M.D., Ph.D., Academician of the Russian Academy of Science, Director of the A.V. Vishnevsky Institute of Surgery Revishvili Amiran Shotaevich
The National Medical Research Center of Surgery named after A. Vishnevsky is decidedly one of the leading medical institutions in Russia. It is just the place that both patients and doctors apply to in the most difficult situations, when they need highly complex medical advice or surgical assistance involving multi-discipline medical specialists.
Director of the Federal State Budgetary Institution “National Medical Research Center of Surgery named after A. Vishnevsky” of the Ministry of Health of the Russian Federation, member of the Russian Academy of Sciences Amiran Revishvili.
Professional advances of our vascular, cardiac, radio-encephalography surgeons, arrhythmia and combustion specialists, specialists in reconstructive surgery of gullet and stomach, liver and pancreas surgery, healing of wounds and wound infections, as well as thoracal surgeons, urologists, traumatic and cosmetic surgeons – are widely known in Russia and abroad. As reputed experts in different fields of surgery, the key specialists of the Center are involved in development of national clinical recommendations for treatment of surgical pathologies.
In the 1940s, the clinic was “a build-up” of the institute, and science was its basis. Basically, at that time the institution itself was called the All-Union Center of Experimental and Clinical Medicine. From then onwards the National Medical Research Center of Surgery named after A. Vishnevsky still remains the medical center where we develop and substantiate new type of surgical interventions using low-traumatic and minimally invasive technologies, including endovascular, video-assisted and robotic technologies. The methods of anesthesiology and intensive care support if surgical process are being improved. On a regular basis the research articles of our employees are published in the leading national and foreign magazines, and their developments are protected with patents.
The National Medical Research Center of Surgery named after A. Vishnevsky is a large educational center. Each year about 250 young professionals and experienced Russian doctors come to the Center to pass their post-graduate programs and to get additional professional education. And they really have what and whom to learn from – our team of professionals includes 3 members and 1 corresponding member of the Russian Academy of Sciences, 26 Doctors of Medical Science and 48 Candidates of Medical Science.
Being a leader is a complex and demanding challenge. We endeavor not only to keep our opportunities at a high bar, but we are constantly setting it higher and higher through introduction of new treatment technologies, renovation of the stock of diagnostics and surgical equipment, providing of comfort in our in-patient department.
People have trust in us, and we highly appreciate this trust!
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The Center of Surgery named after A. Vishnevsky is one of the first scientific and research centers and multi-discipline surgical institutions of the Russian health care system.
The Center of Surgery named after A. Vishnevsky has an unusual history. Its history goes back to the XIX century, and since then despite of all the varieties of fortune this location in Moscow hasn’t lost its distinctiveness and preserved the mission determined by our ancestors – to help the people in need, to serve as a source of charity, generosity, self-forgetfulness and cutting-edge medical ideas.
Starting from the last quarter of the XIX century, at the place where the Institute is currently located, there were built the charity and hospital institutions that by the beginning of the XX century formed a unique ‘hospital campus.
The reference point of the ‘campus history should be deemed the year 1862, when the Emperor Alexander II affirmed the petition of Solodovnikov brothers, the 1st class merchants, to build a charity house in Schipok Street using their own funds.
The three Solodovnikov brothers, major textiles merchants, granted their own parcel of land with a linden garden (about 1.85 ha) for construction purposes. As well, they donated an amount of money (500 000 rubles), that was enormous at that time, for construction and maintenance of a department for poor, diseased and elderly people. The charity house was declared open on July 1, 1865. Upon the death of the last of the founders in 1875, S. Alexeyev – father of S. Stanislavsky – was appointed the curator of the charity house, who stayed at that position during many years.
The charity house at Schipok originated the establishment of a set of care and clinical organizations.
In several years on January 19, 1873, the Moscow Merchants’ Society supported the offer to establish a hospital in honor of recovery of the heir to the throne – Alexander – after a severe disease. Funds for buildings of the hospital were raised through subscription.
The hospital was designed to host 50 people – men and women, irrespectively of their status and welfare. The hospital was named in favor of the Emperor Alexander II – Alexander Hospital of the Moscow Merchants’ Society.
On January 26, 1873, the Emperor granted his acknowledgement and an official permission to establish a hospital named in his favor.
After a long search of a site for construction, the Society bought the lands near the Solodovnikov charity house that as well belonged to the Solodovnikov brothers.
