In the Name of the Future

In the Name of the Future

Professor, Head of the Clinic of Gynecology and new reproductive technologies Anatoly Ischenko its main merit believes that over the years of medical practice he was able to become the «transmission mechanism», which helps to preserve women’s health for the sake of a common future: because it is a woman, in the belly of that emerging life — of its bearer.

First Moscow Medical University — the successor of the Moscow University. It was there in the 1760s. held in the country of birth of the first medical faculty. The first professor of the Faculty became famous Moscow obstetrician Johann Friedrich Erasmus. He has lectured on anatomy, surgery and «Babic case.» Erasmus was an experienced practitioners and an excellent teacher, the author of Russia’s first textbook on the art of obstetrics. He was the first in Russia to use forceps. In their spare time, he was teaching in urban midwives in his apartment on New Basman Street.

The systematic teaching of obstetrics at the University of Moscow was continued by Wilhelm Mikhailovich Richter, who, among other things, was the director of the institute he founded midwife at the Moscow Imperial foster home.

Opening clinics faculty of Moscow State University marked an important stage in the life of the Faculty of Medicine. Since then, the clinical method of teaching was the basis of all educational process. In 1851, the clinic of Moscow University came under the leadership of Professor Vladimir I. Koch, the former director of both obstetrical establishments of the Moscow Imperial foster home. VI Koch became the first professor of obstetrics in Moscow, began to lecture in Latin, and in Russian. When it began to defend the first written in Russian thesis.

Our clinic was built in 1889 by donations from patrons — especially Barbara and Elizabeth Morozova Paskhalov. The building was first a two-story. Construction of the clinic, which began in 1886, was completed in 1889, while specialty was divided into obstetrics and gynecology. The first director of the obstetrics clinic was Professor Alexander Matveyevich Makeev, a prominent Moscow obstetrician who introduced antiseptic obstetrics. From the earliest days of his teaching career, he taught students that «puerperal fever» — not an epidemic and endemic and sepsis. The clinic is widely used different antiseptic (iodoform, sublimate, carbolic acid, creolin). AP Matveev proposed prevention dangerous disease of the newborn — oftalmoblennorei — by introducing into the conjunctival-bags rotary shaft 2% solution of silver nitrate. This has contributed to the almost complete elimination of this disease.

Director of the Gynecological became Professor Snegirev Vladimir Fedorovich, whose name today is our clinic. His portrait, painted by the artist Vladimir Makovsky is in our museum. Behind came another outstanding obstetrician — Professor Nikolai Pobedinskii. This name is associated with the history of the clinic closely enough: in the future grandson Nikolai Ivanovich Nikolai Mikhailovich Pobedinskii for 26 years headed the department of obstetrics and gynecology №1 First Medical Institute. Under him, a second reconstruction of the clinic where outdated internal technological equipment was replaced with new, reconstructed chambers, increased number of hospital beds, the clinic has been equipped with modern equipment. Active participation in this process took Tatyana Andreevna Starostin, professor, at the same time the chief obstetrician-gynecologist of the Soviet Union, as well as the deputy of the Supreme Soviet of the USSR. Through its activities and were to provide funds for the restoration of the clinic.

Without blood and pain

Back in the 30s. the last century, obstetrics and gynecology have been merged into a single specialty. Then the clinic headed by Professor Michael S. Malinowski, one of the great obstetrician-gynecologists in which was carried out the first reconstruction of the clinic. It was in those years it acquired its modern form a five-story building: on the first four floors — clinical departments, while the fifth floor — the postoperative unit and operating unit.

Our history is linked with a number of prominent names. Besides those already mentioned, a well-known gynecologist Professor AP Gubarev, actively develop operative gynecology in Moscow, Professor LS Per-sianinov, KN Zhmakin and many others. These are the names that were the glory of domestic obstetrics and gynecology. For us it is very important continuity of generations, so we try not to forget that we stand on the shoulders of giants.

— WHAT female problems in those early years were in first place, and how they managed to solve?

— Professor NI Pobedinskii was a pioneer of caesarean section in Moscow in 1885, he first carried out this operation. Previously, women in such complications are usually dying. The percentage of survivors was minimal. Professor VF Snegirev, a prominent gynecologist, statistically spent more than two thousand. Operations. In those days an enormous clinical experience, combined with the highest skill of the surgeon. He is known for his work on uterine bleeding, operative gynecology — myomectomy, flash uterine vessels. He also made a great contribution to the diagnosis and treatment of cancer. He was the founder of the first Cancer Society in Moscow, instilled radiation therapy, suggesting that its inclusion in the set of anti-cancer measures lead to favorable results.

— For certain current problems — other than in those years. WHAT WAS LESS ANY MORE?

