METHOD FOR VIDEOSCOPIC NECROSEQUESTRECTOMY FOR NECROTIC PARAPANCREATITIS WITHOUT EXUDATIVE LESIONS OF THE RETROPERITONEAL SPACE Russian patent published in 2022 - IPC A61B17/94 A61B17/00 A61B8/12 A61B8/13 A61M25/01 A61M25/06 A61M25/09 A61M27/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to minimally invasive surgery, gastroenterology. Percutaneous puncture of the retroperitoneal space is performed along the middle or posterior axillary line at the lowest point to the pathological zone by retroperitoneal access. A rigid conductor is passed through the needle into the retroperitoneal space. Departing 4-6 cm above and parallel to the place of the first injection along the middle or posterior axillary line, a second access is made, a rigid conductor is inserted and the puncture channels are bougienage. Two 10 mm trocars are inserted along the bougie. Necrotic tissue is removed. A cavity is formed in the retroperitoneal space, a laparoscope is inserted into it and a pneumorethroperitoneum is created. Sequesters are removed under visual control of the laparoscope. Saline solution is supplied, the washing solution with small fragments of the remaining sequesters is sucked off in the vacuum aspiration mode, after which double-lumen drains are installed and fixed to the skin through each trocar. With negative clinical and laboratory dynamics of the patient's condition, the drains are removed and necrosequestrectomy is repeated along the formed channels. With positive dynamics, the drains are replaced and washing is continued every 4-6 hours until the output of clean washing water is reached.

EFFECT: method allows, in the absence of a liquid component, to create accesses to the retroperitoneal space on the right and left for subsequent videoscopic necrosequestrectomy, reduces the risk of intraoperative complications, minimizes surgical trauma, and also stops the purulent-necrotic process in the retroperitoneal space without using open methods for surgical treatment and achieves a decrease in mortality in patients with infected pancreatic necrosis.

1 cl, 2 ex