UA119073U - METHOD OF FORMATION OF ANASTOMOSIS ON THE Gastrointestinal tract - Google Patents

Abstract

A method of forming an anastomosis on the gastrointestinal tract involves stitching the segments of the intestine with the connection of homogeneous tissues. In this form a single-row nodal precision suture, stitching the submucosal and musculoskeletal layers, and the mucous and serous membranes are not sewn and sewn not seized.

Description

The useful model belongs to the field of medicine, in particular to surgery and can be used to create gastrointestinal anastomoses, anastomoses on the small and large intestines.

The method of forming an anastomosis on the gastrointestinal tract was chosen as the prototype (Patent

Mo. 40059 Sha. IPC Ab1817/00. The method of forming an interintestinal anastomosis / V.K. Husak,

Mininashvili O.I. et al.; Institute of Emergency and Restorative Surgery. AMN

Ukraine! - Application No. 99095195. - Application 21.09.1999. - Publ. 15.08.2001. - Bull. Mo 6. - 6 p.|, which includes suturing of segments of the intestine with the connection of homogeneous tissues, for which the serous-muscular covering is removed in advance for 1-1.5 cm from one segment of the intestine and cut off at the same distance of the mucosa submucosa from another segment of the intestine.

The disadvantage of the known method is insufficient therapeutic effectiveness and high trauma, which is associated with the need for additional preparation of the intestinal wall, and this contributes to the disruption of microcirculation in the area of the joint mouth, which is a prerequisite for the most formidable complication - insufficiency of the intestinal suture.

The basis of a useful model is the task of improving the known method by using a precision seam when creating a gastrointestinal and interintestinal junction on the small and large intestines.

The task is solved by the fact that in the proposed method of forming an anastomosis on the gastrointestinal tract by suturing segments of the intestine with a connection of homogeneous tissues, according to a useful model, a single-row nodal precision suture is formed, suturing the submucosal and muscular-submucosal layers, while the mucous and serous membranes are not sutured and are not captured in the seam.

The features that coincide with the essential features of the claimed model are the suturing of segments of the intestine with the connection of homogeneous tissues.

The technical result of the useful model is an increase in the effectiveness of surgical interventions on the gastrointestinal tract, due to a reduction in trauma and the time of the operation itself, which contributes to a favorable course of repair processes in the anastomosis zone.

The cause-and-effect relationship between the set of declared features and the technical result can be traced as follows: the use of the proposed forming technique

The anastomosis of the gastrointestinal tract makes it possible to achieve the minimum development of an inflammatory reaction in the area of the tissues being stitched and to create conditions for early reparation, and therefore to reduce the number of possible postoperative complications from the side of the anastomosis.

The method of forming an anastomosis in the gastrointestinal tract is as follows.

Operative intervention is carried out at a four-fold increase with the help of a frontal neurosurgical illuminator. At the same time, microsurgical instruments and atraumatic needles with synthetic threads made of vicryl and prolene size 4-0 are used. A single-row knotted precision suture is formed, stitching the submucosal and muscle-submucosal layers, while the puncture channels are made in such a way that they do not connect either with the lumen of the intestine or with the abdominal cavity at the level of the wound gap. When creating an anastomosis with nodal sutures, the submucosal layers on both sides are sutured with the first suture, then the muscular-submucous layers, then only the submucosal layers again, and so on in a circular fashion. At the same time, the mucous and serous membranes are not sutured and are not captured in the suture. In this way, the layers of the sections of the gastrointestinal tract that are stitched together are accurately matched and the anastomosis is biologically sealed.

Information confirming the use of the method.

The proposed method is illustrated by the following clinical example. Patient P., 55 years old (medical card Mo 0526/10) was hospitalized in the surgical department of the Crimean Republican Clinical Oncology Dispensary on January 28, 2010 as scheduled with the diagnosis: rectal cancer of the TZ MO MO, I set., partial intestinal obstruction. After additional examination and preoperative preparation, on February 2, 2010, the patient underwent surgery - abdominal-anal resection of the rectum. The sigmoid colon was brought down to the stump of the rectum and an anastomosis was formed according to the proposed method, using a single-row knotted precision suture. The duration of the operation is 2 hours and 10 minutes.

The postoperative period was smooth, without complications. Skin sutures were removed for 8-9 days - the wound heals with primary tension, and on February 12, 2010, the patient was discharged for outpatient treatment in satisfactory condition. She was examined 1 year after the operation, she has no complaints, she has no dyspeptic symptoms, and no prolongation of the disease has been diagnosed.

The proposed method makes it possible to achieve a minimal development of the inflammatory reaction in the area of the sutured tissues, create conditions for early repair and ensure biological tightness.

The use of the proposed method in clinical practice allows to significantly improve the quality of treatment of patients operated on the gastrointestinal tract, to improve the results of treatment with a decrease in the number of postoperative complications.

Claims (1)

USEFUL MODEL FORMULA The method of forming an anastomosis on the gastrointestinal tract, which includes suturing the segments of the intestine with a connection of homogeneous tissues, which is distinguished by the fact that they form a single-row nodal precision suture, suturing the submucosal and muscular-submucosal layers, while the mucous and serous the shells are not stitched and are not caught in the seam.