METHOD OF SEMI-FLAP EXCRETION OF INTERNAL THORACIC ARTERY USING ULTRASONIC HARMONIC SCALPEL Russian patent published in 2020 - IPC A61B18/04 A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to cardiovascular surgery. Internal thoracic fascia is dissected by an internal thoracic artery (ITA) median projection and accompanying internal thoracic veins from the first intercostal space to the level of attachment to the body of the sternum of the xiphoid. Internal thoracic fascia flap is separated with ITA and accompanying internal thoracic veins. Ultrasound harmonic scalpel is used to ligate the lateral branches of the ITA going upwards from level of 1st intercostal space and to the ITA bifurcation. ITA is separated from internal thoracic fascia throughout, wherein the pleural cavity is not opened. At the next stage coagulation of the lateral branches of the ITA is performed with approach to them both above the ITA, and under the ITA. In the proximal portion of the ITA, a ITA is inserted into a subclavian artery. That is followed by mobilizing a lateral ITA with an accompanying lateral internal thoracic vein. Thereafter, ITA medial surface is mobilized, while accompanying medial internal thoracic vein is ligated. Distal portion of the ITA is clipped and cut off to a ITA bifurcation.

EFFECT: method enables maintaining integrity of pleural cavity, which eliminates risks of developing postoperative hydrothorax and reduces pain in early postoperative period, as well as increase the percentage of successful total arterial revascularization of myocardium, which has a positive effect on long-term operation results.

1 cl, 1 ex, 3 dwg