FIELD: medicine; surgery.
SUBSTANCE: intestinal resection is followed with adducting intestine invagination to abducting followed with interrupted suturing. Anastomosed adducting and abducting segments lumens are closed with stapling suture. Seromuscular layer is dissected circularly under staples until submucous layer of anastomosed adducting and abducting segments are uncovered. Intestinal anastomosis is formed with closed stapling suture in anastomosed intestine lumens. At first posterior lip is formed with interrupted one-row suturing punctures by submucous, muscular and serous membranes of one intestine and puncture out by serous, muscular and submucous membranes of the other intestine. Thus puncture in and out are carried out on distance 0.3-0.5 cm from edge of a seromuscular line of each anastomosed intestine in number of 3 sutures per 1 cm of suture line. Sutures are tightened after whole posterior semicircle is formed. Then anastomosed intestine segments closed with stapling sutures are cut off. Distal segment of mucosubmucous membrane by seromuscular of abducting anastomosed intestine. Surplus of mucosubmucous membrane of proximal adducting anastomosed intestine is formed by crossing its mucosubmucous membrane within 1-1.5 cm from seromuscular layer. Then anterior semicircle of intestinal anastomosis is formed by one-row sutures with knots outside. Puncture in and out is carried out by distance in 0.3-0.5 cm from edge of seromuscular line of each anastomosed intestine in number of 3 sutures per 1 cm of suturing line. Seams are tighten after whole anterior semicircle is formed. During formation of anterior anastomosis semicircle surplus of mucosubmucous membrane of adducting anastomosed intestine is invaginated free within lumen of abducting anastomosed intestine, covering suturing line of formed anastomosis with surplus.
EFFECT: method provides increased reliability of one-row anastomosis of large intestine; to lower operational traumatism and creates conditions for healing anastomosis by primary tension.
2 cl, 7 dwg, 2 ex
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Authors
Dates
2008-07-20—Published
2006-12-29—Filed