METHOD OF RESTORING IMPAIRED INNERVATION OF STOMACH IN CASE OF OPERATIONS OF PROXIMAL STOMACH RESECTION

摘要

FIELD: medicine.SUBSTANCE: invention relates to medicine and can be applied for restoration of impaired innervations of stomach in case of operations of proximal stomach resection. Stem vagotomy at the place of vagus nerve branching is performed. After that, proximal resection with formation of esophagogastric anastomosis is carried out. Serous membrane is transected on anterior and posterior walls of stomach in the area of formed anastomosis line. Intermuscular canal is formed by means of dissector. Distal end of vagus nerve stem is pulled up and submerging epineural sutures are applied with 10-12 mm indent from distal end of transected nerve. End of vagus nerve stem is fixed to epineural sutures, periendoneurolysis of bundles of nerve fibres of its distal part is carried out with needle end on its entire circumference along 5 mm. Vagus nerve is implanted into denervated stomach, for which purpose submerging sutures are passed through formed intermuscular canal in such a way that puncture-in and puncture-out of needle took place from inside outside, and by tightening sutures distal end of nerve is in free way submerged into stomach to the depth 10-15 mm with further fixation by means of two serous-muscular sutures at the place of implantation.EFFECT: method makes it possible to reduce risk of motor-evacuative function impairment.2 ex