METHOD FOR PROVIDING ACCESS TO THE STUFFING BAG AND RETROPERITONEAL SPACE IN CASE OF PURULENT-NECROTIC PARAPANCREATITIS Russian patent published in 2022 - IPC A61B17/94 A61B17/00 A61B8/12 A61M25/01 A61M25/06 A61M25/09 A61M27/00 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to minimally invasive pancreatobiliary surgery. Using ultrasound, the thickness of the subcutaneous fat and the longitudinal size of the fluid accumulation in the omental bag are measured. Based on the data obtained, the injection points are determined, as well as the angle of the needle injection for the primary access. A percutaneous puncture of the cavity of the omental bursa is performed to the pathological zone through the gastrocolic ligament, followed by passing 2-3 rigid conductors through the needles, forming a "triangle" so that its apex is directed into the cavity of the omental bursa, and the sides cover everything throughout the fluid accumulation. 2-3 bioinert tubes with a diameter of 28-32 French are introduced. The access points and the angle of injection of the needle for drainage of the retroperitoneal space are determined. Under ultrasound control, a puncture of the retroperitoneal space is performed, followed by passing 2 rigid conductors through the needles, forming a triangle so that the apex is directed towards the tail of the pancreas into the paracolon on the left or towards the head of the pancreas into the paracolon on the right. Install 2 bioinert tubes with a diameter of 28-32 french.

EFFECT: method allows to create accesses to the omental bag and retroperitoneal space - paracolon on the right and left, taking into account the constitutional and topographic-anatomical features of the patient, without contact with the free abdominal cavity; the location of the drains along the middle and posterior axillary lines leads to minimization of surgical trauma and allows the patient to be in a comfortable position on the back, adherence to the principle of triangulation allows effective instrumental videoscopic necrosequestrectomy and arrest of the purulent-necrotic process, which leads to a decrease in mortality.

1 cl, 4 ex