METHOD OF OESOPHAGEAL-INTESTINAL ANASTOMOSIS AND PROBE FOR METHOD IMPLEMENTATION Russian patent published in 2009 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention concerns medicine, particularly surgery, and can be applied in surgical treatment of stomach cancer patients. To form oesophageal-intestinal anastomosis during gastroectomy a coupling is shaped out of small intestinal loop after oral insertion of probe to oesophagus. Sutures between coupling, diaphragm and oesophagus are made. Oesophagus passes through the coupling attached to diaphragm and esophagus. Then oesophagus is attached to coupling by three sutures. Seromuscular layer of abduct intestine is incised in lengthwise direction, and seromuscular layer of adduct intestine is incised in transverse direction. Adventitial muscular shell of oesophagus is incised in circle. Probe head is shifted forward, content of abdominal oesophagus segment undergoes aspiration. Two pass-through knot corner sutures are made between small intestine sections and oesophagus for anastomosis. Suture ligates are pulled in direction parallel to abduct intestine axis. Pass-through knot sutures are made between internal semicircles of adduct and abduct small intestine wall cut and between left and right oesophagus walls respectively. Suture ligates are tied, threads are cut off, followed by pass-though knot suture application between external semicircles of adduct and abduct intestine wounds. Suture ligates are not tied. Intestine and stomach mucosa are incised. Oesophagus segment is removed along machine stitch line. Probe is removed. Ligates of pass-through sutures applied previously between adduct and abduct intestine are tied. Ligate of the last suture forming T-shaped racket is used to stitch adduct and abduct sections together towards oesophagus, so that the last suture stitch catches diaphragm peritoneum. Special device is used for implementation of method of oesophageal-intestinal anastomosis forming.

EFFECT: facilitated forming of oesphageal-intestinal anastomosis in negative anatomic environment, ie for adiposity patients with short oesophagus and high diaphragm position, prevention of cicatrical stenosis of oesophageal-intestinal anastomosis for patients with wide oesophagus and narrow small intestine.

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