METHOD OF PELVIC PARIETAL PERITONECTOMY DURING CYTOREDUCTIVE SURGICAL INTERVENTIONS IN PATIENTS WITH PERITONEAL CARCINOMATOSIS Russian patent published in 2023 - IPC A61B17/00 A61B17/34 

FIELD: medicine; surgery; oncology.

SUBSTANCE: preperitoneal space in the umbilical region is punctured for performing pneumodissection of the lateral walls of the abdomen. The end of the needle is placed in the subperitoneal fascial layer, gas is insufflated, then the needle is changed to a flexible bougie. Pneumodissection is performed in the cranial and caudal directions, as well as in the direction of the lateral channels of the abdominal cavity. The lower bundles of the costal part of the diaphragm are the cranial border of pneumodissection, the iliac fossa is the caudal border, and the conditional Told's line is the dorsal border. Then pneumodissection of the pelvic peritoneum is performed in three directions: lateral, anterior and posterior. The caudal border of pneumodissection in the lateral direction in women is the cervix, and in men — the seminal vesicles. The caudal border in the anterior direction in women is the vesico-uterine depression, and in men — the vesico-rectal depression. Then pneumodissection of the diaphragmatic peritoneum is performed in three directions: from the side of the costal, sternal parts of the diaphragm, and also from the region of the hepatorenal recess. As a puncture needle, a 18 G Seldinger needle is used, which is inserted under the parietal peritoneum at an angle of 10–30°, and a flexible bougie of 16 G is used.

EFFECT: method allows to increase the effectiveness and safety of the total parietal peritonectomy during cytoreductive surgical interventions in patients with peritoneal carcinomatosis, it is easy to carry out, characterized by low injury rate that creates conditions for unintentional dissemination of the tumor cells in the abdominal cavity.

1 cl, 17 dwg