METHOD OF SIMULTANEOUS OPERATIONAL INTERVENTION WITH CHRONIC CALCULOSIS CHOLECYSTITIS IN CONNECTION WITH THE ULINSULAR HERNIA AND DIASTASTIS OF DIRECT MUSCLES OF THE ABDOMIS Russian patent published in 2019 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to surgery, and can be used in simultaneous surgery of chronic calculous cholecystitis in combination with umbilical hernia and diastasis of rectus muscles. For this, trocars are introduced into the abdominal cavity at 4 places: “Umbilical” – 10-millimeter port is introduced directly above the navel (the first trocar); “Epigastric” – 5 mm port is introduced 2–3 cm below the xiphoid process along the median line (the second trocar); on the anterior axillary line 3–5 cm below the costal arch – 5 mm trocar (the third trocar); on the midclavicular line 2–4 cm below the right costal arch – 5 mm trocar (the fourth trocar). Then laparoscopic cholecystectomy is performed, for which a laparoscope is inserted into the abdominal cavity by means of the first trocar, the second and the third trocars – tools for extracting the gallbladder neck, and the fourth trocar – the clamp that captures the bottom of the gallbladder are introduced into the abdominal cavity. After this, the rectification of rectus muscles diastasis is performed by means of a tension plasty with the closure of the diastasis and installation of a mesh endoprosthesis and umbilical hernia hernioplasty. To do this, an additional 10-mm trocar (fifth trocar) is installed through a separate incision in the mesogastric region on the left, a laparoscope is introduced into the third trocar, a grasper is introduced into the second trocar, tools for fixing the mesh endoprosthesis are introduced. A defect in the navel area is sutured by applying transfascial sutures.

EFFECT: method provides a reduction in the number of surgical interventions, a reduction in trauma of simultaneous surgical intervention, as well as a reduction in the duration of operation, a reduction in the risk of reoperation, while simultaneous improving of the aesthetic result of the surgical intervention.

1 cl, 2 ex