Asqarov Po‘lat Azadovich.

Course history.

  The “Minimally Invasive and Laparoscopic Surgery” course of the Faculty of Postgraduate Education at the Samarkand State Medical Institute was established on 3 March 2021 on the basis of the Department of Surgical Diseases No. 1. The course staffing was approved for two positions. Pulat Azadovich Askarov, Candidate of Medical Sciences (Cand. Med. Sci.), was appointed as the course head. By Rector’s Order of the Samarkand State Medical University dated 18 September 2023, No. 438 AF, the course was separated from the department (established as an independent unit).

  The Course of Minimally Invasive and Laparoscopic Surgery of the Faculty of Postgraduate Education at Samarkand State Medical University was established to ensure the systematic implementation of modern surgical technologies in postgraduate medical education, clinical practice, and research. The development of the course has been closely associated with the gradual transition from conventional open surgery to minimally invasive, laparoscopic, and endovisual procedures that reduce surgical trauma, improve patient safety, and promote faster recovery.

  From the initial stages of its activity, the course placed particular emphasis on mastering laparoscopic procedures, ensuring the rational use of endovisual equipment, improving surgeons’ practical skills, and incorporating contemporary treatment standards into postgraduate education. Clinical training allowed theoretical knowledge to be combined with direct practical experience and contributed to the development of independent clinical decision-making skills among trainees.

  As the course developed, its educational programmes and teaching materials were continuously improved, while new laparoscopic and minimally invasive procedures were introduced into the curriculum. Interactive lectures, clinical case discussions, step-by-step analysis of surgical videos, patient examinations, multidisciplinary consultations, preoperative planning, and postoperative follow-up became integral components of the educational process.

  The course is currently headed by Associate Professor Pulat Azadovich Askarov. Under his leadership, its educational, methodological, clinical, scientific, and organisational activities are conducted in accordance with contemporary surgical requirements. Course Assistant L.M. Khayitov, PhD, actively participates in teaching, clinical case discussions, practical skills training, and scientific research. The course team combines traditional mentorship with modern simulation-based and competency-oriented educational methods.

  The course provides postgraduate training in general and emergency surgery, laparoscopic and endovisual procedures, and the modern diagnosis and management of diseases of the abdominal organs and abdominal wall. Trainees acquire essential skills in safe trocar placement, creation of pneumoperitoneum, handling of optical systems, tissue dissection, haemostasis, laparoscopic suturing, and intracorporeal knot tying.

  The curriculum covers the indications, contraindications, and technical stages of laparoscopic cholecystectomy, appendectomy, diagnostic laparoscopy, adhesiolysis, modern surgical treatment of abdominal wall hernias, and other minimally invasive procedures. Particular attention is paid to selecting the appropriate surgical strategy in complex clinical situations, preventing intraoperative complications, and determining justified indications for conversion to open surgery.

  The clinical activity of the course focuses on the diagnosis and treatment of patients with diseases of the abdominal organs and abdominal wall using modern minimally invasive technologies. Course staff are directly involved in patient examination, diagnostic verification, determination of indications for surgery, assessment of surgical risk, performance of operative procedures, and postoperative management.

  The research activities of the course address current issues in minimally invasive and laparoscopic surgery. Its principal areas of research include gallstone disease and choledocholithiasis, abdominal wall hernias, emergency abdominal disorders, simultaneous surgical procedures, prevention of postoperative complications, and improvement of surgical outcomes. Research findings are presented in scientific articles, conference abstracts, methodological recommendations, and educational manuals and are subsequently implemented in clinical practice.

  The course collaborates with surgical departments, clinical units of the university, and regional healthcare institutions. Open lectures, master classes, seminars, clinical conferences, and integrated educational sessions contribute to the continuous development of specialists’ professional knowledge and practical skills.

  Today, the Course of Minimally Invasive and Laparoscopic Surgery integrates modern educational technologies, clinical expertise, and scientific research within a unified system. Its main objective is to train highly qualified surgeons who can make independent and well-founded clinical decisions, safely operate modern surgical equipment, follow the principles of evidence-based medicine, and place the patient’s interests and safety first.

  The future development priorities of the course include expanding simulation-based training, improving the objective assessment of laparoscopic skills, mastering new minimally invasive procedures, introducing digital monitoring of clinical outcomes, and strengthening international scientific and educational cooperation. The course team is committed to contributing to the scientific, educational, and clinical development of Samarkand State Medical University and to the sustainable advancement of minimally invasive surgery in Uzbekistan.

