METHOD OF INTRAOPERATIVE PREVENTION OF INSOLVENCY OF THE STAPLER SUTURE LINE DURING LAPAROSCOPIC LONGITUDINAL RESECTION OF THE STOMACH IN PATIENTS WITH OBESITY AND HIATAL HERNIA Russian patent published in 2023 - IPC A61B17/00 A61B17/68 G01N33/533 

FIELD: medicine; bariatric; laparoscopic surgery.

SUBSTANCE: after mobilization of the greater curvature of the stomach from the pyloros to the angle of His, a vascular clamp is applied to the lesser omentum in the region of the origin of the left gastric artery. The patient is injected intravenously with a fluorescent solution of Indocyanine green at a dose of 0.25 mg per 1 kg of body weight and angiography of the vessels of the area of the cardioesophageal junction of the stomach — the angle of His is performed. The time of appearance of the most intense glow of Indocyanine green is counted. If the time interval is 70 seconds or less, the abdominal esophagus is mobilized and posterior cruroraphy is performed from the right access with the intersection of the lesser omentum. If the time interval is 71 seconds or more, then after mobilization of the abdominal esophagus, posterior crurorrhaphy is performed from the left approach while maintaining the lesser omentum. Then, a longitudinal resection of the stomach is performed using a linear stapler. After crossing the stomach, the angle of His is immersed inside the stomach using a semi-purse-string suture.

EFFECT: method is easy to use, allows to reduce the frequency of intra- and early postoperative complications, including failure of the stapler suture line, reduce the length of stay in the hospital and improve the quality of life of patients by assessing the blood supply to the gastric wall and optimal planning of the line of the stapler section of the stomach without traumatizing the distal arterial branches supplying the zone of the cardioesophageal junction.

1 cl, 7 dwg, 4 ex