METHOD FOR PREVENTION OF POSTOPERATIVE HERNIAS OF ANTERIOR ABDOMINAL WALL AND INCARCERATION OF INTESTINE AFTER LAPAROSCOPIC ACCESS

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, namely abdominal surgery. A layered linear incision of the skin is performed in the paraumbilical region with a length of 1.5 cm. The edges of the skin are diluted with subcutaneous fat. The anterior leaf of the peritoneum is opened with the dilution of muscle fibers. The posterior leaf of the peritoneum is opened, the preperitoneal tissue is removed and the leaf of the peritoneum is crossed. A 12 mm trocar without a stiletto is installed under manual control. A pararectal incision is performed and a second 12 mm trocar is installed with a stiletto and an endoscopic insufflator is connected, with the achievement of CO2 of 12 mm Hg. The trocar channel is sealed by applying an additional U-shaped seam. After desufflation, the walls of the trocar canal are sutured in layers with a continuous invaginating U-shaped suture from the side of the parietal peritoneum and aponeurosis. ;EFFECT: method allows eliminating a wound defect from the peritoneum, tightly comparing aponeurosis, subcutaneous tissue, preventing the risk of hernia and intestinal incarceration in the trocar region.;1 cl, 3 dwg, 2 ex