METHOD OF MINIMALLY INVASIVE, ORGAN-PRESERVING SURGICAL TREATMENT OF BLIND COLON CANCER WITH EXTENDED LYMPH NODE DISSECTION BY PRIMARY RETROPERITONEAL ACCESS Russian patent published in 2025 - IPC A61B17/11 A61B17/94 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to abdominal surgery and oncology, and can be used in treating blind colon cancer. Transverse skin incision is performed in a right lateral region of abdomen. Approach is performed to reach a transverse fascia, and the transverse fascia is incised to preperitoneal subcutaneous fat. Retroperitoneal canal is formed. Retroperitoneal fat is incised to renal fascia. Dissection between renal fascia and mesocolic fascia is carried out in medial direction at level of lower pole of right kidney, then continued in craniomedial direction to identify descending part of duodenum. Posterior leaf of a mesentery is dissected medially towards a head of pancreas in a projection of a superior mesenteric artery. Vessels of iliac and right colon arteries are clipped and transected at base. Similarly dissection is performed in caudal and cranial directions with identification of base of iliac vein, Henle trunk. Iliac vein is clipped and transected at a base; colonic branches of the trunk of Henle are identically transected. Mesentery in a projection of superior mesenteric vessels is dissected to a visceral peritoneum; subcutaneous fat with third-order lymph nodes is separated and displaced towards the mesentery to be removed. Colon and ileocecal angle are mobilized by dissection between renal and mesocolic fascias to resection border at 10 cm from tumour. Parietal peritoneum of a right lateral canal is opened; the canal is dissected along the full length to a hepatic flexure. Mesentery is transected in a projection of a superior mesenteric artery; at the level of a middle colic artery, the mesentery incision is extended towards a distal border of the colon resection. Then the mesentery incision is extended in the caudal direction to a terminal portion of the ileum. Mobilized portion of colon with mesentery and lymph nodes is brought out onto the anterior abdominal wall and transected at the level of proximal and distal resection borders. Extracorporeal manual isoperistaltic side-to-side ileo-ascendoanastomosis is formed.

EFFECT: method is minimally invasive, reduces injuries, allows to perform a resection of the right colon, including in patients with morbid obesity, presence of adhesive process and somatic contraindications to the classical laparoscopic approach due to the organ-preserving resection of the right colon with extended D3 lymph node dissection.

4 cl, 2 ex