FIELD: medicine, urgent abdominal surgery.
SUBSTANCE: one should carry out longitudinal duodenotomy up to mucous membrane through the center of perforative opening through stenosis, make incisions of serosa being parallel to circular fibers, fulfill tunnelization through incisions in muscular layer, cut out a seroso-muscular flap out of seroso-muscular membrane of anterior gastric wall and apply it through the tunnel, apply a flap onto the ulcer with serous membrane. Due to applying the flap in distal direction one should transform longitudinal duodenotomy into transverse one till the juncture of edges and in this position the flap should be fixed up. Gastric defect should be covered due to suturing up the strand of greater omentum; longitudinal duodenotomy should be fulfilled for the length of about 2-4 cm; serosal incisions should be made at 0.5-1 cm against duodenotomy edge upwards and downwards. The innovation enables to remove duodenal stenosis, increase reliability and hermetic sealing of sutures, improve circulation in this area, exclude deformation of organ's wall and disorders in gastric evacuatory function.
EFFECT: higher efficiency.
2 dwg, 1 ex
