METHOD FOR LAPAROSCOPIC FORMATION OF ESOPHODIC-INTESTINAL ANASTOMOSIS Russian patent published in 2021 - IPC A61B17/00 A61B17/11 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to abdominal surgery, oncology. The stomach is mobilized with the surrounding tissue, a small and a fragment of the greater omentum, and the duodenum is crossed. The distal esophagus is mobilized. Then, stepping back 30 cm from Treitz's ligament, the small intestine is grasped with a clamp, or this place is marked with a ligature. In the left hypochondrium in the projection of the Treyz ligament, a transverse mini-laparotomy 5 cm long is performed. The small intestine is brought out into the resulting hole and crossed at the place of the clamp or ligature. Then, an extracorporeal interintestinal anastomosis according to Roux is formed, and the line of the mechanical suture on the efferent intestine is additionally peritonized with a purse-string suture. Further, at a distance of 7 cm from the plugged end of the abdominal colon along the antimesenteric edge, a technological opening 1 cm long is made. The intestine is immersed in the abdominal cavity and a seal is created in the abdominal cavity using the LAP Disc device. Further, a technological hole is made in the wall of the esophagus, one branch of the laparoscopic linear stapling-cutting apparatus with a cassette of 60 mm is inserted into the hole on the abducent gut, the second - into the hole on the esophagus and stitched. Then, with a continuous suture, they begin to cover the technological opening from the intestine to the esophagus, the intersection is performed and the remaining wall of the esophagus is stitched with a 60 mm linear laparoscopic apparatus. The resulting seam is additionally reinforced with four separate interrupted seams: in the contact area of ​​mechanical seams, at the beginning of a continuous manual seam and two seams between them.

EFFECT: method makes it possible to increase reliability of the esophageal-intestinal anastomosis, reduce the time of surgical intervention, does not require special equipment and is easily reproducible in a surgical hospital of a general medical network.

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