The article reviews the history of inguinal hernia surgery. At various times, different procedures and diverse materials were used for hernia repair. However, the effectiveness and safety of inguinal hernia repair emerged only after the anatomic features of the inguinal region had been elucidated in a monograph by Henri Fruchaud „Anatomie des hernies de l’aine” published in 1956. The Italian surgeon Edoardo Bassini began a new era in herniology. For a longtime, his classic procedure with its modifications was the most popular in surgical practice. In 1959, Lloyd M. Nyhus proposed inguinal hernia repair according to the concept of the pre-abdominal (posterior) approach that later became the basis for developing the transabdominal preperitoneal hernia repair (TAPP). In 1992, M. Arregui performed the first ТАРР using a prolene mesh. In 1986, Irving Lichtenstein proposed the concept of „tension-free repair”. Basing on his concept, Lichtenstein described an open technique of inguinal hernia repair, which now bears his name and is popular in surgical practice. In 1993, the term „extraperitoneal hernia repair” first appeared in an article by Edward H. Phillips. However, J. Dulucq developed the modern ТЕР technique. Currently, three tension-free inguinal hernia repairs (TAPP, ТЕР and Lichtenstein procedure) and one tension inguinal hernia repair (Shouldice procedure) dominate in inguinal hernia surgery.

The aim: improvement of trophic ulcer by surgical treatment with ultrasound cavitation combination. Materials and methods. The analysis of complex surgical treatment of trophic ulcers was conducted. Patients were divided into 2 groups, depending on the strategy of treatment. In the first (main) group (n=43) the combination of surgical treatment with ultrasonic cavitation was applied. By comparison, in the second group (n=43) only surgical treatment was applied. The method of treatment of trophic ulcers with the Sonoca 300 device is based on the effect of ultrasonic cavitation, which is a process of mechanical cleaning of the wound from necrotic tissues, while healthy tissue and vessels are not injured. Ultrasound machine SONOCA 300 is intended exclusively for use in human ultrasound surgery and is intended for the following applications: selective tissue dissection, mechanical grinding and cutting of bone tissue, debridement and cleaning of wounds, tissue cutting, tissue coagulation. The exact purpose of the application is determined by which tool is connected. In our case, this is a Macro ultrasonic tip designed for debridement and wound cleansing. Ultrasound is supplied at an operating frequency of 25 kHz, when you press the foot pedal, and simultaneously with the power of ultrasound, the irrigation and aspiration systems are activated. The irrigation solution from the container with the irrigation fluid passes through the tool, at the same time the aspiration of necrotic tissues and fluid, and their direction into the container for aspirate collection. Results and discussions. The ultrasonic cavitation in treatment of trophic ulcers different localization and etiological factors, achieve partial incarnation of ulcer surface on the average in (14,2±0,5) days in the first group and in (16,9±0.6) days in the second group. The level of bacterial titer of ulcer secretion by (16,5±0,6) days was not higher than the commonly accepted critical one in comparison to the classic situation, in the second group it was on the (27,2±0,9) days. Terms of inpatient treatment were: (21,2± 0,9) days in the first group and (27,2±0,9) days in the second group accordingly. The biological properties of ultrasound are due to bactericidal and bacteriostatic action on various microorganisms. In addition to its own bactericidal effect, low-frequency ultrasound significantly enhances the action of many antibiotics and antiseptics, promotes the deposition of drugs in the surface layers of the wound. Under the action of ultrasound increases the phagocytic activity of leukocytes, there is a stimulation of cellular and humeral parts of the immune system, which accelerates the wound process. Conclusion. The usage of ultrasonic cavitation in the complex surgical treatment of trophic ulcers different localization and etiological factors, significantly increases the time of trophic ulcer cleaning, accelerates incarnation by 1.2, reduce the time of treatment of patients with trophic ulcers by 1.8 times in comparison to the classical approach of cleaning, by means of mechanical cleaning of the ulcers from purulence and necrotic tissue by ultrasound of low frequency.

With the onset of the coronavirus pandemic, the only way to learn and communicate with students is distance learning. The aim. Analyze the features of the student scientific circle on surgery in the mode of distance learning in quarantine. Materials and methods. When the pandemic has suddenly spread to all spheres of life, the only way to learn and communicate with students is distance learning. In Ukraine, distance learning is regulated by an order of the Ministry of Education and Science from 31.10.2013 № 1518 "On approval of the Requirements to higher educational institutions and institutions of postgraduate education, scientific, educational and scientific institutions that provide educational services in the form of distance learning to train and improve the skills of specialists in accredited areas and specialties." With the approval of distance learning, the work of the student scientific circle (CSC) "Sharp Scalpel" at the department also went online. The structure of classes during studies in the CSC consists of a theoretical part where students report the results of scientific research from literature sources according to the topics they work on with supervisors, as well as a practical part where they work directly with patients under the supervision of the CSC leader. Some classes are held in the vivarium, where they learn to suture the intestines of animals. Often the structure of practical training in the CSC is not so clear, because in the presence of an interesting clinical case in the hospital or operating room, students are fully engaged in practical work. Results. With the transition to distance learning, the structure of classes in the CSC has undergone a significant transformation - the most important and interesting part for the group has fallen, namely the possibility of contact with the patient. The group members were divided into two groups: Group I – 8 students (25%) - students who, in addition to the practical part of the lesson, are also interested in the theoretical part of the group, who continued to study literature sources according to the topic they received and actively prepared for the scientific-practical conference. Group II-22 students (75%) – those, who lost interest in the CSC, when the opportunity to work with the patient became inaccessible. Another disadvantage of online learning is the loss of society, are the possibility of direct communication between students is lost, the necessary skills in communicating with the patient are not acquired, which is extremely important in the medical profession. Conclusions. In the case of quarantine, distance learning is an important and necessary form of educational process, even in medical schools, but it can not replace live communication between students, with the patient and the teacher. Online learning does not provide a practical part of the CSC work, which is manifested in the loss of interest in classes in the CSC among students.