FIELD: medicine.
SUBSTANCE: method involves exposing abdominal cavity by making upper median incision. Seromuscular purse-string suture is placed on stomach wall. An incision is carried out in its center. Gastrostoma tube is introduced into the stomach cavity via the incision. Serous canal is built from the stomach wall by additionally stitching two seromuscular semi-purse-string sutures after having applied a seromuscular purse-string suture outward from it. Free ends of threads of one of the semi-purse-string sutures are directed upward and the other semi-purse-string suture are directed downward. Penetrating blanket suture is fixed by tightening and tying thread ends of this suture around the tube. Transrectal layer-by-layer incision is done to the left. The gastrostoma tube exit is made into the wound. Thread ends are brought through the anterior abdominal wall layers to external vaginal membrane plate of the musculus directus abdominis, tightened and tied. Stomach wall is fixed to parietal peritoneum in two stages. Two seroserous sutures are made at the first stage before conducting semi-purse-string suture thread ends through abdominal wall layers to the external vaginal membrane plate of the musculus directus abdominis some distance lateral from the semi-purse-string suture between the anterior stomach wall and parietal peritoneum sheet of the anterior abdominal wall to the left from the transrectal wound mouth. Two seroserous sutures are made at the second stage in medial position with respect to the transrectal incision.
EFFECT: high reliability of fixation; reduced risk of infectious complications.
2 dwg
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Authors
Dates
2004-12-20—Published
2003-02-21—Filed