METHOD FOR SURGICAL ACCESS TO BRACHIAL PLEXUS TRUNKS AND MAIN-LINE VESSELS

摘要

FIELD: medicine, surgery. SUBSTANCE: the method deals with surgical access to a vascular-nervous bundle including brachial plexus trunks and main-line vessels. One should perform a bayonet-like incision beginning in a middle third of a nodding muscle along its posterior surface up to a sternoclavicular joint. Then it is continued along a lower clavicular edge up to a deltoid-thoracic sulcus, then it is continued along deltoid- thoracic sulcus up to an axillary area. Subcutaneous muscle of neck is resected from the upper clavicular edge, and a great thoracic muscle - from its lower edge. Then it is necessary to carry out blunt mobilization of a clavicle together with a retroclavicular muscle depending upon the locus of pathological process. If the main pathological process is situated medially against a middle-clavicular line one should determine a thoracic clavicular end by crossing claviclavicular, clavisternal, clavicostal ligaments to draw a clavicle laterally. If the main pathological process is situated laterally against a middle-clavicular line one should determine an acromial clavicular end by crossing acromially clavicular and wedge-like-clavicular ligaments to draw a clavicle medially that decreases tissue traumaticity and shortens the period for rehabilitation. EFFECT: higher efficiency of operation. 2 cl, 2 ex _