Laparoscopic minimally invasive cystogastrostomy of postnecrotic pancreatic cysts Russian patent published in 2021 - IPC A61B17/94 A61B17/00 A61B17/11 A61B17/34 A61M25/01 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to abdominal surgery. Surgical treatment is performed in two stages. At the first stage, under ultrasound and X-ray control, the cyst is drained with two drains through the gastro-colic ligament, while the cyst is punctured with a ChibaBiopsyNeedle 18G needle, with the help of which a guidewire is then installed to bougie the canal. The first drainage is installed into the cyst cavity along the guidewire. The second drainage is installed in the projection of the stomach body along the greater curvature similarly to the first one. After 5-7 days, the second stage is performed. Access to the abdominal cavity is made through an incision in the upper paraumbilical zone. A trocar is inserted; carboxyperitoneum is applied with a pressure in the abdominal cavity of 14 mm Hg. Through the installed trocar, oblique optics with a viewing angle of 30 degrees are introduced, then under visual control, two additional trocars are installed along the anterior axillary line 6-8 cm below the costal arch, while the 10 mm trocar is installed on the right, and the 5 mm trocar is installed on the left. Next, a gastrotomic hole is formed, around which 3 purse-string stitches are put. The proximal part of the drainage is immersed into the lumen of the stomach, the purse-string stiches are tightened with the invagination of each previous stich into the lumen of the stomach, forming a coupling on the drainage to the anterior wall of the pancreatic cyst.

EFFECT: method makes it possible to create a stable anastomosis between the pancreatic cyst and the stomach lumen with minimal surgical and anesthetic risks, ensure the flow of the contents of the cyst into the lumen of the stomach and restore the digestive function of the pancreas.

1 cl, 1 ex