Aim. The analysis of the history of minimally invasive surgery in a clinical emergency care hospital and the clinical cases associated with first robot-assisted operations. Materials and Methods. We have analyzed 10180 inpatients' maps and protocols of surgical operations from 2002 to 2019. We have also studied the first minimally invasive interventions in the Clinic of Surgery and Endoscopy affiliated to the Faculty of Postgraduate Education of Danylo Halytsky Lviv National Medical University and the municipal non-profit institution "Lviv Clinical Emergency Care Hospital". Results and Discussion. Until the early 1990s, the development of surgical technology took place mainly due to the talents of individual surgeons and their persistence in implementing new treatment methods. The directions of work of our Department of Endoscopic Surgery included the introduction of minimally invasive (laparoscopic) surgical interventions and endoscopic interventions using flexible endoscopy. Robot-assisted operation on a patient with diaphragmatic hernia using da Vinci surgical system was performed with three 8.5 mm robotic instruments and two 5 mm laparoscopic ones. The operation lasted for 6 hours. There were no intra- and postoperative complications. The patient was discharged home in satisfactory condition on the 3rd post-op day. Robot-assisted surgery for complicated gallstone disease was performed with three 8.5 mm robotic instruments and one 5 mm laparoscopic one. The operation lasted for 3 hours. Conclusions. 1. The introduction of modern technologies and minimally invasive interventions results primarily from activities of the clinic's staff, the head of the structural unit and the hospital administration, as well as from the high professional level of surgeons. 2. The usage of minimally invasive, laparoscopic, endoscopic techniques, as well as that of da Vinci surgical system in clinical practice will improve therapeutic outcomes and quality of life among patients with surgical disorders.

Acute mesenteric circulatory disorder belongs to the most serious diseases of the abdominal cavity. Being an emer­gency condition, it is associated with high mortality. Coronavirus infection is an anthroponotic disease in the group of acute respiratory infections, is characterized by damage to the upper respiratory tract, severe intoxication, coagu­lopathy and in severe cases - multiple organ failure. The aim of the work was to analyze the results of the surgical treatment of mesenteric vascular thrombosis in patients with COVID-19. We have studied the results of diagnostics and treatment of 13 patients (9 males and 4 females) with acute mesenteric thrombosis and COVID-19. We have analyzed patients’ complaints and the clinical picture of the disease, as well as performed general medical examination (routine blood and urine tests, biochemical parameters, coagulogram), X-ray examination of abdominal and thoracic cavities, computed tomography / angiography of abdominal organs, diagnostic laparoscopy, diagnostic mini-laparotomy and laparotomy. The symptoms of the disease include nausea, vomiting, abdominal pain, diarrhea, fever, cough, shortness of breath and belching. The disease was diagnosed by contrast computed tomography. Four patients developed simultaneous thrombosis – stroke, thrombosis of the portal and mesenteric veins, splenic and renal infarction, thrombosis of the superior mesenteric and portal veins. Six patients have been suffering from underlying health conditions, 7 patients – had none. Ten patients underwent surgery (laparotomy with resection of the nonviable intestine), 3 – received conservative treatment (heparin therapy). Six patients died (4 out of 10 – during surgery and 2 out of 3 – during conservative treatment). Postoperative mortality was 40%.