METHOD FOR DETERMINING THE POINT OF INSTALLATION OF A FIRST TROCAR DURING URGENT LAPAROSCOPIC INTERVENTIONS IN ACUTE CHOLECYSTITIS AND ACUTE APPENDICITIS IN THE SECOND AND THIRD TRIMESTER OF PREGNANCY Russian patent published in 2022 - IPC A61B17/00 A61B17/34 A61B8/12 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to abdominal surgery. Ultrasound examination is performed preoperatively; the distance between the fundal height and the edge of the xiphoid process is measured. Herein, in order to perform appendectomy, the distance should be at least 3 cm, and at least 6 cm for cholecystectomy. A step back by 3 cm is then made from the fundal edge along the median line in the cranial direction, and the point is marked. An incision of the skin and subcutaneous fatty tissue is made at the marked point up to the aponeurosis; then the aponeurosis is dissected up to the preperitoneal tissue. The preperitoneal tissue is then perforated with the peritoneum, a circular exploration is performed, and the uterine position is determined by palpation. Then, 2 nodal sutures are applied to the aponeurosis, a 10 mm port is installed, the threads are tightened, and a carboxyperitoneum is applied. Additional trocars are then installed under visual monitoring.

EFFECT: method allows for an expansion in the range of indications for safe and effective surgical treatment, provides an adequate view, allows contact with the uterus to be avoided.

1 cl, 4 dwg, 2 ex