MINIMALLY INVASIVE RETROPERITONEAL METHOD OF OPERATIVE ACCESS TO THE INFERIOR VENA CAVA

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, specifically to vascular surgery. They provide operative access to the inferior vena cava in treatment of thrombosis of the inferior vena cava, including a cut of the skin on the abdomen, blunt exfoliation of the muscles, displacement of the peritoneal sac along with the right ureter in the medial direction, dissection of the fascial sheet covering the lower vena cava. Skin cut on the abdomen is made to the right of the median line 6–7 cm long, retreating about 2 cm to the outside. In the special case when the floating part of the thrombus head is located or when the lower vena cava is plication in the projection of the infrarenal section of the inferior vena cava at or below the mouth of the renal veins the lower edge of the incision ends at the level of the navel. In a particular case, when the floating part of the thrombus head is located, or the thrombosed “cava filter” or in case of an unsuccessful attempt to remove it by the X-ray endovascular method in the projection of the middle part of the infrarenal part of the inferior vena cava, the midpoint of the incision is projected at the navel level. In the special case, when the floating part of the thrombus head is located in the common iliac vein or to the middle part of the infrarenal part of the inferior vena cava, the upper edge of the incision begins at the navel level.;EFFECT: method allows to reduce traumatism of the operation and to perform early activation of the patient, as well as to reduce the risk of complications in the postoperative period and shorten treatment period.;4 cl, 4 dwg, 1 ex