METHOD OF OPERATIVE ACCESS IN LAPAROSCOPIC FUNDOPLICATION

FIELD: medicine.SUBSTANCE: pre-operation examination of a patient is carried out, points of introduction of five trocars: 2 manipulational, paraumbilical one, trocar for a retractor, additional trocar and their installation are determined. In the process of pre-operation examination the patient's somatotype: dolichomorphic, mesomorphic or brachimorphic is determined. In case of the dolichomorphic type the point of introduction of the paraumbilical trocar is determined as a point, located 2 cm below the navel on the midline. The trocar for the retractor is introduced in the point, located below the xiphoid process on 1/3 of the distance between the xiphoid process of the sternum and the navel and 2 cm to the right from the midline. The additional trocar is introduced through the point, lying on the left anterior axillary line 3 cm below the navel. In case of the mesomorphic type the point of the paraumbilical trocar introduction is determined as a point located 2 cm above the navel on the midline. The trocar for the retractor is introduced in the point, located on the midline below the xiphoid process on 1/3 of the distance between the xiphoid process of the sternum and the navel. The additional trocar is introduced through the point, located on the left anterior axillary line at the level of the navel. In case of the brachimorphic type the point of introduction of the paraumbilical trocar is determined as a point, located 5 cm above the navel on the midline. The trocar for the retractor is introduced in the point, located below the xiphoid process on 1/3 of the distance between the xiphoid process of the sternum and the navel 2 cm to the left of the midline. The additional trocar is introduced through the point, located on the left anterior axillary line 3 cm above the navel.EFFECT: reduction of intra- and postoperative complications due to the optimal operative access.3 ex Изобретение относится к медицине, а именно к хирургии, и может быть использовано для обеспечения оперативного доступа при выполнении лапароскопической фундопликации с учетом индивидуальных особенностей типа телосложения больного. Выполняют предоперационное обследование больного, определяют точки введения пяти троакаров: 2-х манипуляционных, параумбиликального, троакара для ретрактора, дополнительного троакара и их установку. При предоперационном обследовании определяют тип телосложения больного: долихоморфный, мезоморфный или брахиморфный. При долихоморфном типе точку введения параумбил