| 摘要 |
FIELD: medicine.SUBSTANCE: invention refers to medicine, particularly to surgery, and can be used in diagnostic laparoscopy and laparoscopic surgery of the abdominal cavity in the patients with degree III-IV obesity. In corpulent patients suffering degree III-IV obesity, an abdominal wall thickness exceeds standard lengths of a Veress needle and first introduced trocar. Using the standard instrument kit for laparoscopic operations in the patients suffering degree III-IV obesity, the substance of the method consists as follows: a semilunar transverse incision 2-3 cm long is performed at 1-1.5 cm above a navel. Thereafter, the navel is separated from subcutaneous fat along the whole circular length. A navel base is taken with a holder brought as close as possible to a surface of a white line of the aponeurosis. The navel skin is gripped from both sides using clamps and simultaneously pulled upwards in the holder at an angle of 30-60° in relation of the belly surface towards the pubis and to the sides using clamps. The wound is widened with one or two hooks to tract them to the head and to the sides. An incision 0.5 cm long is performed along the while line to introduce the Veress needle 10 cm long for the eye insufflation to be then removed, and the first trocar 10 cm long being introduced.EFFECT: method enables introducing the trocar with a minimum risk of injuring the internal organs presenting the abdominal wall within the navel region.1 ex, 2 dwg |