  Spiritual and educational activities

  Caring for the younger generation and healthcare professionals and educating spiritually mature, professionally responsible, patriotic, and humane specialists are important elements of the national values of the Uzbek people and the country’s educational policy. Therefore, spiritual and educational activities constitute an integral part of the work of the Course of Minimally Invasive and Laparoscopic Surgery of the Faculty of Postgraduate Education at Samarkand State Medical University.

  Spiritual and educational activities at the course are carried out regularly in accordance with plans approved by the university and the faculty. Their principal objective is to develop high moral standards, professional ethics, medical deontology, civic responsibility, and a patient-centred approach among trainees, clinical residents, young physicians, and members of the course staff.

  Under the leadership of the Head of the Course, Associate Professor Pulat Azadovich Askarov, the staff conduct activities aimed at explaining the significance of the social and economic transformations and the reforms being implemented in education and healthcare in Uzbekistan. The works and speeches of the President of the Republic of Uzbekistan, Shavkat Mirziyoyev, laws adopted by the Oliy Majlis, presidential decrees and resolutions, resolutions of the Cabinet of Ministers, and regulatory documents concerning healthcare development are regularly discussed.

  Spiritual and educational events are intended to broaden the universal, national, and moral outlook of trainees and strengthen their devotion to the Motherland, respect for the medical profession, honesty, discipline, and personal responsibility. Round-table discussions, open dialogues, educational meetings, and thematic events address the rich history of Uzbekistan, the legacy of prominent scholars and physicians, national traditions, and the role of Samarkand in the development of world civilisation.

  Particular attention is paid to the ethical and moral foundations of the medical profession. Trainees are taught to respect the honour and dignity of every patient, maintain medical confidentiality, communicate appropriately with patients and their relatives, make impartial clinical decisions, ensure surgical safety, and follow the principles of humanity when providing medical care. In complex surgical situations, the importance of collective responsibility, mutual respect, and effective professional cooperation is emphasised.

  The application of advanced technologies in minimally invasive and laparoscopic surgery requires not only excellent technical skills but also a high level of moral responsibility. Therefore, the rational use of modern medical equipment, prioritisation of patient safety, evidence-based determination of indications for surgery, prevention of unnecessary procedures, and objective evaluation of treatment outcomes are regarded as essential components of the physician’s moral and professional development.

  Considerable attention is given to promoting a healthy lifestyle. Educational activities address balanced nutrition, physical activity, avoidance of harmful habits, observance of an appropriate work-rest schedule, maintenance of psychological resilience, and prevention of professional burnout. It is emphasised that the personal example of a healthcare professional is one of the most effective ways to encourage a healthy lifestyle among the population.

  To improve the political and legal awareness of trainees, discussions are held on the Constitution of the Republic of Uzbekistan, citizens’ rights in the field of healthcare, the professional responsibilities of medical workers, prevention of corruption and conflicts of interest, and adherence to the principles of academic integrity. Course staff seek to provide trainees with timely, objective, and reliable information about significant social, political, scientific, and medical developments in Uzbekistan and throughout the world.

  Great importance is attached to creating a healthy moral environment within the team and strengthening mutual respect, unity, and the traditions of mentorship. Experienced specialists teach young physicians not only surgical techniques and clinical reasoning but also compassionate attitudes towards patients, respect for colleagues, continuous professional development, and the ability to analyse mistakes constructively.

  To ensure the meaningful organisation of trainees’ leisure time, visits to historical monuments, museums, theatres, and cultural and educational institutions are arranged. Reading events, sports competitions, charity initiatives, and team meetings are also organised. Familiarity with the rich historical and cultural heritage of Samarkand helps strengthen national pride, historical awareness, and a sense of responsibility for the future of the Motherland.

  Course staff also actively participate in public education activities intended to improve the health literacy of the population. They provide information on disease prevention, healthy lifestyle practices, timely presentation for medical care in acute surgical conditions, the dangers of self-treatment, and the importance of following postoperative recommendations.

