FIELD: surgery.
SUBSTANCE: access to the stomach is performed through left-side upper transrectal laparotomy 3-4 cm long. After that, purse-string suture is applied circumferentially (diameter 2 cm) to the anterior wall of stomach. Hole to introduce gastrostomal tube is formed using scalpel. Two semipurse-string sutures are applied at a distance of 1 cm from the purse-string suture and are tied up. Each pair of threads is used to pierce anterior abdominal wall at a distance of 1-1.5 cm from the angle of wound. Ends of these threads are taken out on skin and tied up. Separate six threads, three ones on each side, are used to pierce serous, muscular, and submucous layer of stomach, peritoneum, fascia, coverlets of abdominal wall, and these sutures are then tied up. Finally, additional fixation of gastrostomal tube is made using ends of semipurse-string suture threads taken out on skin.
EFFECT: increased reliability of fixation and prevented possible complications.
2 dwg
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Authors
Dates
2004-08-27—Published
2002-07-09—Filed