METHOD OF FORMING CROSS GASTROJEJUNAL ANASTOMOSIS AFTER SUBTOTAL DISTAL GASTRECTOMY Russian patent published in 2016 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine and surgery. Lesser gastric curvature is formed linear stapling and continuous blanket sutures. After subtotal distal gastrectomy gastrojejunal anastomosis is formed. On jejunal loop, two side serous-muscular-submucosal suture is made. Left seam threat is used to suture wall of stomach along greater curvature. Right seam thread is used to suture lesser gastric curvature. Thread of said joints is pulled, bringing rear wall of stomach closer with intestine. U-sutures are formed outside rear row of future anastomosis. Near external seams, taken on holder, a “spur” is formed, eliminating casting food discharge intestinal loop. Wall of stomach is dissected. Serous-muscular-submucosal U-sutures are sutured edges incisions at small curvature of stomach and jejunum. Serous intestinal edge is closed by connection of gastric walls at curvature. Inner front lip of anastomosis is formed with interrupted sutures without mucosa. Threads of back row of sutures semi-purse-string sutures are formed on wall of intestine. 4-5 "slide" outer seams are made on anterior wall of anastomosis, herewith invaginating stomach in intestine. Leading part of intestine is sutured to curvature above purse-string suture.

EFFECT: method provides portion evacuation gastric content in loop by maintaining a circular structure of muscular layer at its transverse incision, minimises risk of leak due to strengthening internal angle anastomosis, reduces tension in zone of gastroenteroanastomosis by retrocolic location of gastric stump.

1 cl, 1 ex, 7 dwg