METHOD OF RECONSTRUCTION OF VASCULAR BED WITH REMOVAL OF WIDE LOCAL TUMORS OF SMALL PELVIS WITH INVASION IN MAIL ILIAC VESSELS Russian patent published in 2018 - IPC A61B17/11 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to surgery, in particular to oncological surgery of pelvic organs. Iliac vessels are mobilized proximal and distal to the tumor infiltration area. They are clamped and crossed, retreating from the visible boundaries of the neoplastic process at least 1 cm in both directions. In the central stump of the main artery, a flexible polyvinylchloride tube is inserted, wherein the tube is 4-5 times longer than the resected portion of the arterial vessel and is fixed with a purse suture. Other end of this tube is implanted into the peripheral stump of the main artery, after which vascular clamps are removed. Resection stage of the intervention is completed and the temporary shunt is removed. Arterial bed is further reconstructed. Prosthetics of the external iliac artery with a synthetic vascular prosthesis is performed. Venous bed is reconstructed, for this purpose a large subcutaneous vein is mobilized contralateral with respect to the resected iliac vessels of the lower limb. And the mobilization is performed from the entrance to the middle third of the thigh, inclusive. Trunk of the great saphenous vein is crossed and bandaged. Mobilized segment of thegreat saphenous vein through the tunnel formed in the subcutaneous tissue of the suprapubic region is led into the opposite inguinal region, where from a separate access it is anastomosed with the common femoral vein. At the final stage, the synthetic vascular prosthesis is isolated by mobilizing a large gastrocolic omentum strand on the feeding stem, which is reduced to a small pelvis and fixed around the arterial vascular prosthesis with separate sutures.

EFFECT: method allows achieving radicalism without the risk of irreversible ischemic changes in tissues of the lower extremity, ensuring the restoration of venous outflow from the lower limb, shortening the period of rehabilitation of patients in the postoperative period, as well as reducing the risk of arrosive bleeding from the vascular reconstruction area and rejection of a vascular prosthesis.

1 cl, 6 dwg, 1 ex