FIELD: medicine.
SUBSTANCE: investing tissues, pectoral fascia and presternum are reciprocally incised at 1.0 cm from sternal borders at the level of I hypochondrium at 20-30 degrees to a horizontal line. Investing tissues are incised along a left border of mesosternum, ends of II-VII ribs are detached therefrom, and anterior mediastinum is exposed. An anterior mediastinocostal fold of parietal pleura is incised, and a pleural cavity is exposed. A diaphragm portion of pericardium is separated from diaphragm. The incision of investing tissues is extended from a left border of mesosternum along a medial border of abdominal rectus muscle and finished at 5 cm from a femoral arch. An anterior wall of rectus sheath is incised, the muscle is mobilised and brought to the outside. Laparotomy is performed through a centre of a posterior wall of sheath. An abdominal peritoneum is incised from the abdominal cavity along a left lateral, retroperitoneal fat with descending segmented intestine, left kidney, pancreas is detached from a posterior abdominal wall, and brought to the right turning about vascular pedicles. The whole abdominal aorta is exposed. Pericardial diaphragm is incised from an angle of sternocostal triangle to an aortic foramen with opening a portion of descending thoracic aorta through a diaphragm incision.
EFFECT: method enables reducing sternal, muscular and neurovascular injuries.
2 dwg
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Authors
Dates
2012-11-20—Published
2011-07-26—Filed