METHOD FOR PREOPERATIVE MARKING OF AN INTESTINAL STOMA ON AN ANTERIOR ABDOMINAL WALL OF A PATIENT USING AN ULTRASONIC VISUALIZATION

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely coloproctology, and can be used for preoperative marking of intestinal stoma on anterior abdominal wall of patient using ultrasonic imaging. Preoperative visual and palpatory examination of an anterior abdominal wall of the patient is performed while sitting, standing and lying on the back in a horizontal position. Features of abdominal configuration are determined. Deep skin folds are marked out, the edges of the costal arcs, the anterior ends of the iliac bones, the width and diastases of abdominal rectus muscles are located. Presence of ventral hernias, postoperative cicatrices and new growths of the anterior abdominal wall are determined. Preliminary marking of stoma location is applied. Additionally, an ultrasonic examination of the patient's anterior abdominal wall is performed in sitting position, standing and lying on the back in a horizontal position using a linear sensor at a scanning frequency of 5–10 MHz in real time and panoramic scanning with a series of cross sections of the anterior abdominal wall at the level of the expected location intestinal stoma. Obtained in shades of gray ultrasonograms determine thickness and width of abdominal rectus muscle, maximum and minimum thickness of subcutaneous fat, its mobility relative to muscles of anterior abdominal wall at change of patient's body position, defects of anterior abdominal wall of patient are determined. Based on the results of physical examination and ultrasonic visualization, a preoperative marking of the location of the intestinal stoma in a projection of a rectus muscle of the patient's abdomen is applied with a permanent marker on the surface of the patient's anterior abdominal wall.;EFFECT: method provides an objective selection of a stoma removal point by using ultrasound visualization.;1 cl, 3 ex