Construction was carried out according to a unique project for that time with a glance to Russian and foreign experience and modern sanitary requirements.
The hospital opened on April 14, 1891.
In 1893, the Moscow Merchants’ Society received a donation from Tatyana Guryeva, the 1st class merchant, in the amount of 325,000 rubles for establishment and maintenance of a poorhouse.
By that time, the choice of a site for construction was not a problem. The building was designed to form a group with the Alexander Hospital and the Solodovnikov Charity House.
The Moscow Merchant’s Society bought the land for the developing group of buildings in advance from different owners.
The Poorhouse was intended to shelter 70 elderly and 20 incurably ill people, as well as 10 blind women – without any regard to their status.
As well as all the previous buildings, this building had three floors. The eastern part of the building housed a temple: on the ground floor, there was a Church dedicated to Saint Martyr Tatiana, on the first floor – the Church of Holy Virgin Protection.
The Poorhouse named after T. Guryeva opened in January 1896. During the whole construction period, T. Guryeva did not stop to deliver additional donations. As well, she bought the nearby lands and mentioned in her testament the possibility of their future use for building purposes.
Eleven years afterwards, the Moscow Merchants’ Society allocated 50,000 rubles for construction of an extension to the Poorhouse named after T. Guryeva.
In January 1908, the construction was finished and the extension was attached to the existing building to form an entire unit. This improved its capacity for 50 people more.
In subsequent years, the Poorhouse received new donations and the established nominal scholarships, but it still was maintained using the funds of its founder – T. Guryeva.
As the Moscow Merchants’ Society was a trustee of the Solodovnikov Charity House, the Poorhouse named after T. Guryeva and the Alexander hospital, the complex of those establishments was considered an entire unit. All the decisions on maintenance, service and development of those buildings then were made based on their common mission.
One more building that now belongs to the Institute of Surgery named after A. Vishnevsky is a building of a former charity house. It was built in the beginning of the XX century using the donations of Pavel Tretyakov. His donations amounted to the total of 993,758 rubles. The land for construction of a charity house for 380 people was bought in the Bolshaya Serpukhovskaya Street, in order to integrate the new building into the existing ‘hospital campus’.
The building was constructed in the Neo-Russian style using stylized decorations of the old Russian buildings. The construction was performed with account of the modern achievements in construction and health care. The heating system allowed to reach the temperature of +20 degrees indoors while it was -30 degrees outdoors. The provision was made for the double ventilation system – through the supply of heated and humid air, and the exhaust system. Rooms and the canteen had oak parquet floors. The Charity House had electrical illumination that was a rare innovation for that time. The Moscow Merchants’ Society approved this innovation and decided to use electric illumination in all buildings of the ‘hospital quarter’.
The Tretyakov Charity House became famous in Moscow for its comfort and facilities long before the construction was finished. It was solemnly open on November 19, 1906.
Up to 1917, the complex of four major buildings and a set of auxiliary buildings (that had been built using the donated funds) was under the supervision of the Moscow Merchants’ Society.
After the Russian October Revolution of 1917, the charity houses gradually were converted into a hospital that was named after N. Semashko, the first People’s Health Care Commissar. It was one of the largest and well-equipped hospitals that included two Departments of Surgery, as well as Orthopedics, Therapeutics and Neurology Departments, a maternity hospital, an outpatient department, a dissecting room, an X-ray department, and a drug store. The admission department worked round-the-clock. The hospital was designed to receive 425 people for in-patient treatment. The hospital successfully operated for 15 years.
On August 11, 1936, by a resolution of the USSR Soviet of People’s Commissars No. 1462 the hospital passed to the All-Union Institute of Experimental and Clinical Medicine named after A. Gorky (VIEM).
Based on Solodovnikov and Tretyakov Charity Houses, the Alexander Hospital and the Guryeva Poorhouse there was established a single complex of experimental and clinical medicine. There the diseased could get various health care assistance. Moreover, there appeared a new important function of the complex – it had to become the largest research center.
It included four independent clinics that nevertheless worked in close cooperation:
- Surgery Clinic headed by Professor A. Vishnevsky (in the building of the Charity House named after P. Tretyakov);
- Therapeutics Clinic headed by Professor M. Konchalovsky (in the building of the Poorhouse named after T. Guryeva);
- Neurology Clinic headed by M. Korol, a corresponding member of the USSR Academy of Sciences (in the building of the Alexander Hospital);
- Women Clinic headed by Professor M. Malinovsky (in the building of the Solodovnikov Charity House).
