METHOD FOR ENDOSCOPIC SURGICAL TREATMENT OF GUNSHOT PENETRATING WOUNDS Russian patent published in 2024 - IPC A61B17/02 A61B17/94 A61B17/14 A61B17/15 A61B6/02 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to surgery, traumatology and neurosurgery. Under computed tomographic navigation or X-ray guidance using by a navigated guide, the trajectory of the wound canal is determined by aligning the inlet of the gunshot wound and localizing the distal X-ray contrast wounding projectile along a given trajectory through the inlet. Tube the diameter of which exceeds the size of the wounding projectile is installed along the navigated guide. Before the tube is inserted, the diameter of the bone part of the wound canal is increased with a crown cutter along the navigated guide. After the guide is removed, a manipulation multichannel endoscope is inserted into the tube, the length of which exceeds the length of the tube. Under endoscopy control under conditions of irrigation with physiological solution of sodium chloride with dioxidine using by instruments introduced through endoscope, mobilization, capture and extraction of wounding projectile together with endoscope through tube are performed. Endoscope is again inserted into the tube at the previous depth. Endoscopic visualization under previous irrigation conditions involves sanitation, instrumental surgical treatment of a wound canal by resection of visible necrosis areas; final haemostasis is performed with gradual removal of the tube and endoscope from the wound. If it is necessary to drain the wound under endoscopic control, the tube is again introduced into the wound canal. Endoscope is removed. Catheter is inserted into the distal portion of the tube; the tube is removed from the wound with the catheter left therein.

EFFECT: method makes it possible to provide minimally invasive surgical treatment of gunshot penetrating wounds of muscular-bone structures of neck, back, girdle of upper and lower extremities, spine and pelvis, with deep-lying wounding shell, not accompanied by damage to hollow, parenchymal organs and large vessels; to minimize risks of infectious complications of gunshot wound.

1 cl, 10 dwg, 1 ex