The Volga District Medical Centre (VDMC)

Sergey Romanov,

Director оf the Volga District Medical
Centre, FMBA of Russia, Associate Professor
of the Surgery Department at the Nizhni Novgorod
State Medical Academy, Ph.D.(Medicine).

The  Volga  District  Medical  Centre  (VDMC) was established by the Ministry  of Health of the Russian Federation on October 17, 2001. Now VDMC is a state institution under the Federal Medical and Biological Agency (FMBA). The purpose of the Medical Centre is to provide health services to employees of industrial organisations with hazardous working conditions, including industries with high risk of occupational diseases, and to the population of certain territories where FMBA is responsible for providing such services in accordance with the list approved by the Russian Government. The mission of the Medical Centre is to provide medical aid to insured members of local population in accordance with the law of the Russian Federation and to contractual patients, including primary, specialized, high-tech medical care, specialized care by mobile fast-response teams in case of emergencies.

The Medical Centre  embraces  practically all areas in modern medicine and possesses an extensive network of hospitals with a total capacity of 1154 beds  and 2804 visits per shift: 4 clinical hospitals, 5 outpatient clinics (including a dental clinic) in the city of Nizhny Novgorod plus 16 branches located in 6 regions and 3 republics of the Russian Federation.

Serving 142200 persons of the designated cohort and working within the regional programs of compulsory health insurance, the Medical Centre is working closely with local health authorities of constituent entities of the Russian Federation. This provides the treatment and diagnostic procedures in a single protocol, ensures continuity in the interaction of branches with the main centre and supports the waiting lists of patients who need high-tech medical care.

High quality primary health care is now available to  workers of the nuclear industry, water transport, and civil servants.  Outreach specialist consultation services, clinical examination, and immunizations on epidemic indications are also provided for such workers.

In 2011, the Medical Centre received 4 off-road vehicles complete with modern diagnostic and treatment equipment to provide specialized medical care in the format of a mobile hospital to be deployed in emergencies.

Over the last two years, a large number of new medical departments were opened. The newly established ophthalmological clinic includes an outpatient unit and an inpatient unit. Departments of maxillofacial surgery, neurosurgery, traumatology and orthopedics, cardiology were opened in the Medical Centre. There are such profiles of high-tech health care facilities: organ and tissue transplantation, abdominal surgery, oncology, urology, cardiovascular surgery, traumatology and orthopedics, obstetrics and gynecology, extracorporeal fertilization, neurosurgery, maxillofacial surgery, ophthalmology, endocrinology.

The Medical Centre has organized operational interventions in cases of cancer through liver resection, liver transplantation, local destruction (ablation) of tumors, transarterial chemoembolization, portal vein embolization, transarterial radioembolization, brachytherapy (introduction of local sources of radiation) in accordance with international protocols. New research is underway with the aim of creating a "bio-artificial liver".

The Medical Centre is one of few medical institutions of FMBA, where surgeons perform liver transplantations. Only 5 clinics in Russia perform such operations. The Nizhny Novgorod City Prize in the Medicine was awarded to a team of researchers from our institution in 2011. This is the third award of the City, which the staff of the institution received during the 11-year period of its existence.

Fig.1. Evolution of high-tech medical care at  VDMC .

In the framework of a complete cycle of diagnosis and treatment in the Medical Centre, some of the rapidly developing areas now include: reconstructive surgery of the genitourinary system, minimally invasive and interventional procedures in surgery, urology, gynecology, ENT, neurology (conditions after strokes, severe traumatic brain injury, brain surgery, rehabilitation treatment for degenerative diseases of the spine, peripheral nervous system, rehabilitation treatment for diseases and injuries of the musculo-skeletal system), the treatment of patients with renal and hepatic impairment, with focal and diffuse liver diseases, neoplastic and inflammatory diseases of pancreas, etc. The protocols including instrumental methods of therapy of patients with severe chronic heart failure in the development and implementation phase.

Rehabilitation treatment programs are an important element in the cycle of diagnosis and treatment. A unified rehabilitation treatment centre is organized, which has combined outpatient and inpatient rehabilitation and uses the most modern methods of rehabilitation, using the achievements of evidence-based medicine.

Multidisciplinary teams in the section of neurology provide a comprehensive approach to the follow-up treatment with motor rehabilitation, speech therapy and psychological adjustment. Various techniques use high intelligence equipment for treatment of degenerative diseases of the spine, peripheral nervous system, treatment of diseases and injuries of the musculo-skeletal system, including rheumatologic diseases and conditions after hip replacement surgery. Arthroscopic surgery of the knee is actively introduced. Rehabilitation centre continues to evolve motor rehabilitation, myo electric neuro stimulation in stroke recovery period, neuro rehabilitation of patients who received high-tech medical care.

Highly developed technical infrastructure and increasing professionalism allow us to implement in clinical practice a high level of operations and methods in the treatment of patients with the most serious diseases. Endoscopic mucosa resection for early gastric cancer (EMR), Computer Assisted Surgery treatment of colorectal cancer, the Birmingham system of surface arthroplasty (BHR), neuromodulation for the treatment of neurogenic bladder dysfunction are used in the Medical Centre. The laboratory and instrumental monitoring can significantly reduce the risk of complications of the underlying disease and to take measures to prevent multiple organ pathology in time.

The Medical Centre is a clinical base for 9 departments of the Nizhny Novgorod State Medical Academy. Conferences, workshops, schools and seminars with leading Russian and foreign specialists are held on a constant basis. Scientific papers, patented designs (9 patents) were presented at Russian and international conferences on surgery, cardiology, hepatology, maxillofacial surgery, IVF, ultrasound diagnostics, rehabilitation. Our specialists produce annually an impressive number of articles in collaboration with scientists. VDMC's plans for the nearest future in the field of scientific and clinical research include: preparing for heart transplantation and transplantation of pancreas, assessment of the structural and functional condition of organs using radio physical methods, radioisotope technology for recognizing and treatment of cancer, mechanical methods of restoration and preservation of the lumen of hollow organs of patients with neoplastic diseases, cell technologies in medicine.

Thus, our Medical Centre is a high technology hospital, a modern rehabilitation centre and a medical service network; it is a single well-organized system, which combines all elements of modern medical care. VDMC is a dynamically developing institution, which masters the most complex areas of modern medicine with great ardor. The Medical Centre occupies the leading position among the health care organizations of the Volga Federal District due to its highly professional team and its desire to achieve new horizons in medicine.