| 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 umbilical access. On internal edge of umbilical ring indenting 1.0-1.5 cm from central part of navel outwards made is semilunar skin cut 1.5-2.0 cm long without going beyond umbilical ring. Subcutaneous fatty tissue is pulled apart by means of Bilrot's type clamp, exposing aponeurosis of rectus muscle of abdomen. Through formed semilunar cut carried out is direct puncture of abdominal cavity by 10-mm trocar though anterior and posterior leaves of sheath and medial edge of abdominal rectus muscle. Into wound of umbilical access installed are two 5-mm trocars by separate aponeurosis puncture, passing them through anterior and posterior leaves of sheath and medial edge of abdominal rectus muscle indenting 2-3 mm from the first trocar. After carrying out intracorporal appendectomy trocar holes in aponeurosis are layer-by-layer sewn by suture material with long term of biodegradability by separate interrupted sutures covering both leaves of sheath and muscular fibres of abdominal rectus muscle. Skin sutures are applied on umbilical wound. ^ EFFECT: method makes it possible to obtain air-tightness of abdominal cavity, eliminate leak of carbon dioxide, used for creation of pneumoperitoneum, providing prevention of formation of hernia in placed of trocar installation, as puncture trocar wound canals pass through muscle massive and sheath of abdominal rectus muscle. ^ 2 dwg, 1 ex |