— Cancer today is definitely in the lead, so they are highlighted in a special strukturu- cancers. Our department of obstetrics and gynecology that narrowly not engaged, because It has its own «brand» of the trend. In operational terms, it is primarily the introduction and improvement of endoscopic operations. After the reconstruction of this part of the hospital surgical care has evolved extensively. We are actively introducing laser technology. Today, 70% of operations are performed endoscopically. This operation of any size. A team of scientists, professorov- V.I.Kulakov, VI Krasnopolskiy, LV Adamyan, GM Savelyev, yours truly and many others — in 2000, was awarded the Russian government just for the development of endoscopic methods for the diagnosis and treatment of gynecological diseases. Currently, this area continues to develop rapidly.

The large sections of urgent surgical operation pelvic surgery. This is a very painful social problems associated with the peculiarities of the female body when needed reconstruction of the pelvic floor. This occurs against the backdrop of pathologies such as urinary incontinence, prolapse, or uterine prolapse. With age, this is, unfortunately, becoming a serious problem, although the percentage of young women suffering from this type of disease is increasing. Accordingly, it requires modern methods of correction.

ENDOMETRIOSIS — disease of the century

To perform intrauterine surgical interventions introduced laser technology. It is better to use these technologies, primarily because they are more forgiving. They are needed when adenomyosis, endometrial changes of various origins, both congenital and acquired. When using lasers tissue injury is minimal, which means that less and the percentage of postoperative complications. Laser technology shows and laparoscopic procedures, especially in the treatment of endometriosis: a laser to vaporize itself allows endometriosis without further severe adhesions and cicatricial changes in the pelvic organs.

— What could be called your ‘flavor «, Insignia clinic?

— If you talk about me personally, I worked all my life endometriosis, its heavy, complicated forms. It is a disease of the century. Endometriosis — a benign disease that is localized to the female genital organs, but can spread to adjacent organs. This may be affected intestine, organs of urinary system. Running processes can lead, for instance, to the loss of the kidney or ureter shock.

— WHY develop endometriosis?

— If I knew, I could qualify for the Nobel Prize. It is a multifactorial disease, and so far we do not have a sufficiently precise idea of ​​its nature. Underway in molecular biology research, which allow deeper into the understanding of the pathogenesis of this disease, but the precise knowledge, we are still far.

— What are its forms?

— Most often it is pain during menstruation, heavy, prolonged bleeding with clots. If a woman has symptoms of this whole must not be tolerated, it is necessary to consult a doctor. It is important to emphasize that the introduction of laparoscopic techniques has led to the reduction of severe endometriosis. At first it was just a diagnosis, which gradually developed into surgical care. All this has allowed to identify the disease at an earlier stage and successfully treated. At the same time, if you do not treat this pathology, endometriosis often results in different formations — endometrial cyst, infiltration, foci on the pelvic peritoneum, which can also capture the adjacent organs. Cysts are dangerous because by micro perforation and rupture of the content they provoke «acute abdomen», and these patients often fall into the surgical hospital. In severe lesions of the distal colon stenosis is formed, there is a partial obstruction of the colon. The disease is quite complicated — in terms of both diagnosis and treatment. Currently accepted it considered combined approach: surgical removal of endometriosis and follow an anti-hormone therapy. To not bring themselves to such a state, I urge all women more careful about their health and do not forget that a woman — the bearer of the future.

Thus says Hippocrates

— About the future. You too hereditary gynecology?

— No, I come from a military family. The mother — a teacher. However, one of the ancestors, the stories grandmother spoke the blood, and with all sorts of injuries, cuts and bleeding ran to him.

-And You can not stop the bleeding with a thought?

— No, I am an adherent of traditional technologies.

— How did it happen that you decided to become a doctor?

— In my youth I read a lot, and something from the life of the doctors I was impressed. This youthful appearance and led me into the profession, and not something that I’ve dreamed about this since childhood. I never had to regret. Children’s fantasy and reality coincide. However, the next generation is partially gone for medical line: the eldest son — the surgeon-gynecologist, the eldest daughter — a psychiatrist.

— Surely you have a patient, they say, sunk into the soul who managed to escape from some very serious diseases.

— Yes, there are. I remember a case when I was first confronted with the same severe endometriosis. It was a patient from the Moscow region. Then fate brought me to my teacher in gynecology, professor, academician of the Academy of Medical Sciences and now Vladislav Ivanovich Krasnopolsky, director of the Moscow Regional Institute of Obstetrics and Gynecology. It was a young woman with severe colon, and I had to operate on her. That is, this operation has sparked my interest further to the disease. Unfortunately, the operation was radical, had to remove part of the bowel and uterus, but it was about saving lives. At the same time we were able to do without the imposition of the stoma. The woman recovered, although the postoperative period demanded considerable effort.