Since 1936 to 1941, i.e. for only five years, the mentioned clinics functioned as leading research centers of the VIEM. Nevertheless, it is hard to overestimate their contribution to the development of the medical science. It is the very place where the most audacious ideas that made Russian medical science worldwide renown were generated and implemented. Even the war that brought necessary changes to the nature of scientific research could not fully stop its scientific activities.
Since 1941, the medical evacuation hospital No. 5002 was deployed in the buildings in Serpukhovskaya Street. Thousands of soldiers with various types of wounds were treated there.
On July 30, 1944, the USSR Soviet of People’s Commissars with its Resolution supported the enterprise of academic doctors to establish the Academy of Medical Sciences in the country. At that very time ten clinical institutes were created within the Academy. One of them was the Institute of Experimental and Clinical Surgery.
After the Great Patriotic War was finished, the surgeons began to return from the front line to the Institute. It is hard to outline all the talented surgeons that returned from the war and adorned not only the Institute but also the national medical science. For instance, a member of the Russian Academy of Medical Sciences D. Sarkisov, corresponding members of the USSR Academy of Medical Sciences N. Krakovsky and P. Mazayev, and also professors D. Blagovidov, G. Vilyavin, M. Voropayev, N. Galankin, T. Darbinyan, V. Demikhov, S. Protopopov, V. Pshenichnikov, V. Sologub, A. Kharnas, L. Shik, M. Shraiber, V. Yudenich.
For a short period, the members of the USSR Academy of Medical Sciences M. Akhutin, S. Yudin and B. Petrovsky served as directors of the Institute.
In 1947, the acting member of the USSR Academy of Medical Sciences Professor Alexander Vishnevsky was approved as director. For a good reason the name of Alexander Vishnevsky stays in line of outstanding scientists that made huge contribution into development of national surgery science. He left his mark in the Russian surgery science as the greatest clinician, an outstanding surgeon, and a creator of innovative academic school.
The outstanding scientific achievements of A. Vishnevsky include the proposed local anesthesia according to the serpiginous infiltrate method and the theory of nervous trophism in surgery. The pain treatment method after Vishnevsky was one of the basic methods used by Soviet surgeons that made its inventor widely renowned.
A. Vishnevsky had applied local anesthesia for many years especially during inflammatory processes. It helped him to prove the beneficial effect of novocaine solution on tissues that not only surround the inflammation locus, but even the remotely located tissues. The academic compilation made by A. Vishnevsky resulted in application of profuse novocaine infiltrates, or novocaine blocks. According to the clinical practice, novocaine blocks showed up as an effective remedy for complex treatment of various malignant processes, inflammations, muscle dystonia, shock, and surgical sepsis.
Using as a basis the idea of mild excitation of the nervous system as a therapeutic factor, A. Vishnevsky successfully applied special balmy liniment later called “Vishnevsky liniment” to treat wounds and uncreative processes. It has become a popular remedy to treat wounds.
The “Vishnevsky triad” (methods of local anesthesia, novocaine blocks, oily-balsamic bandages) marked an epoch in development of Soviet surgery especially in the battlefield. During the Great Patriotic War, these methods helped to save the lives of hundreds of thousands of the injured people.
After the death of Alexander Vishnevsky in 1948, his outstanding contribution into the development of the national surgery was commemorated through giving his name to the Institute.
In 1948, the Institute was headed by the son and successor of Alexander Vishnevsky – Alexander Vishnevsky Jr., member of the USSR Academy of Medical Sciences, Hero of Socialist Labor, Colonel General of the Medical Service. He served as the director of the Institute up to 1975, alongside as the chief surgeon of the Ministry of Defence of the USSR – up to 1978.
Alexander Vishnevsky Jr. developed the anesthesia problems for cardiac, lungs and mediastinal surgeries, neural trophism in surgery, polymers application in surgery. In 1953, he was the first in the world to make a heart surgery regarding mitral stenosis with local anesthesia. In 1957, for the first time in the USSR he performed the first successful open heart surgery using the home-produced heart-lung apparatus.
