FIELD: medicine.SUBSTANCE: invention refers to medicine, namely to maxillofacial surgery, and is applicable for elimination of extensive hard palate defect. Mucous membrane of the oral cavity is incised by 0.8–1.2 cm from the bony edges of the extensive hard palate defect on both sides, two mucous flaps are separated and cut out, which are tilted to the center of extensive hard palate defect, brought together and fixed with each other with the help of suture material. Access to recipient vessels – facial artery, facial and submental veins is performed through an incision of skin, subcutaneous fat, intrinsic fascia of neck in submandibular area, along upper neck fold. Recipient vessels are separated and transected. Tunnel is formed in a submucosal layer extending from the soft palate further parallel the wing-mandibular fold along an inner surface of the lateral mandibular side anterior to the projection of the anterior border of the masseter in the submandibular region. At preoperative preparation stage, preliminary projection of medial gastrocnemius artery is pre-marked, required shape and area of skin-fascial medial gastrocnemius autograft taking into account extensive hard palate defect in recipient area. Dissecting of skin-fascial medial gastrocnemius autograft on vascular pedicle – medial iliac artery and veins start with anterior approach. Skin and subcutaneous fat are incised along the medial border of the skin-fascial medial gastrocnemius autograft. Dissection is performed until a medial gastrocnemius artery is detected. Then, the fascia of the shin is dissected； along the direction of the medial gastrocnemius artery, it is released from the medial gastrocnemius muscle by intramuscular dissection. Small vascular perforators are alloyed and crossed during preparation. Dissection is continued in the proximal direction to the level of the projection of the popliteal fossa, where the mouth of the medial gastrocnemius artery is visualized in the popliteal artery.
