FIELD: medicine, neurosurgery.
SUBSTANCE: in a patient's sitting position at fixing the head and bringing the brachial girdle inwards it is necessary to fulfill the incision in the form of "a hockey bandy", the line of which should be started from the spinous process of C-5 vertebra to continue it through the middle of the distance between spinous processes and internal scapular edge to finish it at the level of scapular spine. Skin and subcutaneous-fatty fiber should be dissected to introduce a retractor by opening the posterior surface of trapezius muscle which should be crossed by separating muscular edges with the help of the retractor; then it is necessary to open elevator muscle of scapula and minor rhomboid muscle to mobilize them and separate laterally by opening the posterior thoracic surface followed by subperiosteal dissection of long muscles of head and neck; then the retractor should be replaced by separating elevator muscle of scapula out wards, and long muscles of head and neck - inwards by opening the arches and intervertebral foramens C-5, C-6 and C-7 of vertebrae and the contours of the first rib, near the site of fixation towards the first rib one should dissect scalene and intercostals muscles to install the second retractor by opening the trunks of brachial plexus. The innovation enables to carry out efficient therapy at different forms of the lesions of the trunks of brachial plexus due to providing adequate safe approach to the affected structures and their complete survey, it enables to considerably decrease the risk in the development of post-surgical complications caused with the lesions of nervous-vascular structures, pleura, affected integrity and reconstruction of muscular carcass and avoid the development of scapular dislocation.
EFFECT: higher efficiency.
1 ex
