METHOD FOR DETERMINATION OF OPTIMAL TROCAR ARRANGEMENT DURING LAPAROSCOPIC OPERATIONS ON ABDOMINAL AORTA AND ITS BRANCHES Russian patent published in 2017 - IPC A61B17/34 

FIELD: medicine.

SUBSTANCE: CT aortography is performed preoperatively. Two main instrumental axes are plotted, with the angle between the axes equal to 45°, laparoscope optical axis is plotted, with the angle between the optical axis and the surgical actions plane equal to 90°, the angle between the main instrumental axes and the optical axis of more than 10°, and the angle between the main axes of instruments and the intervention object plane of 60°. At that, the vector is directed to the conditional plane of the intervention object. Location and degree of calcification of the aorta and its branches is estimated to determine aortic clamping zones and direct additional instrumental axes for endoscopic vascular clamps, assistant tools. The point of axis intersection with the anterior abdominal wall skin is recorded, which is the point of instrumental trocar introduction, with a distance between trocar introduction points less than half the length of the instrument used, length of the segment from the point of axis intersection with the anterior abdominal wall skin to the intervention object of no more than 2/3 of the length of the instrument used. A vertical line is plotted through the xiphoid process, a horizontal line - through the iliac bones spine; these lines act as x and y axes to form the coordinate plane on the anterior abdominal wall. Using the obtained coordinates, trocar introduction points are projected to the anterior abdominal wall.

EFFECT: method allows to provide adequate laparoscopic access to the abdominal aorta and its branches.

2 dwg