METHOD OF CHOOSING THE TACTICS OF SURGICAL TREATMENT OF PATIENTS WITH OBESITY ASSOCIATED WITH TYPE 2 DIABETES MELLITUS COMPLICATED BY SARCOPENIA Russian patent published in 2021 - IPC A61B17/00 A61B17/11 A61B17/68 G01N33/48 A61L17/00 

FIELD: medicine; bariatric and metabolic surgery.

SUBSTANCE: at the stage of preoperative examination, the level of total protein and albumin in the blood of patients is examined, and the skeletal muscle mass index (hereinafter – SMMI), kg/m², is determined by bioelectrical impedance analysis. If the indicators of total protein and albumin correspond to the norm for this age group, and the SMMI is 8.51-10.75 kg/m² for men and 5.76-6.75 kg/m² for women, Roux-en-Y gastric-jejuno-bypass is performed. A post-gastric tunnel is formed 1 cm below the level of the first branch of the gastroesophageal artery, into which a linear stitching device with a 6 cm long cassette is inserted, and the first stitching is performed. Then, with a 6 cm long cassette, the stomach is crossed longitudinally. A stomach stump with a volume of no more than 35 ml with an excess of the posterior wall is formed using a calibration probe 36 Fr. From the gastroenteroanastomosis, in the distal direction, 100 cm of the intestine alimentary loop is counted, and a Roux-en-Y manual single-row continuous anastomosis is applied between the biliary loop of the small intestine, which is 60 cm long, and the alimentary loop of the small intestine, which is 100 cm long. The intestine biliary loop is crossed between the gastroenteroanastomosis and the enteroenteroanastomosis using a linear stitching device. Both stumps of the intestine are immersed by a pouch suture with a PDS 2.0 thread.

EFFECT: method allows one to adequately reduce excess body weight and get an incretin response to increase the production of endogenous insulin, avoid a deficiency in the assimilation of protein food and the progression of protein deficiency and sarcopenia, and improve the quality of life of patients by reducing the drug load and their social adaptation.

1 cl, 4 ex