METHOD FOR LAPAROSCOPIC ASSISTED DIVERTICULECTOMY WITH PARTIAL RESECTION OF ILEUM THROUGH SINGLE APPROACH IN CASE OF MECKEL'S DIVERTICULITIS IN ADULTS

摘要

FIELD: surgery.;SUBSTANCE: invention relates to surgery and namely to abdominal surgery. A transverse skin incision with a length of 25 mm is performed along the midline of the abdomen caudal to the navel at a distance equal to 1/3 of the distance between the navel and the projection of the symphysis pubis, and 1 cm to the right of the midline. The anterior sheath of the rectus abdominis muscle is dissected along its medial edge. The inner edge of the rectus muscle is retracted outward with a Farabef hook. The posterior sheath of the rectus abdominis muscle is visualized, which is dissected together with the peritoneum. After installation of the device for a single laparoscopic approach of the Karl Storz Company, a carboxyperitoneum of 12 mm Hg is created. A 5 mm video laparoscope and a 5 mm bipolar instrument with the LigaSure tissue dissection function from Medtronic are introduced. Electrocoagulation of the mesentery of Meckel's diverticulum and its intersection are performed. The same instrument is used to grab the apex of the diverticulum, remove the rubber seal and, together with the loop of the small intestine, bring it into the device for a single laparoscopic access. A Medtronic linear suturing stapler is applied to the base of the diverticulum with the capture of the ileal wall, diverticulectomy with partial resection of the ileum is performed, the loop of the small intestine is immersed in the abdominal cavity through a device for a single laparoscopic access. The rubber seal is installed in place. A carboxyperitoneum of 12 mm Hg is created. Examination of the abdominal cavity is controlled, desufflation with removal of the device for a single laparoscopic access is performed. The posterior sheath of the rectus abdominis muscle is sutured, the latter is returned to its place. The anterior sheath of the rectus abdominis muscle is sutured. Sutures are applied to the subcutaneous fatty tissue and skin.;EFFECT: method allows expanding and simplifying possibilities of conducting laparoscopic diverticulectomy with resection of the ileum through a single laparoscopic approach system, providing protection of the wound edges in order to prevent purulent complications, ensuring the prevention of herniation at the site of the surgical approach by displacing the layers of the wound canal at the stage of layer-by-layer suturing of the abdominal wall.;1 cl, 5 dwg, 1 ex