Telerobotics is a wide term and include multiple directions and aspects in its development. When speaking of different aspects of its development, one should think of its functionality, construction aspects, communication aspects, implementation safety and acceptance by the environment. Robotics is a science dealing with possibilities of implementing different tasks, through mechanical instruments, controlled by humans. Telesurgery does not include only aspects of teleconference but assists in surgical procedures, i.e. enables for the part of surgical procedure to be performed through electronic commands on bigger distances. Currently, two robotic systems are employed in clinical practice. One is ZEUS system, constructed by the Computer Motion and manufactured by AESOP. Second one is Da Vinci surgical system. For laparoscopic robotic telesurgery, identical set of apparatus and instruments as the one used in a routine laparoscopic surgical procedures is needed. In all reports, authors refer to safe and successful surgical method. Recovery of the patient is identical as in classic laparoscopy. No statistically significant difference has been found in the duration of the surgery between robotic and classic laparoscopy. When counting used instruments, it was found that less instruments were used in the robotic laparoscopy. From presented studies related to the robotic laparoscopy, it can be seen that there is an intention to present this method as safe and usable. One thing is sure--this method is the first step toward new model of planning and performing surgical procedures with only one goal--to help the patient.

Cancers of rectum and anus are among most frequent cancers with a tendency of increasing frequency. According to available data, the percentage of surgeries performed during period 1973-1977 was 61%, and during period 1991-1993 78%. From those data it can be seen that the frequency of performed surgical treatments is evidently increasing lately. High percentage of patients suffer from the process that is involving neighbouring organs and tissues, therefore declared as inoperable. In this study we present five cases with malignant tumors of pelvis who were treated during period 1990-2002 with mutilating surgical technique--chemipelvectomy. In all surgical procedures we have used King's and Steelquist's methods. At the same time, these surgical procedures are moving the limits of tumors' inoperability. The survival period for 4 patients was over one year, and 1 patient died due to postoperative embolism. In 1 patient, the wound has healed per secundam. We registered no cases of local recurrence. The new possibilities in the treatment of pelvic tumors which are often declared as inoperable are opened due to the fact that chemipelvectomy is moving the limits of so-called inoperable types of tumors. We believe that it is necessary to open new discussions on this issue because the coming time will offer new possibilities in the surgical treatment of pelvic tumors.

Operations malignity on the colon and rectum belong into a group of risky operational treatment, which has a high percentage of early postoperational complications in comparison to the other operational treatments in digestive surgery. To determine the precentage of the postoperational complication of the resectional treatment on the colon and rectum, obtained results compare with the experience of the other authors. Analysed 439 patients operated from malignity on the colon and rectum in five year period (1998-2002). Bleeding after the postoperation had 8 patients (1.82%). Dehiscentio anastomosis has been evident in 21 patient (4.78%). Interintestinal apscess has been evident in 4 patients (0.91%). The infection of operational would of the 45 patients has been (10.25%). Dehiscentia of the operational wound of 10 patients has been (2.27%). Ileus in early postoperational stage has been evident in 16 patients (3.64%). The Total number of reoperation based on the analysed complications has been evident in 50 patients (11.38%). As e conclusion we can see that ours results coincides with the experience of the other authors.

The laparoscopic surgical technique differs significantly from the classical operative technique especially concerning the post-operative treatment of the patient. Introducing a new operative technique called for an adjustment of the patients' treatment on the ward. The laparoscopic operative technique has a number of advantages in comparison with the classical operative technique. The main advantage is less damage done to the tissue, which reduces the possibility of post-operative complications. Furthermore, the rehabilitation of the patient is faster. Patients experience far less pain and the recovery period is shorter. Consecutively, this means fewer days in hospital, fewer days on sick leave, a faster recovery and returning to work sooner. Patients operated on using the laparoscopic operative technique are mobilised sooner, they start their nutrition sooner, the set of laboratory tests that are conducted is different, the time of post-operative stay at the clinic is shorter. In this paper we have analysed only operations of the holecyst over a period of one year, comparing two different operative methods. Our objective was to compare the time of post-operative mobilisation of the patient as well as the time when they start taking in liquids and food. Especially emphasised in the paper are operations with complications that call for a different treatment. In the period under analysis we did 728 holecystectomies, of which 114 were done laparoscopically. We paid special attention to the analysis of data concerning the post-operative mobilisation of the patient and the start of nutrition. The results we obtained testify in favour of the significantly shorter post-operative period without peroral nutrition following a laparoscopic holecystectomy. The period when the patient is mobilised is also different and should be given special attention. Based on this, we can conclude that at the Abdominal Surgery Clinic in Sarajevo, over the course of one year, the period of post-operative mobilisation of the patient after laparoscopic holecyctectomy has been shorter in comparison with the classical operative method.

