METHOD FOR FORMING END-LOOP ILEORECTAL ANASTOMOSIS DURING RECONSTRUCTIVE STAGE OF OPERATION AFTER COLECTOMY Russian patent published in 2021 - IPC A61B17/00 A61B17/11 A61L17/06 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to colorectal surgery. The rectum is mobilized with the mesorectum to the muscles of the pelvic diaphragm. The wall of the rectum up to 2 cm long is exposed while its viability is maintained. The distal edge of the small intestine is skeletonized for 2 cm. At a distance of 20 cm from the distal edge of the small intestine, an opening is formed in the mesentery of the small intestine in the avascular zone through which the rectal stump is passed, so that the mesentery of the small intestine lies on the proximal edge of the mesorectum. The rectal wall is fixed to the mesentery of the small intestine in avascular areas. The walls of the small intestine are fixed to the skeletal wall of the rectum, with a suture pitch of 1.0-1.5 cm so that the first suture is applied strictly in the center of the loop of the small intestine, until the small intestine is completely folded around the rectum. The serous-submucosal layers of the rectum and the loops of the small intestine around the rectum are opened 2.0 cm from the mesentery of the small intestine. The serous-submucosal layer of the small intestine is fixed to the serous-submucosal layer of the rectum with a suture pitch of 1.0-1.5 cm. The mucous layer of the small intestine is opened around the rectum, the rectal stump is cut off and a mucous-mucous anastomosis is formed between the rectal stump and the small intestine loop around rectum. The front wall of the end-loop ileorectal anastomosis is closed with separate serous-muscular sutures. The adducting and abducting knees of the small intestine are fixed between each other with separate serous-muscular sutures with a suture pitch of 1.0 cm. The distal end of the abducting knee of the small intestine is cut off at an angle of 45 degrees. The wall of the adducting knee of the small intestine is dissected in the transverse direction along the length corresponding to the oblique cut end of the abducting knee cut, and an “end-to-side” anastomosis is formed. An intubator is installed through the rectum to the ileorectal anastomosis zone. The mesorectum and sacrum periosteum are fixed in the promontorium area.

EFFECT: method makes it possible to improve the motor and evacuation functions of the anastomosis, to improve the circulation of intestinal contents along the formed anastomosis, to reduce the frequency of stools, pain during defecation, to reduce the risk of pathology of the perianal region in patients.

1 cl, 4 dwg, 2 ex