  The spiritual and educational activities of the Course of Minimally Invasive and Laparoscopic Surgery contribute to the education of highly qualified, patriotic, honest, dedicated, and broad-minded physicians for whom the interests and safety of the patient are the highest professional priorities. By combining professional excellence with spiritual maturity, the course team contributes to strengthening the educational, clinical, and social standing of Samarkand State Medical University.

Educational and Methodological Activities.

  The educational and teaching-methodological activities of the Course of Minimally Invasive and Laparoscopic Surgery are aimed at training highly qualified specialists who can think independently, make well-founded clinical decisions, and safely apply modern surgical technologies. The educational process combines theoretical knowledge, practical skills, clinical experience, and the principles of evidence-based medicine.

  Educational activities are carried out in accordance with the approved curricula and programmes of Samarkand State Medical University, the Faculty of Postgraduate Education, and applicable regulatory documents. The organisation of training takes into account the trainees’ medical specialisation, level of professional preparation, practical experience, and individual educational needs.

  The course provides training designed to improve surgeons’ qualifications, professional knowledge, and practical skills and to introduce them to new diagnostic and therapeutic technologies. The curriculum covers general and emergency surgery, minimally invasive and laparoscopic procedures, and the modern diagnosis and management of diseases of the abdominal organs and abdominal wall.

  Important components of the programme include the diagnosis and management of gallstone disease, acute and chronic cholecystitis, choledocholithiasis, acute appendicitis, abdominal wall hernias, intra-abdominal adhesions, emergency abdominal disorders, and other surgical conditions. Each topic includes indications and contraindications for surgery, preoperative preparation, assessment of surgical risk, selection of the appropriate surgical procedure, and postoperative management.

  Trainees study the principal stages of laparoscopic cholecystectomy, appendectomy, diagnostic laparoscopy, adhesiolysis, modern surgical treatment of abdominal wall hernias, and other minimally invasive procedures. Particular attention is paid to selecting the optimal surgical strategy in complex clinical situations, preventing intraoperative complications, and determining justified indications for conversion to open surgery.

  Theoretical training includes conventional and interactive lectures, multimedia presentations, clinical case scenarios, problem-based questions, small-group discussions, and critical appraisal of scientific literature. National clinical protocols, international guidelines, current scientific publications, and the clinical experience of the course are integrated into the teaching materials.

  Practical training is conducted in clinical departments, operating theatres, diagnostic units, and simulation-based settings. Trainees participate in patient examination, history taking, interpretation of laboratory and instrumental investigations, formulation of preliminary and final clinical diagnoses, preparation of treatment plans, and organisation of postoperative follow-up.

  In practical skills training, particular attention is given to preparing endovisual equipment, operating a laparoscopic tower and optical system, correctly positioning the patient, safely inserting trocars, establishing pneumoperitoneum, performing tissue dissection, applying coagulation and haemostasis techniques, and carrying out laparoscopic suturing and intracorporeal knot tying.

  Step-by-step analysis of surgical video recordings is an important component of the educational process. During video-based reviews, trainees learn to identify anatomical landmarks, follow critical safety requirements, recognise technical errors, analyse the causes of complications, and select appropriate methods for their prevention and management.

  Clinical case discussions, morning conferences, multidisciplinary consultations, preoperative meetings, and postoperative outcome reviews are regularly organised. These educational activities develop clinical reasoning, teamwork, evidence-based decision-making in complex situations, and personal responsibility for patient safety.

  As part of its teaching-methodological activities, the course staff develop and regularly update educational programmes, working curricula, lecture materials, practical training guides, methodological recommendations, educational manuals, clinical case scenarios, assessment tests, and evaluation criteria. The materials are revised in accordance with current advances in surgery, changes in clinical protocols, and the needs of practical healthcare.

  The trainees’ knowledge and skills are assessed through entry, continuous, and final examinations. Theoretical knowledge is evaluated using written tests, oral questioning, clinical scenarios, and problem-based assignments. Practical competency assessment considers compliance with surgical safety requirements, appropriate use of equipment, accurate identification of anatomical structures, correct sequencing of surgical manoeuvres, and the ability to work effectively as part of an operating team.

  Under the leadership of the Head of the Course, Associate Professor Pulat Azadovich Askarov, the quality of the educational process is regularly monitored. Course Assistant L.M. Khayitov, PhD, actively participates in organising lectures and practical sessions, conducting clinical case discussions, coordinating independent study, and preparing teaching and methodological materials.

