LAPAROSCOPIC METHOD FOR FUNDOPLICATION CUFF FORMATION Russian patent published in 2015 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to surgery and is applicable for the laparoscopic formation of a fundoplication cuff. The lesser curvature of the stomach is mobilised. Branches of the left gastric artery and secretory fibres of the tenth cranial nerve are transected. The motion portion of the nerve of Latarjet is preserved. The gastric fundus is mobilised with transecting 2^nd-3^rd short gastric arteries. The retroperitoneal portion of the cardiac orifice and 6-7 cm of the abdominal oesophagus are mobilised. The fundoplication cuff is formed on a thick gastric probe. The first non-absorbable suture covers the seromuscular layer of anterior and posterior walls of the gastric fundus and obligatory the muscular layer of the oesophageal wall at 3-4 cm above the oesophagogastric junction. The gastric and oesophageal walls are pulled by the anterior gastric wall traction from the left lateral approach by means of a non-traumatic clamp. The posterior and anterior gastric walls are put together about the abdominal oesophagus. The fundoplication cuff 4.0-4.5 cm long is formed with a continuous suture from up to down from the first suture. The suromuscular layer of the anterior and posterior gastric walls and the muscular layer of the oesophageal wall are taken into a non-absorbable suture. The upper edge of the cuff is fixed to the oesophagus from the front and from the back with a non-absorbable suture similarly to oesophagofundography. The method enables reducing the risk of postoperative complications, improving functional results and the patient's quality of life, reducing the surgical risk, achieving symmetry and preventing the cuff deformity and slipping, as well as providing a shorter period of staying in hospital, earlier activation and use of enteral nutrition by using a laparoscopic technique, taking the anterior and posterior walls of the gastric fundus by the first suture of the seromuscular layer and obligatory anchoring of the muscular layer of the oesophageal wall, accurate alignment of the posterior and anterior walls of the gastric fundus by traction with the use of the non-traumatic clamp, cuff formation from up to down, use of the continuous non-absorbable suture.

EFFECT: laparoscopic formation of the fundoplication cuff.

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