FIELD: medicine.
SUBSTANCE: invention relates to medicine and namely to abdominal surgery. Trocars are placed. The place for the imposition of the gastrostomy is determined. With the help of clamps, the stomach wall is grasped along the greater curvature. The endoscopic apparatus of the linear anastomosis is introduced and brought under the clamps, and the said apparatus is positioned in such a way so that after it crosses the stomach wall, a cone-shaped gastric tube is formed, the size of which is sufficient for the formation of a gastrostomy. A cone-shaped polypropylene mesh sleeve-implant is prepared, the dimensions of which allow completely covering the gastric tube at its base, while its height corresponds to 1/5 of the length of the specified tube. The implant sleeve is placed in the abdominal cavity. The gastric tube is passed through the central opening of the sleeve-implant. Through a 10 mm trocar, installed in the left hypochondrium, a clamp is inserted to capture the end of the gastric tube. The gastric tube, captured by a clamp, is pulled into a 10 mm trocar installed in the left hypochondrium and pulled out onto the anterior abdominal wall. The gastric tube is pulled up and fixed with interrupted sutures to the skin with surgical suture. Trocars are removed, sutures are applied to the skin with surgical suture. The gastric tube is cut with scissors so that the tube protrudes above the skin to form the resulting gastrostomy tube. A Foley catheter is inserted through the gastrostomy tube into the lumen of the stomach to feed the patient.
EFFECT: method makes it possible to achieve tight fixation of the stomach wall to the anterior abdominal wall, to reduce the risk of failure and the number of wound complications, to reduce the risk of postoperative ventral hernias. The method does not require the use of additional devices fixing the gastrostomy tube.
1 cl, 5 dwg, 1 ex
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