FIELD: medicine; abdominal surgery; bariatric surgery.
SUBSTANCE: after installing the trocars, the stomach is mobilized along the greater and lesser curvature. The stomach is sutured with a stapler in the direction perpendicular to the lesser curvature. A vertical intersection of the stomach is performed along the lesser curvature, directing the stapler towards the angle of His and the fundus of the stomach, forming a small stomach on a calibration probe with a thickness of 33 FR. The suture of the formed small stomach and the suture above the preserved pylorus are peritonized with a continuous suture using a thread with notches, capturing the surrounding tissues. The disconnected part of the stomach is removed through a trocar access in the left hypochondrium. Along the antimesenteric edge of the small intestine, an ultrasonic scalpel is used to make a hole with a diameter of 12 mm, to which a small stomach is brought, and an end-to-side gastrojejunostomy is formed using a double-row continuous suture with a notched thread.
EFFECT: method is easy to use, reduces the risk of hardware suture failure and death, prevents intraoperative and postoperative complications, including bleeding, provides a restrictive effect of the operation, and does not require the use of foreign materials.
4 cl, 11 dwg, 2 ex
