SU1138135A1 - Method of gastroplasty - Google Patents

Abstract

The method of gastrointestinal tract, including oblique intersection of the esophagus, the formation of the intestinal reservoir from the intestinal duplicature, the imposition of a pneumo-reservoir anastomosis and its cover with a sero-muscular fold of the reservoir, characterized in that, in order to prevent the inconsistency of the stitches and the anastomotic anesthesia, the ureteric cavity of the bowel cavity is treated, and the urethral osteoporosis The esophagus is carried out so that its anterior wall is longer, the reservoir is formed from the T-shape of the cross-linked gut duplication, and the anastomosis is applied by stitching the walls of the organs through all layers.

Description

The invention relates to medicine, in particular to surgery, and can be used in operations for removing the stomach, for example, in its oncological damage,

There is a method of gastroplasty, including the transverse intersection of the esophagus, the T-shaped stitching of the jejunum loop with the inter-intestinal anastomosis, the formation of the esophagus aastomosis with the diverging knee of the loop, the cover of the anastomosis zone with the musculoskeletal fold CO "

The disadvantages of this method are often incompatible with stitches, cicatricial strictures of fistulae, reflux esophagitis, disabling 12 duodenal from digestion and 25-50 cm of the jejunum during the formation of an intestinal-intestinal joint with an intestinal loop.

There is a method of gastroplasty, including oblique intersection of the esophagus, the formation of the intestinal reservoir from the intestinal duplication, the imposition of the esophageal-reservoir anastomosis and its shelter with a sero-muscular fold of the reservoir 2},

However, according to this method, a complete cover of the anastomosis front wall is not provided., The width of the lumen of the anastomosis is limited, therefore, there may be a lack of sutures or stenosis of the joint,

The aim of the invention is to prevent the inconsistency of the sutures and stricture of the anastomosis.

The goal is achieved by the method of gastroplasty, including oblique intersection of the esophagus, the formation of the intestinal reservoir from the intestinal duplication, the imposition of the esophageal reservoir anastomosis and its covering by the sero-myecal fold of the reservoir, oblique intersection of the esophagus is carried out so that its anterior wall will obstruct, the reservoir is formed from a T-shaped cross-linked, duplicatory intestine, and the anastomosis is imposed by cross-linking the organs through all the layers,

 The method is carried out as follows.

Perform laparotomy. The stomach is mobilized and removed. The esophagus is cut off along the edge of an obliquely imposed clamp so that a longer

was its front wall. After dissection of the Treitz ligament from the jejunum and duodenum, form a T-shaped duplicate by means of a continuous serous-nylon nylon suture of the racket type.

The esophagus is fixed nodal sero-condom sutures to the rocket-like intestinal loop. Next, along the edge of the obliquely cut esophagus, two loops of the reservoir are cut to form openings 1.5 times the diameter of the obliquely cut esophagus. Next, the right wall of the esophagus is hemmed with full nylon seams to the dissected loop loop of the reservoir. The left wall of the esophagus is also hemmed with full-layer sutures to the outlet loop of the reservoir. Such a surgical technique creates an esophageal-reservoir anastomosis, which prevents the development of a junction of strictures. The sero-muscular coupling of the T-shaped duplicatory. Covers the anterior wall of the esophagus and the anastomosis, immersing the esophagus into the reservoir prostrate.

Example, Patient C.70 years old produced upper median laparotomy, A large tumor of the stomach grows into the mesentery root of the transverse colon. The method of a single unit mobilized and

the stomach is totally removed along with the glands, the ligament apparatus and: the collectors of the lymphatic drainage, the esophagus is cut off with a scalpel, while its anterior wall is longer than the posterior by

1 cm, 12 duodenal ulcer cut off from the stomach. From the jejunum and 12 duodenal ulcers, a T-shaped duplicature (racket) is formed; Further along the edge of the obliquely cut esophagus, two loops of the reservoir are dissected with the formation of holes 1.5 times the diameter of the obliquely cut esophagus. The rights of the esophagus wall are hemmed with three expanding full-layer nylon sutures to the dissecting leading loop of the reservoir, and the left wall to the discharge loop,

Additionally, the proximal duodenal stump was stitched into the reservoir distal to the esophageal fistula, the abdominal cavity was sutured, leaving drainage. The postoperative course without complications.

3 1138135

The proposed method has a coupling from a T-shaped: du11l: the following advantages: elevators of the intestine,

the lumen of the joint, strengthened-the proposed method is applied in 49

| The danger of the front of the danger zone, no complications were observed

walls of the esophageal rez.varuarnogo5 recommended for use in klinianastomosis due to serous-muscular practice.

Claims (1)

METHOD OF GASTROPLASTICS, including oblique intersection of the esophagus, formation of the intestinal reservoir from the intestinal duplicate, overlapping of the esophageal-reservoir anastomosis and covering it with the serous-muscular fold of the reservoir, characterized in that, in order to prevent inconsistency of the sutures and stricture of the anastomosis. the esophagus is carried out so that its anterior wall is longer, the reservoir is formed from a T-shaped cross-linked intestinal duplicate, and the anastomosis is superimposed by stitching the walls of organs through all layers. OE 00 NSh OZ SP 1 11