METHOD FOR WOUND CLOSURE ACCOMPANYING LAPAROSCOPIC ORGAN-PRESERVING MANAGEMENT OF KIDNEY CANCER IN THERMAL ISCHEMIA

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to surgery. A preoperative PADUA value is determined to predict a degree of complexity of a partial nephrectomy. Applying a Polysorb-1 haemostatic uninterrupted mattress suture at 5 mm from a wound angle and 15 mm from a wound edge at a pitch of 1.5 mm with a 40 mm needle with S curvature follows the tumour removal. The suture extends through a fibrous capsule of the kidney through the parenchyma thickness leaving walls of the exposed cavity free and the needle pricked out into the wound bottom. The suture is further extended from the wound bottom through the parenchyma thickness with the needle pricked out into the fibrous capsule. The suture is pulled through to reach a clip contact to the fibrous capsule. After each underrunning manipulation, the needle is lock clipped at a right angle. The clip is advanced along the suture to ensure the reposition of the wound edges, the compression of the parenchyma and the primary haemostasis. The same technique is used for the second line of the uninterrupted mattress sutures.;EFFECT: method provides forming the uninterrupted suture, the adequate wound haemostasis; it reduces the length of the kidney ischemia, the risk of postoperative complications and the time of recovery.;9 dwg, 1 ex