  Particular importance is attached to independent learning. Trainees receive assignments involving the study of current scientific literature, critical appraisal of clinical guidelines, preparation of presentations, analysis of surgical videos, preparation of written reviews, and work with clinical protocols. The results of independent study are evaluated during seminars, group discussions, and individual interviews.

  The future development of the course’s educational and teaching-methodological activities includes expanding simulation-based training, introducing objective assessment of laparoscopic skills, developing digital educational resources and an electronic surgical video library, using elements of distance learning, and integrating international educational standards into the curriculum.

  The educational and teaching-methodological work of the Course of Minimally Invasive and Laparoscopic Surgery contributes to improving trainees’ professional knowledge and practical expertise, ensuring the safe adoption of modern surgical technologies, and preparing highly qualified specialists for whom the interests and safety of the patient remain the highest professional priorities.

Scientific activity.

  The research activities of the Course of Minimally Invasive and Laparoscopic Surgery are focused on current problems of modern surgery, improvement of diagnostic and therapeutic methods, development of safe and effective minimally invasive technologies, and implementation of research findings in clinical practice.

  Research is conducted in accordance with the research plan of Samarkand State Medical University, the priority objectives of the healthcare system of the Republic of Uzbekistan, and current international trends in surgical development. The principal objectives are to reduce surgical trauma, improve treatment safety, prevent postoperative complications and recurrence, shorten hospital stay, and improve patients’ quality of life.

  Under the leadership of the Head of the Course, Associate Professor Pulat Azadovich Askarov, course staff, independent researchers, clinical residents, and young physicians actively participate in research activities. Course Assistant L.M. Khayitov, PhD, contributes to clinical data collection and systematisation, analysis of current scientific literature, statistical processing of research results, and preparation of scientific articles and methodological recommendations.

  The priority areas of research include:

• Improvement of modern diagnostic methods and minimally invasive treatment of gallstone disease, cholecystitis, and choledocholithiasis.
• Evaluation of the effectiveness and safety of one-stage, two-stage, and hybrid laparoendoscopic treatment strategies for choledocholithiasis.
• Development and scientific validation of a “Rescue” strategy for complex clinical situations in which standard endoscopic interventions are unsuccessful.
• Evaluation of endoscopic, laparoscopic, and staged decompression procedures for benign obstructive jaundice.
• Improvement of modern alloplastic and minimally invasive methods for abdominal wall hernia repair, individual selection of the surgical technique, and prevention of recurrence.
• Evaluation of the clinical effectiveness of simultaneous procedures in patients with ventral hernias associated with morbid obesity.
• Improvement of indications and surgical strategies for simultaneous operations in patients with combined abdominal diseases.
• Assessment of the role, capabilities, and safety of diagnostic and therapeutic laparoscopy in emergency abdominal conditions.
• Improvement of algorithms for the prevention, early recognition, and management of intraoperative complications during laparoscopic surgery.
• Development of modern approaches to enhanced postoperative recovery, early mobilisation, and improvement of short- and long-term treatment outcomes.

  Clinical, laboratory, instrumental, endoscopic, ultrasonographic, radiological, and statistical methods are used in the research. Surgical outcomes are assessed according to procedure duration, intraoperative difficulties, the need for conversion, complication rates, repeat operations, length of hospital stay, disease recurrence, and patients’ quality of life.

  Particular attention is paid to the principles of evidence-based medicine. Research topic formulation, study design, patient grouping, definition of inclusion and exclusion criteria, selection of statistical methods, and objective interpretation of the results are performed in accordance with current scientific standards.

  Research findings are presented by course staff at national and international scientific conferences, congresses, seminars, and master classes. The results are published in national and international journals as scientific articles and conference abstracts and are also used in the preparation of monographs, educational manuals, methodological recommendations, and information materials.

  The main areas of scientific and educational-methodological work prepared by the course staff include:

  Research findings are introduced into clinical practice in the form of diagnostic and therapeutic algorithms, practical recommendations, new surgical strategies, and improved operative techniques. The implementation of these developments helps reduce surgical risk, decrease the need for repeat interventions, and improve the effectiveness of surgical treatment.

  Training and supporting young researchers is an important component of the course’s scientific activities. Scientific and methodological assistance is provided in selecting research topics, developing study protocols, collecting clinical data, performing statistical analyses, and preparing dissertations, scientific articles, and conference abstracts. Scientific discussions, seminars, and critical reviews of the literature contribute to the development of research competencies among young specialists.

