FIELD: medicine; colorectal surgery; oncology.
SUBSTANCE: when performing a colonoscopy, signs of potential malignancy of the tumor and factors preventing its endoscopic removal are determined. A circular incision is made in the mucous membrane with an indentation from the edge of the tumor. An endoscopic loop is placed at the bottom of the resulting wound, and the intestinal loop is fixed. From the abdominal cavity, the tip of the endoscopic loop is grasped and held and the intestinal wall with the neoplasm is invaginated into the intestinal lumen. From the side of the abdominal cavity, separate interrupted intracorporeal sutures are preventively applied and tied to the wall of the colon in the area of the formed retraction of the intestinal wall. The endoscopic loop is tightened under constant visual control, and its tip is fixed at the time of tightening. The section of the colon wall with the neoplasm is excised as a single block and removed through the intestinal lumen. The intestinal wall defect is covered with endoclips.
EFFECT: method allows to clearly visualize the edges of the tumor, and then radically and safely remove it due to endoscopic control and laparoscopic fixation of the loop; allows to perform a safe radical and low-traumatic operation avoiding extensive surgical intervention; eliminates contamination of the abdominal cavity with intestinal contents, which leads to a decrease in the level of pain, faster activation of patients and, as a consequence, a decrease in the length of stay of patients in the hospital.
1 cl, 3 ex
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Authors
Dates
2023-11-16—Published
2023-05-17—Filed