METHOD OF SEWING PERFORATED OPENING WITH UNINTERRUPTED TWO-LEVEL SUTURE Russian patent published in 2009 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to surgery, can be applied for sewing perforated opening in treatment of perforated ulcer of pyloroduodenal part of gastrointestinal tract. Uninterrupted serous-muscular two-level suture is applied using knots-fixers. For this purpose during application of first level of suture first stitch is made at distance 0.5-1.0 cm more aborally than perforated opening in transversal direction from lesser curvature side. Further, second stitch is applied in longitudinal direction at distance 0.5 cm from perforated opening. Third stitch is made 0.5-1.0 cm higher than perforated opening in transversal direction. Further, fourth stitch is made parallel to second at distance 0.5 cm from perforated opening. Then fifth stitch is made parallel to first with outgoing of thread on the opposite edge of duodenum wall. First level of suture is fixed with knot-fixer at the beginning of thread before first stitch and knot-fixer by applied at the end of first level suture after tightening the thread till tissue contact. Application of second level of suture is performed with the same thread. For this purpose stitch on stomach is applied successively in transversal direction 1.0-2.0 cm higher than perforated opening. After that stitch on duodenum is applied in transversal direction 1.0 cm lower than perforated opening and stitch on stomach in transversal direction 1.0-2.0 cm higher than perforated opening. After that thread is tightened until full tissue contact. Ends of threads are tied to each other.

EFFECT: method allows to sew perforated opening reliably due to increase of area of contact of sewn walls serous membranes, reduces probability of stricture formation in pyloroduodenal part due to application of knots-fixers.

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