METHOD OF MANUAL ASSISTED LAPAROSCOPIC SURGERY WITH OPEN ABDOMINAL INJURY Russian patent published in 2018 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to surgery and may be applicable to manual assisted laparoscopic surgery with open abdominal trauma. First trocar is injected into right or left iliac region, opposite the localization area of the wound of the abdominal wall. Through the trocar in conditions of carboxyperitoneum 12–14 mm Hg. conduct video laparoscopy and assess the nature of damage to wound of the abdominal wall. Perform a mini-access in the middle line above the umbilicus 7–8 cm in length, install an access device containing a wound retractor and a lid with a diaphragm to insert the surgeon's arm. Second trocar is injected into ileum, opposite the first installed trocar. In the second trocar, a video laparoscope is moved. Endoscopic instrument is injected into first trocar. Surgery is continued under carboxyperitoneum conditions. Under control of the video laparoscope with use of endoscopic instruments and manual assistance, first a revision of the abdominal organs located in the area of injury, then – in the opposite direction. In presence of damage of inspected organs, they are corrected. Carboxyperitoneum is eliminated. In the wound of the mini-access in the middle line above the navel, the small intestine is removed, its revision is performed and, if damaged, it is sutured. Perform drainage of the abdominal cavity. Device is removed from the wound. Wound of the mini-access is sutured layer-by-layer.

EFFECT: method allows to simplify the technique and shorten the operation time, provide good visualization and low traumatism.

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