FAEV ALEKSEJ ALEKSEEVICH,Фаев Алексей Алексеевич,BARANOV ANDREJ IGOREVICH,Баранов Андрей Игоревич,ALEKSEEV ANDREJ MIKHAJLOVICH,Алексеев Андрей Михайлович,LEONTEV ANTON SERGEEVICH,Леонтьев Антон Сергее
申请号：
RU2014109502/14
公开号：
RU0002546955C1
申请日:
2014.03.12
申请国别(地区):
RU
年份:
2015
代理人:
摘要：
FIELD: medicine.SUBSTANCE: umbilical approach is formed. A device for single laparoscopic approach is inserted. A carboxyperitoneum is created. A gallbladder bottom is fixed. An abdominal wall is pricked through in a right hypochondrium. A pointed needle is inserted into the abdominal cavity. A gallbladder wall is pricked under the control of a videolaparoscope. The gallbladder contents is aspirated through a hollow needle. A needle tip is brought out of the gallbladder. A type of inflammation of its wall is visually assessed to select a string of the correct diameter. A doubled metal string 0.1-0.3 mm in diameter is inserted into the needle. The metal string is projected as a loop into the abdominal cavity. The loop is placed within the lateral surface of the gallbladder neck wall. Endoscopic forceps are inserted through the device for single laparoscopic approach. The forceps are advanced into the projected loop opening. The forceps are used to grasp the gallbladder neck wall and pull it into the lumen opening. The loop is tightened. The string ends are fixed out of the abdominal cavity by grasping with the surgical forceps along an outer edge of the needle. The endoscopic forceps are removed from the gallbladder neck wall and moved towards the gallbladder bottom. The endoscopic forceps grasp the gallbladder bottom to cover a needle point. That is followed by traction of the gallbladder bottom with the endoscopic forceps towards a diaphragm. Traction of the gallbladder neck wall is caudal and lateral by manipulating the needle that makes visualise Calots triangle. An electrosurgical hook inserted through the device for single laparoscopic approach to separate the duct and gallbladder artery, which are clipped and transected separately. The gallbladder is separated from a bed by means of the electrosurgical hook with alternating the medial and lateral direction of the neck traction. After the gallbladder is separated from the bed, the loop is removed from the gallb
