FIELD: medicine.
SUBSTANCE: right-sided hemi-colectomy is performed. A spout with a feed mesenteric vessel is formed at a distal end of the small intestine. A colonic wall is incised transversally. An anterior and then posterior lips of the anastomosis are formed with one-row interrupted sutures. Creating an ileotransversoanastomosis with an absorbable suture involves pricking a needle into an enteric wall at 2.0-2.5 cm from the edge from a mucous membrane, moved through a muscular layer, a submucous layer and pricked out onto the enteric mucosa at 1.0-1.5 cm from the edge. The needle is pricked in from the enteric mucosa at 0.5-0.8 cm from the edge, and a free end of the spout is inserted into a point between the submucous and muscular layers of the small intestine. Inside out, the needle is pricked into a point between the submucous and muscular layers of the large intestine and brought out onto the serous layer at 0.25-0.3 cm from the edge. The sutures are crossed over and held tight. The ectopic excess enteric mucosa and submucous layer are put inside to form antireflux valve leaflets. The serous layers of the small and large intestines are aligned to make the anastomosis leak-proof. A blind part of a proximal end of the large intestine is underrun above the anastomosis with interrupted seromuscular sutures to cover the anastomosis additionally.
EFFECT: method enables providing the reliable homeostasis, leak-tightness, the adequate valve function of the end-to-side transversal invaginated ileocolonic anastomosis ensured by the precise alignment of the intestinal wall layers.
1 ex, 2 dwg
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Authors
Dates
2015-07-10—Published
2014-10-17—Filed