| 摘要 |
FIELD: medicine. ^ SUBSTANCE: invention relates to field of medicine, namely to abdominal surgery and can be used in carrying out laparoscopic appendectomy through monoaccess. Monoaccess is performed through umbilicus or above lap. Endoscopes and holding threads for capturing vermiform appendix with its further exposure are introduced. Processing of mesenteriolum and transaction of vermiform appendix with its ablation are performed. Mesenteriolum of vermiform appendix is caught by means of endoscopic clip and through hole is created with dissector at the distance 1.2-1.5 cm from its base, through said hole by means of dissector passed is ligature, which is tightly tied up by intracorporal method on vermiform appendix, closing its lumen, ends of ligature are retained and used as holding thread. Traction by holding thread is performed towards anterior abdominal wall, vermiform appendiz is lifted above blind colon head, tightening its mesenteriolum, one of 5-mm trocars is replaced with 10-mm trocar, through which into abdominal cavity introduced is endoscopic clipper, which is used to fix holding threads with 8-mm first clip to parietal peritoneum of lateral abdominal wall ventrally, laterally and cephally from vermiform appendix base. Bipolar coagulation and transaction of mesenteriolum of vermiform appendix are performed. Second clip is applied on base of vermiform appendix. Vermiform appendix is transected between second clip and holding thread. Vermiform appendix together with holding thread and second clip are extracted in polyethylene container through umbilical wound. ^ EFFECT: method makes it possible to carry out laparoscopic appendectomy through monoaccess and carry out prevention of infectious complications. ^ 1 dwg, 1 ex |
