multifascial structure of the anterior abdominal wall determine the need for an in-depth topographic and anatomical study of the anterior abdominal wall and substantiation of options for endovideosurgical inguinal hernioplasty in different categories of patients. The purpose of the study – to clarify the clinical and topographic-anatomical criteria for choosing a rational method of hernioplasty in patients with inguinal hernias to reduce the risks of postoperative complications and disease recurrence. The clinical study was based on data on 1,517 patients with inguinal hernias who underwent surgery at the Clinic of the Faculty of Surgery at the University of Medicine in the period from December 2014 to October 2021. The topographic and anatomical study was carried out using cadaveric material (11 objects) and analysis of plastinated transverse cuts of the abdomen (n = 17) of human corpses to determine the individual features of the transverse and preperitoneal fascia in the main types of human physique. The significance of these anatomical structures in performing endovideosurgical hernioplasty has been determined. It was found that the preperitoneal fascia was visualized during the study on all 11 corpses, the thickness of which differed in different areas of the anterior abdominal wall. The technical possibility of performing endoscopic hernioplasty using the TER technique is available in patients of all body types. The TEP access to the interfascial preperitoneal cellular space, developed and justified from a topographic and anatomical point of view, significantly reduces the risk of damage to the peritoneum, epigastric vessels, and nerves in the "triangle of pain" and reliably installs a mesh prosthesis without stapler fixation, prosthetics all the "weak" points of the inguinal, femoral, and occlusive regions. The modified therapeutic and diagnostic algorithm for choosing a rational minimally invasive method of inguinal hernioplasty made it possible to reduce postoperative pain syndrome, minimized the risk of postoperative complications during TEP surgery from 3.9 to 1 % at p<0.05; reduced TAPP and Lichtenstein operations from 4.5 to 3.6 % and from 9.5 to 6.3 % respectively when p>0.05; reduced the frequency of access conversions by 3 times, recurrence of the disease after TEP surgery from 1.2 to 0.3 % at p<0.05; TAPP from 1.5 to 0.9 % and Lichtenstein surgery from 2.9 to 2.1 % at p>0.05. A modernized differentiated approach to choosing a particular surgical technique in the treatment of patients with inguinal hernias should take into account the type of hernia according to the modern classification, the presence of concomitant surgical diseases of the abdominal cavity, the general comorbid condition of the patient, predict and minimize the possible risks of perioperative complications, as well as the technological capabilities of the medical institution and manual skills of the surgeon.

Damage to the bile ducts is considered the most serious complication of operations on the organs of the hapatopancreatoduodenal zone, they often cause severe consequences in the early postoperative period, as well as the cause of disability of young and able-bodied patients in the late stages. Thus, unintended damage to the bile ducts is a medical and social problem, many generations of specialists from various clinics are engaged in the search for optimal solutions to various problems of early complications of the postoperative period and the late consequences of reconstructive operations on the bile ducts. In modern conditions, the place and role of minimally invasive operations in the care of patients with bile duct injuries are being determined, and the possibility and effectiveness of percutaneous combined operations in the treatment of patients with biliobiliary strictures and biliodigestive anastomoses are being determined. The aim of the work is to evaluate the effectiveness and alternative of the developed combined minimally invasive operations for early complications and late consequences of various types of damage to the bile ducts. The study included 193 patients, of which 55 patients with early complications of unintended damage to the bile ducts, 138 with late consequences of reconstructive biliary tract and biliodigestive operations. Original minimally invasive combined operations were used to restore the integrity and patency of unintentionally damaged bile ducts after surgery on the organs of the hepatopancreatobiliary zone. Analyzing the effectiveness of the developed minimally invasive operations, the following data were obtained: in early complications of unintended damage to the bile ducts, the effectiveness was 90.91 %, and in patients with biliary and biliodigestive strictures – 97.82 %.

Mesh implants have become an integral part of modern hernia surgery. Although polypropylene remains the most used material, its limitations – such as degradation, chronic inflammation, and potential systemic immune reactions – have drawn increasing attention. As a result, alternative polymers such as polyvinylidene fluoride (PVDF) are being actively explored for their superior biocompatibility, chemical stability, and lower complication rates. This review outlines the historical evolution and current classifications of synthetic meshes used in abdominal wall reconstruction. It highlights the biomechanical, morphological, and immunological characteristics of various implant materials, with particular emphasis on PVDF-based prostheses. Future directions are also discussed, including the development of bioactive, MRI-visible, and patient-specific meshes.

