METHOD FOR SURGICAL MANAGEMENT OF III-IV CARDIAC ACHALASIA, COMPLICATED BY S-, L-SHAPED OESOPHAGEAL DEFORMATION Russian patent published in 2020 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to abdominal surgery. Wall-to-wall mobilization and lower thoracic oesophagus lowering is performed to its moderate tension state. Seromuscular membrane of the anterior and posterior walls of the stomach is incised at 3.5 cm from the cardia. From the edge of the incision, the seromuscular lining of the stomach and the lowered oesophagus are removed in the form of a "stocking" for 16 cm. Demuscularization area of the mucous-submucosal layer is invaginated into the gastric lumen by means of 6 interrupted sutures applied along a line of osseous membrane and stomach contact. On the anterior wall of stomach at 14 mm below the sutures a seromuscular flap with length of 45 mm, width of 20 mm with axial circulation in the region of the stomach bottom is cut out. Submucosal area after the flap cutting is closed. Seromuscular flap is passed between the left wall of the oesophagus and the stomach bottom to the posterior wall with fixation of the flap on the anterior wall of the stomach below its base in a phase of moderate tension.

EFFECT: method enables improving the clinical results of severe cardiac achalasia, eliminating oesophageal enlargement and deformity, restoring its shape and tone, as well as the closing and reflux functions of the oesophageal-gastric junction.

1 cl, 1 ex, 6 dwg