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首页> 外国专利> METHOD FOR SURGICAL MANAGEMENT OF PATIENTS WITH COMBINED RENAL, ADRENAL AND GALLBLADDER PATHOLOGY

METHOD FOR SURGICAL MANAGEMENT OF PATIENTS WITH COMBINED RENAL, ADRENAL AND GALLBLADDER PATHOLOGY

机译：肾，肾上腺和胆囊病理合并症患者的外科手术治疗方法

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FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to surgery and urology, and can be used for surgical management of patients with a combined renal, adrenal and gallbladder pathology. Method involves creation of a retroperitoneal working cavity, for which a bulletin dissection is performed, under control of a laparoscope three working ports are installed: by posterior axillary line below edge 12 of rib, along middle axillary line 2 cm above comb of ilium, along anterior axillary line at same level. Retroperitoneal endoscopic intervention is performed on the kidney or adrenal gland, and the kidney, adrenal gland or parts thereof are placed in a polyethylene container for further extraction to the outside. In the same patient's position on the operating table and the installed working ports, on the side of the retroperitoneal working cavity under the control of the laparoscope, a parietal peritoneum is exposed near the anterior wall of abdomen for 15 cm. Laparoscope and working tools are advanced through the produced peritoneal opening into the abdominal cavity, the gallbladder is visualized, tissue dissection is performed in the area of the Kalo triangle, clipping and intersection of the cystic duct and cystic artery. Gallbladder is mobilized from a bed and placed in the same polyethylene container, which is removed in nephrectomy through a supernumerary incision of skin, subcutaneous fat, an external sheet of aponeurosis and straight abdominal muscles, with kidney resection or adrenalectomy - through the expanded aperture of the port along the back-axillary line. In surgical intervention on left kidney or adrenal gland for performing simultaneous cholecystectomy after parietal peritoneal dissection and performing laparoscope and working tools in abdominal cavity, in area of umbilicus additional working port is installed.;EFFECT: method provides higher surgical efficiency ensured by performing cholecystectomy after the main stage of the operation without changing the patient's body position on the operating table and performing additional incisions for working ports.;1 cl, 1 ex
机译：技术领域本发明涉及医学，即外科和泌尿外科，并且可用于肾，肾上腺和胆囊合并病理的患者的外科治疗。该方法涉及创建腹膜后工作腔，在腹腔镜的控制下对其进行公告解剖，安装三个工作端口：通过肋骨边缘12下方的后腋窝线，沿着lium骨梳上方2 cm的腋窝中线，沿着前腋线在同一水平。对肾或肾上腺进行腹膜后内窥镜干预，并将肾，肾上腺或其部分放置在聚乙烯容器中以进一步提取到外部。在腹腔镜控制下腹膜后工作腔一侧，在手术台和已安装的工作端口上同一患者的位置，腹膜腹膜暴露于腹部前壁附近15 cm。腹腔镜和手术工具通过产生的腹膜开口进入腹腔，使胆囊可视化，在Kalo三角形，胆囊管和胆囊动脉的夹层和相交处进行组织解剖。胆囊从床上动员并放置在相同的聚乙烯容器中，在肾脏切除术中，通过皮肤，皮下脂肪，外来腱膜和腹直肌的多余切口，通过肾脏切除或肾上腺切除术-通过扩大的沿后腋线的端口。在左肾或肾上腺的外科手术中，在进行腹膜腹膜剥离后同时进行胆囊切除术并在腹腔内进行腹腔镜检查和工作工具时，在脐带区域安装了额外的工作端口。效果：该方法通过在胆囊切除后进行胆囊切除术确保了更高的手术效率手术的主要阶段，而无需改变患者在手术台上的身体位置并在工作口上进行其他切口。; 1 cl，1 ex

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