SURGICAL APPROACH METHOD FOR MINIMALLY INVASIVE MYOCARDIAL REVASCULARIZATION Russian patent published in 2021 - IPC A61B17/00 A61B17/94 

FIELD: medicine.

SUBSTANCE: invention relates to the field of medicine, in particular to cardiovascular and thoracic surgery. Prior to operation start, chest shape is to be determined as anatomical features. Patient is placed on his back with a roller under left half of the chest at an angle to operating table plane. Depending on anatomical features patient's left arm is raised and fixed above his head. Three trocars are inserted: the first one for video camera, the second one for harmonic scalpel, and the third one for endoscopic clamp. Patient with flat shape of the chest is placed on his back with roller under the left half of the chest at an angle of 60° to operating table plane. In this case, the first trocar is inserted into IV intercostal space in the middle of distance between anterior and middle axillary lines, the second trocar is inserted into VI intercostal space along posterior axillary line, the third trocar is inserted into III intercostal space along middle axillary line. Patient with cylindrical shape of the chest is placed on his back with roller under the left half of the chest at an angle of 50° to operating table plane. In this case, the first trocar is inserted into IV intercostal space along anterior axillary line, the second trocar is inserted into VI intercostal space in middle of distance between middle and posterior axillary lines, the third trocar is inserted into III intercostal space along middle axillary line. Patient with conical shape of the chest is placed on his back with roller under the left half of the chest at an angle of 35° to operating table plane. In this case, the first trocar is inserted into V intercostal space along anterior axillary line, the second trocar is inserted into VI intercostal space in the middle of distance between middle and posterior axillary lines, the third trocar is inserted into III intercostal space along middle axillary line, then mobilization of internal thoracic artery is performed.

EFFECT: method makes it possible to increase effectiveness of surgical treatment of patients with coronary heart disease reducing surgery time and intraoperative blood loss.

1 cl, 3 ex