— How often have to deal with similar severe cases now?

— Much less than before, but it is necessary. It is about 10-15 cases per year.

— And among these patients including young, nulliparous women? But SO severe cases of endometriosis can lead to the inability to have children FURTHER.

— In young women, we try to keep the reproductive capabilities. Besides, now contribute to this new reproductive technologies that are introduced around the world, including ours.

— Because your department IVF oldest in Moscow, and maybe in the country.

— The founder of the clinic has offices in HELENA Kalinin. She became the «mother» of the first in the USSR «test-tube baby.» There was another «daddy» — Professor Boris Leonov. The girl was born. Several years ago, she became a mother — we went grandchildren. Now we continue to work successfully in this direction. Those patients, who because of that endometriosis had to make removal of the uterus, can turn to surrogacy. We often give birth to a surrogate mother, and this is one way to solve the problem.

— YOU HAVE MANY PATIENTS you spent such operations, and then HELPED become mothers. Whether they lead their children TO YOU AND THAT YOU FEEL SEEING SO concrete results, INCLUDING ITS EFFORTS?

— I rejoice. It’s great when a person is happy when he has a child, and I became a transfer mechanism that contributed to this.

— You, as it should in such clinics, MANY pregnant women. TO YOU ALL WOMEN ARE MAINLY OR HEAVY?

— We have a federal health agency, but we are not a regular hospital, which has a network of advice. We have only one advisory department where people come to pregnant patients, often with a specific problem. This is a different disease that periodically accompany pregnancy, and in general, any woman in the country, if he wants to give birth in our clinic can come here.

— I looked COMMENTS ABOUT YOU IN THE INTERNET. Not one was bad. Many such «gives birth to her daughter HERE. SECOND CHILD PRNDU GIVE BIRTH ONLY HERE. » How do you achieve this?

— In medicine, as in the army, should prevail unity of command. From the need to get rid of bad doctors. I’m pretty hard head, and it’s probably genetically laid. I’m the son of a military man. However, to get rid of almost no one did not have to: those who do not fit into our system of work, gone yourself. The rest looks pretty routine: everyday training team, lead by example, work on the bugs, talk with each head of department. All of this, I hope, help to preserve the good name of our clinic.

-What Else you HEAD of obstetrics and gynecology number one and this obliges. Today’s students are different from those they were ten years ago?

— Different. This generation has again turned to the medical profession. In 1990-ies. medical education many received, trying to go to the drug companies. When frank conversation with the students turned out that the main part of the group has no plans to engage in medical practice. Now communication with students shows that the prestige of the profession is growing again.

— Obviously with the salary? Indeed, in FARMFIR, we left not a good life.

— Of course. It is important that it was something to feed my family. Today, the average salary of a doctor close to earning the same farmfirm workers or companies that sell medical equipment, so if a person is going to link their lives with medical practice, then he should get it. Today, seven or eight people in the group want to become a doctor, but a man two or three still plan something lighter. After all, the medical profession is still not easy.

— Directly opposite the entrance to your clinic, I saw advertising machine ‘birth in Miami. DUAL CITIZENSHIP for your kid. » YOU WOULD NOT WANT THIS MACHINE REMOVE somewhere far away?

— No, let it cost. They are not our competitors. It is human psychology, largely due to the big money. They think that by paying a particular amount, you can get a guarantee better care. But in the same Miami give birth under the supervision of a midwife and the doctor comes only happen if some difficulties, but we have to place the entire brigade on duty, several doctors.

— However, some time ago, our country is a strong tendency GIVE BIRTH TO LEAVE abroad. It is believed that there are much higher level of medical care, WHILE WE HAVE SOLID risk to mother and child. Has the situation now?

— Today, this trend began to decline. Most women trust the domestic attendants. On all occasions there are proverbs and sayings. One of them — «Houses and walls help.» It’s true. Another thing, if people do not plan to live in our country and want to make a son or daughter of a US citizen, then it makes sense to give birth in Miami.

— Do you have hanging on the wall Beautifully decorated Hippocratic oath in Greek language. WHAT DOES THIS MEAN FOR YOU — just a souvenir or something more?

— Upon graduation, we do not read the Hippocratic oath, and the oath of the Soviet doctor. She was more ideological, but essentially no different — do no harm, etc. At all times, the community had its own doctors, who determined the position of the people of this profession, and usually it was unambiguous. I have one of the patients was an archivist, and one day she brought me a curious document. In Byzantium, it was a union of doctors, and there existed a charter, which was proclaimed this truth: «Any appreciation should be sufficient for you.» It’s the same Hippocratic Oath.

— For you it is true PHRASE?

Yes, I am standing on such principles. They grew up and I was trying to impress them with his students and colleagues.

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