METHOD laparoscopic fundoplication DEPENDING ON CONSTITUTIONAL TYPE PATIENT

摘要

A method of performing laparoscopic fundoplication depending on the constitutional type patient comprising administering to the endoscope, inspection of the abdominal cavity, the installation trocars, characterized in that the patient is determined somatic at makrosomaticheskom type patient laparoscopic fundoplication operate when administered into the peritoneal cavity of five trocars, with the first 11 mm trocar is introduced at 20 cm below the xiphoid process, the second 11 mm trocar is introduced in the midline, 1 cm below the xiphoid process, the third 11 mm trocar is introduced by eredney left axillary line, 1 cm below the costal arch, the fourth 5 mm trocar is introduced at the left midclavicular line, 4 cm below the costal arch and the fifth 5 mm trocar is introduced at the midline to the right, 4 cm below the costal arch, with micro- and mezosomaticheskom types of the first 11 mm trocar is introduced through the navel, a second trocar 11 mm administered in the midline, 1 cm below the xiphoid process, the third trocar 11 mm administered by perednepodmyshechnoy line left midway between the lower edge of the costal arch and the anterior iliac spine, the fourth 5 m is introduced in the midclavicular line to the left, 2 cm below the costal arch, a fifth trocar 5 mm is introduced in the midclavicular line to the right by 2 cm below the costal margin, then perform fundoplication to form nenatyazhnoy fundoplikatsionoy cuff so that the grip front wall stomach fundus of the esophagus, 3-4 cm departing from the large curvature performed behind the esophagus to the right, in an amount sufficient to form nenatyazhnoy cuff applied first seam without tension between the anterior surface of the stomach bottom left, re