METHOD OF SURGICAL MANAGEMENT OF PULMONARY TUBERCULOSIS Russian patent published in 2012 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: method involves thoracoplasty, separation of muscle bundles from parietal pleura, extrapleural pneumolysis of an apex of lung, creation of a new pleural cupula by application of a contractive element which is fixed to anterior and posterior segment of an underlying rib onto the apex of lung, formation of a bone-rib block. Thoracoplasty is implemented in its osteoplastic version. That is ensured by making a paravertebral incisions to expose the posterior segment of the first to fifth ribs to be transected at a spinal column; the second and third ribs are resected by 3 cm and 5 cm respectively; the forth rib - to a posterior axillary line, and the fifth rib - to an anterior axillary line. The contractive element is cut out in the form of a tape 2-5 cm wide from a fine-meshed screen of a non-absorbable biocompatible synthetic material and long enough to fix the tape ends to the respective ribs. The first tape end is fixed to a first costosternal joint, or in case of the cavern size exceeding 4 cm, to a second costosternal joint. Thereafter, a free tape end is thrown over a lung cupula with holding one end close to a mediastinum. Upon completion, the tape is tighten and kept in such a manner to fix its free end. Then a bone-rib frame is formed of the posterior segments of the first to third ribs.

EFFECT: use of the given invention enables preserving the integrity of the parietal pleura, providing an effective controlled collapse of the apex of lung, creating a reliable support for a new lung cupula, reducing a probability of paramediastinal lung hernia.

7 dwg, 2 ex