UA100769U - Method for antiregurgitation sealing gastrostomy - Google Patents

Abstract

The method for antiregurgitation sealing gastrostomy provides for left-side transrectal laparotomic section of the abdominal wall, 7-8 cm in length, in the case of inoperable cancer stenosing esophagus or cardiac division of the stomach. Over the perimeter of the left-side laparotomic wound, the peritoneum is sewed with aponeurosis of rectus abdominal muscle in 1-cm interval using the silk ligatures. The sutures are taken with the retainer. The gastrostomic rubber tube with two extra lateral openings is bound around with the silk ligature at the distance of 2-3 cm from its end. The transverse cut, 2 cm in length, opens the lumen of the stomach inside its anterior wall. At the end of this wound, the circular mucous-serous purse-string suture is applied. Through this opening, the anterior wall of the stomach is sewed from the inside of the stomach towards the esophagus with the intestinal needle up to 5 cm in length with the ends of ligature fixed to the tube. The tube is inserted into the stomach to the depth of 6-7 cm with pulling simultaneously the ligatures exited from the tube. Temporarily, the ligatures are kept untied. The circular mucous-serous purse-string suture around the inserted tube is pulled, tied and cut. At the distance of 2 cm from the first suture, the second mucous-serous purse-string suture is applied. When the second suture is tied, the first suture is covered with mucous-serous layer. The ends of the ligatures exited from the stomach are pulled and tied. This site is covered with mucous-serous layer, sutured with the ends of the ligatures that are tied and cut. The wall of the stomach is passed through the prepared opening by pulling the sewed-in tube. The wall is fixed around the edge of the wound to the abdominal wall with the separate stitches of the uncut peritoneal-aponeurotic ligatures. Following sewing and tying all ligatures, they used for suturing the edges of the skin fixing around the perimeter of the wound to the peritoneal-aponeurotic attachment of the stomach. Finally, the tube is fixed to the skin with the separate ligature.