Endoscopic Ultrasonography, or EUS, has joined medical techniques of endoscopy with high frequency ultrasound technique, known as ultrasound. This removable achievement allows physician for microscopic tissue examination, not only in digestive system, but also in its surroundings by highly frequent technique. Endoscopic ultrasonography detects all kinds and nature of possible abnormalities, including and information, which are necessary for proper diagnosis and optimal treatment. In experience hands, EUS can detect abnormalities, which are undetectable during any other techniques of examination. EUS is applied from inside the body, near or even touching the examined surface, so the precise, highly frequent energy of showing the images can be used. The sonography, MRI, CT techniques must show the inner organs through outside surface of body, loosing the resolution during process. The superior resolution of EUS shows 5 layers of digestive tract, almost equally good as by microscope; none of other techniques allows showing of intestinal wall equally good as this one. By EUS liquid has been proved with 90% of precision in diagnosis of operative degrees of pancreas tumours. CT in this case has shows only 50% of precision. Highly skilled surgeons are aware of application of these diagnostics techniques in preoperative cases so the surgical removement of tumours is going to be more effective. The precision of EUS findings are of critical importance for the utilisation of maximum of new treatment having in mind that abnormalities could be diagnosed and characterised without operative intervention. To be able to focus on specific anatomic surfaces, there is need of great knowledge, skillfulness and praxis during the manipulation with EUS instrument. The years of experience are needed to be able to achieve high standard of expertise. The accuracy of results varies, depending on physicians diagnostic experience, sub-optimal results are not going to be a good guide during treatment planning. Endosonographist must be in position to document at least 80% of accuracy in diagnosis and determination of disease stage in order to achieve 30-60% changes in plans treatment.

The basic characteristics of war in Sarajevo are occasional shelling, sniper fire, unexpected shelling and a lack of a front line in the classic sense of the word. The extent of the wound is the key factor in deciding how the patient is to be treated. A primary contamination of this kind of wound has all the conditions to turn into a manifest infection. The abdomen wounds, because of their severity and direct threat to life, are among the most dangerous wounds altogether. They make up on average 10% of all war wounds and the mortality of these patients by today's literature is high, about 6%. The aims of this paper are to show which organs in the abdomen are wounded and what is their relationship to the wounding of the colon, and to show what is the relation between multiple and isolated wounding of the abdomen. During the years 1992 and 1993, 1106 patients with war wounds were treated at the clinic for the abdominal surgery. From that number 71 patients were treated with explorative laparotomy. The large intestine was injured in 274 patients while 221 patients had injuries of the small intestine. An injury of the liver was found in 165 cases. The gall bladder was injured in 18 cases. The stomach was injured in 324 patients. The pancreas was damaged in 72 patients. There were 94 cases of injured spleens. The kidneys were wounded in 30 cases. In 40 cases there was bleeding from the retroperitoncum. Treatment of the omentumen was carried out in 753 patients. The number of patients who did not survive is 135 of which 44 had an injury of the large intestine. A retrospective analysis data shows that the number of multiple wounds makes up over 98% of all wounds. Isolated wounds of abdominal organs are found in less than 2% of all cases. The increase mortality in our research can be explained greater energy of the projectiles which amplify the acceleration at asphalt surfaces which product the greater destructions of the tissue and the massiveness of the injuries.

Malignant tumours are important health problems today. In most countries they are second cause of death in general population. In this work it was presented epidemiology of rectal cancer which are treated in Abdominal Surgery Department at University Clinical Center in Sarajevo of Bosnia and Herzegovina. This is only part of complete investigation of incidence malignants in Bosnia and Herzegovina. Our study is a retrospective and observation two five years periods. First is between 1987.g. and 1991.g., and second is between 1996 and 2001.g. During first period in Abdominal Surgery Department, we had 668 cases of abdominal malignant and 225 of these cases were carcinoma colorecti. In the second period we had 831 cases of abdominal malignant and 311 of these cases were carcinoma colorecti. When we compared our data with other referents from East Europe, we can say that the results mostly the same, and when we compared first five years period (1987-1991), with second five years period (1996-2001), there are also no statistically significant increase.