METHOD OF LAPAROSCOPIC APPENDECTOMY CONVERSION THROUGH UMBILICAL APPROACH Russian patent published in 2012 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: umbilical laparoscopic monoapproach along an inner border of an umbilical ring is made by a half-moon-shaped skin incision 1.5-2.0 cm long to the right from an umbilical centre towards an anterior superior spine of iliac bone. Subcutaneous fat is taken apart by Bilroth's hemostatic forceps with exposing aponeurosis of abdominal rectus muscle. A 10-mm trocar is used for direct abdominal puncture through the half-moon-shaped incision through anterior and posterior sheath leaves and a medial edge of abdominal rectus muscle. Two 5-mm trocars are inserted into the approach wound by separate puncture of aponeurosis to be brought through a layer of subcutaneous fat around the navel, the anterior and posterior sheath leaves and the medial edge of abdominal rectus muscle at 2-3 mm from the first trocar. It is followed by conversion to transumbilical video-assisted extracorporeal appendectomy by removing two trocars, eliminating carboxyperitoneum, bringing a vermiform appendix through the approach wound, and performing appendectomy outside the abdominal cavity.

EFFECT: method enables the surgical intervention in the patients with obesity, reducing a risk of postoperative hernias.

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