FIELD: medicine.
SUBSTANCE: invention relates to surgery and can be applied for application of permanent gastrostomy. Medial upper laparotomy is carried out. Anterior wall of stomach of body area is pulled out with holder. Near cone base from the side of greater and minor curvature two semi-purse-string sutures are applied with formation of 2.5-3 cm long and 3-4 cm high transverse fold of anterior stomach wall. Formed fold of stomach wall and threads of semi-purse-string sutures are taken out through separate left-side transrectal 3 cm long access, skin, anterior wall of sheath of rectus muscle of abdomen and rectus muscle are dissected vertically, posterior wall of sheath of rectus muscle and parietal peritoneum are dissected horizontally. Anterior stomach wall is fixed with threads of semi-purse-string sutures to posterior wall of sheath of rectus muscle of abdomen near ends of its transverse cut. By means of two serous-muscular sutures, applied with 1-1.5 cm indent from holder, fold is stretched vertically and sutured to anterior wall of sheath of rectus muscle of abdomen near the ends of its cut. Fold apex is opened and stomach mucosa is sutured to edges of skin cut with formation of slit-like fistula, passing through anterior abdominal wall in two mutually perpendicular planes.
EFFECT: method makes it possible to increase reliability of fistula valve apparatus and its air-tightness.
1 ex, 3 dwg
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Authors
Dates
2011-08-27—Published
2010-04-26—Filed