FIELD: medicine.
SUBSTANCE: invention refers to medicine, namely to coloproctology. The pedicle ileoascendocecal complex is mobilised after the rectum resection, rotated counterclockwise after appendectomy, and descended. Anastomoses are formed between the oral end of the ileum and the aboral end of the ascending ileum, the oral end of the sigmoid colon or the descending ileum, and the aboral end of the ileum of the ileoascendocecal graft. The oral end of the ascending colon is closed tightly with a handmade suture or with using a linear stapling apparatus. A blanket purse suture of the rectal stump is formed from the abdominal cavity; a head of a circular suturing device is inserted into the lumen from the side of the abdominal cavity, and the purse suture is tightened thereby fixing the head in the rectal stump. A hole, equal to the diameter of the suturing device is formed in the head of the blind colon of the graft; the purse suture is applied around. The graft is laid into the presacral space; the circular suturing device of the respective diameter is inserted into the lumen of the ileoascendocecal complex in the antegrade direction; the colon wall is perforated with using a surgical pike within the oral end of the ascending ileum, and its central canal is connected to the head of the stapling apparatus in the rectal stump or anal canal. An instrumental anastomosis is formed, and the apparatus is removed; thereafter the purse suture is tightened and closed with single interrupted sutures.
EFFECT: method enables reducing the rate and intensity of defecation and continence disorders following the rectum resection and anastomosis-associated complications.
1 dwg
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Authors
Dates
2015-07-10—Published
2013-03-14—Filed