UA135447U - METHOD OF REMOVAL OF THE DRUG FROM THE ABDOMINAL CAVITY DURING LAPAROSCOPIC OPERATIONS - Google Patents

Abstract

The method of removing the drug from the abdominal cavity during laparoscopic operations includes a number of standard procedures, such as incision of the skin in the umbilical region without prior application of pneumoperitoneum, perforation of the abdominal wall with a trocar, revision of the abdominal cavity, surgery, and removal of the drug from the abdominal cavity. fixed by means of a ligature inserted through the trocar with a Raeder loop at the end and by tightening the loop at the edge of the drug pull it through the trocar by the ligature after removal of the laparoscope.

Description

The useful model belongs to medicine, namely to surgery, and can be used to treat patients with pathological processes of the abdominal cavity, when removal or resection of an organ is performed by laparoscopic access.

Known methods of removing the drug from the abdominal cavity through a trocar with a diameter of 10 or 12 mm using a laparoscopic instrument (1, 21.

The disadvantage of these methods is that they cannot be performed when using trocars with a diameter of 5 mm and a trocar for a laparoscope with a diameter of 10 mm, because the size of the removed organ is more than 5 mm, and removal through the trocar occupied by the laparoscope is impossible due to the lack of visualization during the removal of the laparoscope.

The basis of the useful model is the task of creating such a method of removing the drug from the abdominal cavity during laparoscopic operations, which, due to the exclusion of the introduction of additional trocars, would ensure safe removal of the drug through a trocar with a diameter of 10 or 12 mm with a laparoscope under visual control.

The task is solved by the fact that the method of removing the drug from the abdominal cavity during laparoscopic operations includes a number of standard procedures, such as skin incision in the umbilical region without prior application of pneumoperitoneum, puncture of the abdominal wall with a trocar, revision of the abdominal cavity, further surgical intervention is required, and then, according to a useful model, the drug to be removed is fixed with a ligature inserted through the trocar with a Roeder's loop |Z| at the end and by tightening the loop on the edge of the drug, it is pulled through a trocar with a diameter of 10 or 12 mm behind the ligature after the removal of the laparoscope.

The method is performed as follows. After the resection or removal of the organ, the laparoscope is removed and through the laparoscope trocar with a diameter of 10 or 12 mm using a laparoscopic clamp, a ligature with a formed Roeder's loop is inserted at the end, the free end of the ligature is left outside the trocar, the laparoscope is again inserted parallel to the ligature through the trocar, a loop is placed on the edge of the preparation and tighten it on the edge of the preparation with the help of tools that are introduced through operating trocars with a diameter of Ж or 5 mm. After tightening the loop by traction on the free end of the ligature, the drug is pulled to the trocar, the laparoscope is removed and the drug is pulled out through the trocar by the ligature.

Example: Patient O., medical history Mo 1741/2018, hospitalized in the clinic with a diagnosis of gallstone disease: chronic calculous cholecystitis. A trocar with a diameter of 10 mm was inserted into the patient through the navel, three trocars with a diameter of 3 mm were inserted into the typical points, and a laparoscopic minicholecystectomy was performed. After removal of the gallbladder, the laparoscope was removed and a ligature with a formed Roeder's loop at the end was inserted through a trocar for a laparoscope with a diameter of 10 mm using a laparoscopic clamp, the free end of the ligature was left outside the trocar. Parallel to the ligature, a laparoscope was again introduced through the trocar, a loop was placed on the edge of the gallbladder in the neck area and tightened on the gallbladder with the help of instruments inserted through operating trocars with a diameter of 3 mm. After tightening the loop, the gallbladder was pulled to the trocar by traction on the free end of the ligature, the laparoscope was removed, and the drug was pulled out through the trocar by the ligature. The patient was discharged the next day in a satisfactory condition, the postoperative wounds healed with primary tension.

The proposed method was performed in 16 patients with cholecystitis and appendicitis; no complications were observed.

Thus, the use of this method allows you to reduce the trauma of the operation and improve the cosmetic effect of the intervention.

Sources of information: 1. Sazhyn V.P., Fedorov A.V., Sazhyn A.V. Endoscopic abdominal surgery. - M.:

GZOTAR-Media, 2010. - P. 228. 2. Pryakhin A.N., Gazizullin R.3. Laparoscopic appendectomy. - Chelyabinsk, 2005. -

P. 34. 3. Sazhyn V.P., Fedorov A.V., Sazhyn A.V. Endoscopic abdominal surgery. - M.:

GZOTAR-Media, 2010. - P. 66.

Claims (1)

USEFUL MODEL FORMULA The method of removing the drug from the abdominal cavity during laparoscopic operations, which includes a number of standard procedures, such as a skin incision in the umbilical region without prior application of pneumoperitoneum, puncture of the abdominal wall with a trocar, revision of the abdominal cavity, surgical intervention, which is distinguished by the fact that the removal of the drug from the abdominal cavity is carried out as follows: the drug is fixed with the help of a ligature introduced through the trocar with a Roeder's loop at the end, and by tightening the loop on the edge of the drug, it is pulled out through the trocar by the ligature after removing the laparoscope.