METHOD OF FORMATION OF ILEORECTAL SUPRAMPULLAR ANASTOMOSIS IN CHILDREN Russian patent published in 2023 - IPC A61B17/00 A61F2/04 

FIELD: medicine; pediatric surgery.

SUBSTANCE: ends of the rectum and ileum are brought to the same diameter and connected according to the “end to end” type using a single-layer submucosal-muscular-serous separate interrupted suture, which is formed as follows: the needle is injected into the submucosal layer of the rectum, piercing the submucosal, muscular and serous layer. The puncture is made through the serous membrane to the surface of the intestine at a distance of 0.3–0.4 cm from the edge. The next injection of the needle is performed in the serous membrane of the ileum at a distance of 0.3–0.4 cm from the edge opposite the ileum, piercing the serous, muscular and submucosal membranes. The needle is punctured at the border of the intestinal mucosa and submucosa opposite the puncture in similar layers of the rectum, the surgical knot is formed on the instrument. When forming the next node, before comparing the walls of the intestines, the previous node is immersed inside with tweezers, leaving it between the walls of the intestines. The posterior and then the anterior lip of the anastomosis is formed, and to create an ileorectal connection, the anterior lip of the anastomosis is formed on a stent inserted before the formation of the anterior lip transanally into the rectum and into the adductor ileum to a depth of 5–10 cm from the distal edge of the ileum, and a silicone tube-stent with a diameter of 10–15 mm is used as a stent.

EFFECT: method makes it possible to provide the most physiological position of the intestine, tightness and patency of the anastomosis, maintain microcirculatory blood supply in the layers of the anastomosed intestinal walls, which contributes to better healing of the anastomosis in the postoperative period, prevents inflammation, leakage and stenosis of the anastomosis.

1 cl, 1 ex