Earlier diagnosis of cancer, increased effectiveness of therapeutic measures in combination with improved surgical treatment methods have led to improved prognosis and functional outcomes for patients, increased life expectancy and constant expansion of survival boundaries, as well as an increase in the proportion of patients with comorbidities. With the increase in life expectancy and population aging in general, the problem of comorbidity and "frailty" and the treatment of oncourological diseases in this group of patients are currently receiving increasing attention. Over the past decades, approaches to the management of such patients have changed significantly in favor of expanding the indications for radical treatment. At the same time, robot-assisted surgery, as one of the most modern, effective and safe methods, seems to be an extremely promising way to treat prostate cancer and kidney tumors in patients with severe comorbidities. This article presents world data on the treatment of prostate cancer and kidney cancer in comorbid patients using robotic surgery, as well as our own results of these methods.

Bariatric surgery remains the most effective method of treating morbid obesity, however, modern approaches require the integration of pharmacotherapy and multidisciplinary support to achieve sustainable results. The purpose of this literature review was to analyze current trends in bariatric surgery, evaluate the effectiveness of various surgical interventions, as well as the role of pharmacotherapy and standardization of protocols in improving the quality of treatment. A review of randomized clinical trials, meta-analyses, and registry data on the outcomes of laparoscopic longitudinal gastric resection (PRG), the use of GLP-1 agonists and double GIP/GLP-1 agonists, multidisciplinary patient management, and the implementation of ERAS protocols has been performed. Longitudinal gastric resection provides 60–70 % of excess body weight loss (EWL) within 5–7 years and remission of type 2 diabetes in 50–60 % of cases, comparable with the results of gastric bypass surgery. For patients with superobesity, this technique remains highly effective and safe. A multidisciplinary approach helps to reduce the risk of relapse and increase the effectiveness of therapy. Pharmacotherapy using semaglutide and tirzepatide is effective both before and after surgery, reducing the frequency of weight loss. The standardization of treatment protocols has reduced the incidence of complications to 1.06 % and shortened the duration of hospitalization. Laparoscopic longitudinal gastric resection remains the basic method of bariatric surgery, the effectiveness of which is significantly increased when combined with pharmacotherapy and comprehensive multidisciplinary management. The use of digital technologies and the standardization of treatment protocols contribute to increased safety and improved longterm treatment outcomes for patients with morbid obesity.

The article provides an overview of recent publications on the clinical efficacy, safety, and technological aspects of radionuclide sentinel lymph node biopsy in patients with early forms of squamous cell carcinoma of the head and neck. The results of four randomized trials and a large meta-analysis in 2022, data from systematic reviews in 2023–2024, prospective cohorts from Europe and Asia, as well as a series of observations performed using the 99mTc human albumin nanocolloid ("Nanotope") were analyzed. A separate section discusses the physico-chemical and clinical advantages of the radionuclide method in comparison with alternative tracers.

Evaluation of the clinical efficacy of intraoperative quantitative fluorescence angiography using indocyanine green (ICG) for assessing intestinal wall perfusion to reduce the rate of colorectal anastomotic leakage. A prospective single-center comparative study was conducted, including 81 patients who underwent colon resection with anastomosis. In 42 patients, ICG fluorescence with real-time quantitative perfusion assessment was used. The control group (n = 39) underwent conventional visual assessment of tissue viability. The primary endpoint was the rate of anastomotic leakage; secondary endpoints included the rate of resection line modification and postoperative complications. In the ICG group, the anastomotic leakage rate was 4.8 % compared to 7.7 % in the control group (p = 0.664). Resection line modification based on fluorescence data was required in 14.8 % of patients. The relative risk of anastomotic leakage in the ICG group was 0.62 (95 % CI: 0.12–3.18), indicating a trend toward reduced complications that did not reach statistical significance. Intraoperative ICG fluorescence angiography demonstrates potential clinical benefits in perfusion assessment and resection level modification but did not show a significant reduction in anastomotic leakage rates. The method requires further investigation and standardization of quantitative data interpretation.