METHOD FOR SURGICAL REMOVAL OF CAVA-FILTER THROUGH RETROPERITONEAL MINIACCESS Russian patent published in 2020 - IPC A61B17/00 A61B17/122 A61F2/01 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, specifically to vascular surgery. Skin incision line is 2–4 cm lateral to median line, 6 cm long, ending the lower edge at the navel level. Rectus muscle is moved back medially, a posterior wall of rectus sheath is dissected, a parietal peritoneum is stripped to an inferior vena cava, liver mirrors are established. Inferior vena cava is prepared with scissors upwards to the upper pole of the cava filter and down to the lower pole. Blood flow along the inferior vena cava is covered with vascular clamps in the proximal direction and distal from the cava filter (CF). Clamps are applied on the renal and lumbar veins along the anterior surface of the inferior vena cava. In a projection of a cava filter a longitudinal venotomy is performed. After the cava filter is visualized, its legs are separated from the walls of the inferior vena cava, its removal is performed; within the longitudinal incision, an endophlebectomy is performed with a vascular trowel. Vascular clamps are repeatedly inserted from the inferior vena cava, from its distal and proximal parts. Lumen of the inferior vena cava, within the longitudinal venotomy, is washed with a solution of sodium chloride 0.9 % from a syringe with volume 20 ml of a jet. Longitudinal venotomy of the inferior vena cava is closed with a continuous suture "Prolen" 5/0. Vascular clamp is removed from a distal portion of the inferior vena cava to form nodes, and a final node consisting of 6 to 8 nodes is formed. Proximal clamp and vascular clamps "bulldogs" are removed from the inferior vena cava and lumbar veins. Wound is reinforced with separate suturing of the transverse fascia, posterior and anterior walls of rectus abdominis muscle, the subcutaneous fat is closed with separate interrupted sutures, and the skin – with continuous intradermal suture from the absorbable synthetic thread.

EFFECT: method enables reducing late complications of cava filter implantation; includes the cancellation of lifelong oral anticoagulants in the absence of genetic thrombophilia, reduced risk of complications during pregnancy and delivery, as well as the possibility of effective stenosis of stenosed underlying cavities of the inferior vena cava, including in May–Thurner syndrome.

1 cl, 3 ex, 6 dwg