METHOD FOR PROSTHETICS OF EXTENDED CIRCULAR TRACHEAL DEFECTS Russian patent published in 2022 - IPC A61B17/24 A61F2/04 A61F2/02 A61F2/20 A61F2/82 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to surgery. Prosthetics of extended circular tracheal defects are performed in multiple stages. At the first stage, a skin incision is made along the 8th intercostal space under endotracheal anaesthesia. The fascia of the latissimus dorsi and the periosteal flap of two ribs on a vascular pedicle between the periosteum and the distal parts of the anterior serratus muscles are prepared. A 4-layer bioengineered prosthesis is formed, consisting of the fascia of the latissimus dorsi, a fibrin matrix impregnated with the bone marrow of the patient, a prolene mesh, and a periosteal flap on a vascular pedicle, formed on a polyvinyl chloride stent. The resulting bioengineered prosthesis is submerged in subcutaneous fat, and the skin wound is sutured. At the second stage, the polyvinyl chloride stent is removed through the 2 skin incisions in the projection of the stent edges under endotracheal anaesthesia, followed by suturing the skin edges to the bioengineered prosthesis. At the third stage, 40 ml of the bone marrow of the patient is collected under local anaesthesia to cultivate epithelial cells in a bioreactor in order to form the mucosa of the bioengineered prosthesis. At the fourth stage, the cheek mucosa of the patient is collected under endotracheal anaesthesia, transferred and fixed inside the formed bioengineered prosthesis over the entire surface. At the fifth stage, cells resulting from cultivation in the bioreactor are injected into the inner shell of the bioengineered prosthesis. At the sixth stage, circular tracheal resection is performed under endobronchial anaesthesia. The formed bioengineered prosthesis on a vascular pedicle is transposed from the subcutaneous fat into the pleural cavity.

EFFECT: possibility of preserving the proper blood supply of the bioengineered prosthesis, lowering the risk of thrombosis and stenosis along the vessel suture line, ensuring the prosthetics of the tracheal defect regardless of the localisation due to the fully formed layers of the bioengineered prosthesis as of the time of transposition into the chest, as well as seal tightness, safety, and satisfactory frame quality of the bioengineered prosthesis.

1 cl, 6 dwg, 1 ex