METHOD FOR FORMING COMPRESSION-VALVULAR ESOPHAGEAL-SMALL-INTESTINAL ANASTOMOSIS Russian patent published in 2007 - IPC A61B17/11 

FIELD: medicine, surgery.

SUBSTANCE: the present innovation deals with forming esophageal-small-intestinal anastomoses after gastrectomy. It is necessary to suture in duodenal stump, form muscular sphincter at esophageal distal end due to folding and suturing up a muscular membrane to longitudinal esophageal layer, apply an esophageal-small-intestinal anastomosis upon a long loop. Before applying a compression anastomosis onto counter-mesenteric edge of small intestine one should fulfill hydropreparing of seroso-muscular membrane against mucous-submucous layer with physiological solution for the length of about 2.5-3 cm. In transverse direction at the site of hydropreparation it is necessary to fulfill an incision of seroso-muscular layer for the width of esophagus, form a tunnel in aboral direction. It is important to apply interrupted sutures onto posterior semi-circumference of inferior edge of esophageal sphincter and inferior edge of seroso-muscular layer of small intestine, esophageal mucosa should be applied into the tunnel formed, onto anterior semi-circumference of inferior edge of esophageal sphincter and seroso-muscular layer one should apply interrupted sutures. Parallel to the applied anastomosis at the distance of 4 cm being aborally it intestinal incision should be carried out to dissect through this incision a mucous-submucous layer along inferior edge of the tunnel formed. Anterior semi-circumference of esophageal mucosa should be fixed with interrupted sutures through enterotomal incision towards intestinal mucosa. Through the incision it is necessary to apply an implant as a cooled and unclasped clip out of two coils of shape-memory titanium nickelide. One coil should be applied onto posterior semi-circumference of esophageal mucosa, and another - onto exfoliated mucous-submucous intestinal membrane. The clip should be heated with the flow of hot physiological solution from the syringe till its compression. Enterotomal incision should be sutured with separate interrupted sutures. The innovation enables to remove reflux-connected complications and helps to simplify technical procedure of operative interference.

EFFECT: higher efficiency.

11 dwg, 1 ex