METHOD OF ANTEGRADE INTRAOPERATIVE IRRIGATION OF LARGE INTESTINE IN ACUTE OBTURATION INTESTINAL OBSTRUCTION IN CANCER OF LEFT LARGE INTESTINE Russian patent published in 2009 - IPC A61B17/11 A61M31/00 

FIELD: medicine.

SUBSTANCE: invention concerns medicine, namely surgery. A device is introduced into large intestine lumen through its wall to perform irrigation of large intestine. Thus large intestine is decompressed by puncturing its wall above and closer to the tumour with using a trocar with a polyvinyl tube. After an affected region of large intestine is resected, a sterile tube bushing made of medical polymer material with circular corbellings in its external surface is inserted into the lumen of proximal end. With using said corbellings, wall of proximal end of large intestine is tightly fixed with purse-string suturing on external surface of the tube bushing. Onto external surface of proximal end of large intestine fixed on the tube bushing, a sterile whole-cut evacuation polyethylene sleeve is fixed on circle of the tube bushing with interrupted ligature. Excess sleeve closes fixation point of wall of proximal end of large intestine with the tube bushing. The second end of the evacuation sleeve is placed in a container with an antiseptic. Through vermiform appendix, after its half-length resection, a metal catheter is inserted. Its diametre relates with the lumen of vermiform appendix. The catheter is fixed circumferentially with silk ligature to the rest of vermiform appendix. The second end of the catheter is tubed to a device that supplies perfusion solution into large intestine lumen. Large intestine is cleaned from intestinal contents within 30-40 minutes. Perfusion solution is 0.9% saline solution in amount 5-7 litres. At the end of large intestine irrigation procedure, the last litre of perfusion solution is additionally added with enterosorbent in amount 40-50 gram, metronidazole in amount 100 ml and Perftoran in amount 100 ml. After irrigation the catheter is removed from resected vermiform appendix that is followed with standard appendectomy. From proximal end of large intestine, the tube bushing with the evacuation sleeve within resection of wall of large intestine over the removed bushing. A single-layer anastomosis is formed without protective colostomies. In that specific case, as an enterosorbent in perfusion solution for cleaning large intestine from intestinal contents, Enterosgel is used.

EFFECT: method allows improving reliability of intraoperative irrigation of large intestine with simultaneous simplification of manipulation of large intestine in preparation thereof for resection and intraoperative irrigation, reducing operative injuries and risk of infection of abdominal cavity, providing consistency of intestinal anastomosis.

2 cl, 2 dwg, 3 ex