  The research activities of the Course of Minimally Invasive and Laparoscopic Surgery are intended to improve the quality of modern surgical care, support the evidence-based implementation of new technologies, train qualified scientific and teaching personnel, and contribute to the continued development of minimally invasive surgery in Uzbekistan.

International cooperation

  International cooperation is one of the priority areas of the Course of Minimally Invasive and Laparoscopic Surgery of the Faculty of Postgraduate Education at Samarkand State Medical University. It is aimed at studying advanced international experience, introducing modern surgical technologies into education and clinical practice, improving the quality of scientific research, and developing the professional competencies of healthcare specialists.

  Since its establishment, the course has cooperated with the All-Russian Centre for Emergency and Radiation Medicine of the Ministry of the Russian Federation for Civil Defence, Emergencies and Elimination of Consequences of Natural Disasters, located in Saint Petersburg. This partnership provides a foundation for long-term experience exchange in minimally invasive and laparoscopic surgery, emergency medical care, patient safety, and postgraduate medical education.

  Joint master classes, short-term professional development programmes, clinical training placements, telemedicine consultations, and scientific seminars are organised annually within the framework of the partnership. Course staff, clinical residents, postgraduate trainees, young researchers, and practising surgeons participate in these activities.

  The joint master classes cover modern laparoscopic and endovisual surgical techniques, preoperative planning, selection of surgical strategy, management of complex clinical cases, and prevention of intraoperative complications. Surgical video recordings are analysed step by step, technical aspects of procedures are discussed, and approaches used by different surgical schools are compared.

  One of the priority scientific and clinical areas of cooperation is the application of hybrid technologies in the diagnosis and treatment of gallstone disease and disorders of the hepatopancreatoduodenal region. The partners study the combined use of laparoscopic, endoscopic, radiological, and other minimally invasive methods, optimisation of treatment stages, and selection of individual strategies for complex forms of disease.

  In emergency surgery, experience is exchanged in the early diagnosis of acute abdominal disorders, the application of diagnostic laparoscopy, determination of indications for minimally invasive procedures, staged treatment of critically ill patients, and prevention of postoperative complications.

  Within the bariatric surgery programme, the partners discuss comprehensive assessment of patients with obesity, indications for surgical treatment, selection of minimally invasive procedures, reduction of perioperative risk, monitoring of nutritional status, and long-term postoperative follow-up. Particular attention is paid to simultaneous procedures in patients with morbid obesity combined with ventral hernias or other surgical conditions.

  Patient safety represents an important component of the partnership. The regular agenda includes the use of surgical safety checklists, prevention of potential errors, safe operation of medical equipment, prevention of infectious complications, and effective communication among members of the operating team.

  The expertise of the Russian specialists in radiation medicine and radiation safety is another significant area of cooperation. Knowledge and practical skills are improved in protecting patients and healthcare professionals from ionising radiation during diagnostic and therapeutic procedures involving radiological and navigation technologies. Particular attention is paid to radiation dose optimisation and strict compliance with safety requirements.

  Telemedicine consultations enable specialists to discuss complex clinical cases remotely, evaluate diagnostic findings, and develop individual treatment strategies. This form of cooperation provides timely access to expert advice, improves the validity of clinical decisions, and facilitates the dissemination of advanced experience among a broader professional audience.

  Current scientific publications, international clinical guidelines, and research findings are discussed during joint scientific seminars. The scientific partnership is aimed at conducting collaborative research, preparing articles, conference abstracts, methodological recommendations, and educational materials, and presenting the results at international scientific events.

  The practical outcomes of this cooperation include updated educational modules and clinical protocols. Current information on hybrid surgical technologies, emergency and bariatric surgery, patient safety, and radiation safety has been incorporated into the course curriculum. The implementation of international experience contributes to improved diagnostic and treatment effectiveness, reduced complication risks, and better clinical outcomes.

  Further development of joint scientific projects, academic mobility programmes, reciprocal clinical training, international publications, distance education, and telemedicine technologies is planned. Cooperation with the All-Russian Centre for Emergency and Radiation Medicine of EMERCOM of Russia contributes to strengthening the international standing of Samarkand State Medical University and supporting the development of minimally invasive surgery in Uzbekistan.