METHOD FOR LIVER GRAFT POSITION STABILIZATION IN ABDOMINAL CAVITY Russian patent published in 2024 - IPC A61B17/00 A61M25/10 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to surgery and liver transplantation. Liver graft is placed in the subphrenic space of the abdominal cavity of the recipient. Vascular anastomoses, including caval anastomosis, are formed. After formation of vascular anastomoses, state of venous outflow is assessed, factors causing disturbed venous outflow: presence of a demarcation zone corresponding to the hepatic vein outflow basin; presence of torsion – rotation relative to the sagittal axis of the graft; presence of caval anastomosis deformation. If at least one of the listed factors of venous outflow disturbance is detected, a balloon-catheter is implanted in the form of a flexible tube having a working part configured to be placed in the subphrenic space of the recipient, and a proximal portion configured to be fixed on the skin of the recipient. Working part of the balloon-catheter is equipped with a balloon inflated by the medium to volume of 300 ml, the medium used is physiological saline, and a T-shaped branch on the distal end of the tube containing drainage holes. Balloon-catheter is brought into the incisional wound with its “folded” T-shaped end through an incision in the abdominal wall along the median axillary line and placed in the posthepatic subphrenic space. Balloon-catheter tube is positioned behind 6th and 7th graft segments. After the balloon-catheter is installed, its proximal part is fixed on the skin of the recipient. Under the intraoperative ultrasound control, the balloon is inflated to the size ensuring adequate blood flow in the graft vessels. Wound is closed in layers. Starting from 10th day, the balloon-catheter is deflated under ultrasound control. In case of detecting displacement of the graft, which causes deformation of the portal anastomosis, the balloon is again inflated to a volume providing the initial position of the graft. Test is repeated at least 2 days later, and if there is no displacement of the graft, the balloon-catheter is removed.

EFFECT: method enables providing reliable fixation of the graft in one position for stabilizing the caval anastomosis, reducing the risk of its rotation, and simultaneously providing active drainage of stagnant content from the subphrenic space.

1 cl, 4 dwg, 1 ex