Since 1976 until 1988 the Institute was headed by Mikhail Kuzin – an outstanding surgeon, scientist, sponsor of the medical science, community leader, educator, Hero of Socialist Labor, laureate of the USSR state prize, honored worker of science of Russian Soviet Federative Socialist Republic, member of Russian Academy of Medical Sciences.
During the service of M. Kuzin, the Institute not only continued to develop the progressive vectors of research and practical activities started by A. Vihnevsky Jr., but launched activities that let the Institute to preserve its leading position in Soviet surgery for many years.
Different changes of academic research fields towards their perfection and intensification happened almost in all departments, units and laboratories. The most substantial changes occurred in three departments: the abdominal surgery department, the department of wounds and wound infection and the heat injury department. The method of selective proximal vagotomy developed under the direction of M. Kuzin resulted in permanent cure with minimal functional disturbances. This surgery became widely spread both in our country and abroad. At that period, the specialists started to carry out complex surgeries: hepatic resection, surgeries on bile passages and pancreatic gland. There were implemented the methods of laser and endoscopic papillosphincterotomy and microsurgical technique. In cooperation with laboratories of endocardiac methods and medical polymers, the surgeons were the first in the country to perform curative embolization of bronchial arteries with pulmonary hemorrhage. In cooperation with cardiac surgeons, the specialists of the laboratory of endocardiac methods started to carry out endocardiac operations on stenotic rheumatic heart disease by means of endovascular access. At that time, the method of heart cavity examination with fiber optics was developed and implemented into the clinical practice.
The Department of vascular surgery started to carry out surgeries of aortic arches and their branches, carotic and vertebral arteries, and brachiocephalic trunk. The preferred directions of scientific research included the development of diagnostics and treatment of heterospecific aortal arteritis, as well as studying the application of endovascular occlusion in angiodysplasia treatment.
The research activity of the Injury Department was substantially extended. The Injury Department was the major department of the country to develop and implement new surgical methods for extensive and complicated injuries, wound sepsis, purulent osteomyelitis.
Instead of using traditional salve fat-based bandages for local treatment of wounds, they started to use multicomponent hydrophil ointments and multicomponent medical pulverized adsorbents based on polyvinyl alcohol, as well as spongiform bandages based on collagen and analgesics.
In the mid-1970s, in the Heat Injury Department of the Institute there was developed and implemented the treatment mode of extensive burns without the use of bandages. It helped to reduce the number of painful bandaging procedures and reduce the period of in-hospital treatment of patients almost twofold.
The Department of Reconstructive and Plastic Surgery was created to correct after-burn scars and malformations. Within a short period of time the specialists mastered different methods to correct malformations including balloon tissue distention and microsurgery.
Based on the Pathomorphology Department there was established the tissue culture laboratory. The laboratory helped to cultivate and study fibroblast cultures of the patient to determine the possibility to apply them to fill extensive wounds and burns. For the first time in the country, there appeared the computer tomography laboratory as a part of the X-ray and Radiology Department.
In 1988, the Institute was headed by one of the leaders of national surgery of the end of XX century – beginning of the XXI century – Professor Dmitry Fedorov, laureate of state prize of the USSR and Russia, prize of the Russian Government, member of the Russian Academy of Medical Sciences.
His very hard task was to manage the Institute during the fall down of the Soviet Union and formation of the new health care system of the Russian Federation. At that time there emerged and became widely spread the new scientific areas, unique diagnostics and treatment methods. Inter alia, the methods of laparascopic and thoracoscopic surgery were developed and implemented; symptomatology and diagnostics of numerous surgical diseases by means of computerized tomography, angiography and ultrasound were developed. During the period that turned to be very hard for the medical science, the Institute did not lose its reputation and proceeded with fundamental research in various areas of surgery.
To treat the patients with extensive burns, there was developed and implemented the grafting method of cultivated fibroblasts. For the first time in the country there were developed the most complex liver surgery techniques: advanced hernihepatectomy, median hepatic resection, plural segmentectomy, occasional hepatic resection at recurrent tumor. Modern radio-surgical interventions and thermal ablation technique for malignant neoplasms were implemented. There developments were introduced in such fields as surgeries on pancreatic gland and non-organ neoformations in the retroperitoneal space. Single-step complex operations for multi-organ injures were implemented. The huge experience in this field made it possible to make a breakthrough in the surgery thus extending its opportunities and demonstrating medical and economic effect of such operations. In the Institute there was developed a unique system that used the helical computed tomography data for diagnostics of diseases. The operative treatment simulation technique using the computerized tomography has been patented. The radio-endovascular methods of diagnostics and treatment became widely spread.
