| 摘要 |
FIELD: medicine. ^ SUBSTANCE: invention relates to surgery and can be applied for entero-enteroanastomosis accompanying gastrostomy. It involves forming an external line of a posterior labium of the entero-enteroanastomosis by serous-muscular non-absorbable sutures between adducting and abducting small intestinal loops. A serous membrane is dissected at 0.5 cm from the external line of eth posterior labium of the entero-enteroanastomosis transversally to a small intestinal longitudinal axis at 18-20 mm on the adducting and abducting small intestinal loops. A point puncture 2-3 mm is used to exposure muscular, submucosal and mucosal layers with the mucosal layer being extended by a long curved clamp in a direction perperdicular to the small intestinal longitudinal axis to 18-20 mm with forming transversal holes on the adducting and abducting small intestinal loops. An atraumatic needle with a synthetic absorbable suture delivered through the intestinal thickness and delivered out on the serous membrane of the formed opening on the adducting small intestinal loop at the distance of 2.0-2.5 mm of the border of the formed opening on the adducting small intestinal loop into a wall of the adducting small intestinal loop from inside to outside. Thereafter at the distance of 4.0-4.5 mm from the border of the formed opening on the abducting small intestinal loop from the serous membrane, the atraumatic needle with the synthetic absorbable suture is delivered though the serous membrane, the muscular and submucosal layers not covering the mucosal layer, and delivered out on the serous membrane in a point at 3.0-3.5 mm from the border of the formed opening on the abducting small intestinal loop. The ends of the synthetic absorbable suture are crossed over and strained in opposite sides with the excess mucosal and submucosal layers of the abducting small intestinal loop turned outside are placed back to form cusps of an areflux valve, while the serous membranes of the adducting and abducting small intestinal loops are matched together. A similar procedure is used to attach the following sutures to close the internal line of the posterior and anterior labiums of the entero-enteroanastomosis. It is followed by forming the external line of an anterior labium of the entero-enteroanastomosis by serous-muscular non-absorbable sutures between the adducting and abducting small intestinal loops. ^ EFFECT: method provides reduced injures of intestinal musculature, ensures leak proof. ^ 1 ex, 3 dwg |
