METHOD FOR LAPAROSCOPIC MOBILIZATION OF THE RIGHT HALF OF THE COLON IN RIGHT-SIDED HEMICOLECTOMY Russian patent published in 2022 - IPC A61B17/94 A61B17/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to endoscopic surgery, oncology, abdominal surgery. The peritoneum is dissected above the lower horizontal part of the duodenum. The line of intersection of the mesentery of the terminal ileum, mesocolon and retroperitoneal space are visualized. The peritoneum is dissected through the above line towards the ileocecal zone with penetration into the space between Toldt's fascia and Gerota's fascia. The dissection is continued in the cranial direction towards the head of the pancreas until reaching the transverse colon, then towards the ascending colon to the right lateral canal. The mesentery is dissected from the ventral side below the iliocolic artery and vein, thus connecting with the previously mobilized space between Toldt's fascia and Gerota's fascia. In the medial direction, v.Ileocolica is skeletonized at the confluence with v.mesenterica superior, while visualizing a.Ileocolica, separate clipping and intersection of a.Ileocolica and v.ileocolica are performed. Then dissection is performed along v.mesenterica superior in the cranial direction. In the cranial direction, the peritoneum is crossed in the region of the right lateral canal to the hepatic flexure of the colon. Then the hepatocolic ligament, gastrocolic ligament are crossed to the border of the middle and distal third of the transverse colon, clipping is performed at the same level a. and v.gastroepiploica dextra. Traction is carried out for the greater curvature of the stomach in the cranial direction and countertraction for the greater omentum at the border of the middle and distal third of the transverse colon, followed by crossing the greater omentum at the border of the middle and distal third of the transverse colon.

EFFECT: method provides a reduction in trauma due to the intervention of 4 accesses and standard guidelines for the start of dissection, which provides an "easy" hit in the desired layer of dissection, as well as a significant reduction in surgical intervention in time due to the absence of the need to change the position of surgeons during the operation.

1 cl, 3 ex