Since 2011 until 2016, the Institute was headed by Professor Valery Kubyshkin, laureate of state prize of the Russian Federation and Government of the Russian Federation, member of the Russian Academy of Medical Sciences. V. Kubyshkin is a Vice-President of the Hepatology Surgeons Association of Russia and the CIS countries, Russian Unit of the International Association of Hepato-Pancreato-Biliary Surgeons, Deputy Chairman of the Domain-Specific Committee on Abdominal Surgery of the Russian Academy of Medical Sciences, academic secretary of the section of the Russia Presidential Committee on state awards in the domain of science and engineering, representative of Russia in the European Association of Endoscopic Surgeons, member of the board of the Russian Association of Endoscopic Surgeons, editor-in-chief and editorial board member of numerous competent medical magazines – “Surgery”, “Endoscopic Surgery”, “Annales of Surgical Hepatology”. V. Kubyshkin is the author of 7 monographic studies, 6 chapters of the national surgical guidelines and over 300 academic articles. He directed 12 doctorate theses and 18 master’s theses. The achievements of V. Kubyshkin to the national medical sciences were marked with the Order of Honor.
According to the order of the Ministry of Health of the Russian Federation No. 400 of 21.06.2013, V. Kubyshkin was appointed the Chief Out-of-the-Staff Surgical Specialist of the Ministry of Health of the Russian Federation.
V. Kubyshkin worked in the following fields: implementation of the laparoscopic surgical technique in Russia to treat the diseases of liver, gut-bread, bile passages, spleen, diaphragm, and gastrointestinal tract; unique academic works on pathologic behavior of purulent peritonitis and pancreatonecrosis; as far as diagnostics and treatment of peritonitis is concerned, he contributed to application of endoscopic, angiographic and ultrasonic methods for forecasting the course of a disease and surgical operations.
Since January 2016, the Institute of Surgery named after A. Vishnevsky has been headed by Amiran Revishvili, laureate of the state prize of the USSR, honored worker of Russian science, laureate of the prize of the Government of the Russian Federation, member of the Russian Academy of Medical Sciences, Professor, Chief Out-of-the-Staff Expert Surgeon of the Ministry of Health of the Russian Federation. A. Revishvili published over 500 research works that include 5 monographic studies, 5 books, over 190 major magazine articles. He is the President of the All-Russia Scientific Society of Specialists in Clinical Electrophysiology, Arrhythmology and Cardiac Stimulation, member of the expert advisory body of the State Commission for Academic Degrees and Titles, member of the European Working Group on Clinical Electrophysiology and Cardiac Stimulation, editor-in-chief of the Russian edition of “Progress in Biomedical Research” Magazine, member of numerous Russian and foreign societies.
The main field of scientific activities of A. Revishvili is research of clinical electrophysiology of heart and development of arrhythmia mechanisms. He obtained priority data on electrophysiological and anatomical substance of supraventricular and non-coronary ventricular arrhythmias particularly for children with cardiac malformations and adults with coronary heart disease. He was the first to offer special classification of pre-excitation syndrome variations and minimally traumatic (tube) methods of arrhythmia elimination with such pathologies. He was the first to describe arrhythmogenic dysgenesis of the right atrium leading to auricular flutter. Further, he developed the treatment techniques for such pathology by means of cryo- or radio-frequency destruction.A. Revishvili invented new algorithms for differential diagnostics of supraventricular tachyarrhythmias, atrial fibrillations and life-threatening ventricular arrhythmias. He invented the methods for diagnostics and electrotherapy of arrhythmias that further have been implemented in implantable cardioverters of the new generation – defibrillators that nowadays are commonly used for sudden cardiac death prevention in dozens of countries of the world. His priority competence in the field of electrophysiological diagnostics and electrotherapy of life-threatening arrhythmias is supported by European and US patents. The results of academic research of A. Revishvili and his employees provided a new approach to electrophysiological diagnostics and treatment of tachycardia.
In February 2018 according to resolution of the Ministry of Health of the Russian Federation the Institute of Surgery named after A. Vishnevsky changed its status and name. Now it is called the Federal State Budgetary Institution “National Medical Research Center of Surgery named after A. Vishnevsky” of the Ministry of Health of the Russian Federation.