METHOD FOR SURGICAL MANAGEMENT OF ACHALASIA OF CARDIA Russian patent published in 2015 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgery, and is applicable in treating achalasia of cardia. An approach is exercised. An abdominal cavity is inspected. A lesser curvature, a cardia and a fundus of stomach are mobilised with transecting short vessels, left gastroomental artery and vein, and diaphragm pedicles. Diaphragm and lower thoracic oesophagus are mobilised and brought down into the abdominal cavity. An oesophagocardiomyotomy is performed along a mid-line of a posterior oesophageal wall of the length of 7.5-8.5 cm and extends onto a posterior wall of the fundus of stomach of the length of 2.5-3.5 cm. Gastric walls are fixed to an oesophageal wall and a diaphragm. An incomplete oblique fundoplication cuff is formed with increasing a degree of oesophagus wrapping in the distal direction. The cuff is fixed to the diaphragm by anchoring the posterior gastric wall to right and left lateral oesophageal walls and respective walls of an oesophageal opening with covering a myotomy incision. The gastric wall is fixed along the right anterior oesophageal wall 0.4-0.6 cm above the cardia at 0.5-0.8 cm in the medial direction from the distal suture fixing the posterior portion of the fundoplication cuff along the medial oesophageal wall directly above the cardia.

EFFECT: method provides increasing the clinical effectiveness in achalasia of cardia, reducing the manifestations of pain syndrome, rate of postoperative complications, preventing remote development of reflux oesophagitis and dysphagia by mobilising the oesophagus throughout the great duration, performing the posterior oesophagocardiomyotomy, forming the anterior-posterior extended fundoplication cuff.

2 dwg, 1 ex