LAPAROLIFTING AS A VARIANT OF TECHNICAL SUPPORT IN REPEATED OPERATIONS OF ACUTE BOWEL ISCHEMIA
Background . During the last decades, lethality rates (63-95 %) in patients with acute intestinal ischemia remain consistently high. To increase the effectiveness of planned repeat operations, it is necessary to provide tools to control pathogenetic mechanisms of development of typical postoperative complications in this group of patients. Material and methods. A retrospective study of 28 clinical cases of surgical treatment of patients with acute intestinal ischemia developed as a result of mesenteric thrombosis ( n = 10) and infringement of the small intestine in hernias ( n = 18) was performed. The risks of development of respiratory insufficiency and peritonitis with features of surgical tactics and its instrumental support are compared. Results. It has been established that the increased risk of development of infectious abdominal complications is associated with tactics of closed abdominal management and emergency relaparotomy ( p = 0.028). The requirements for the instrumental support of the re-examination operations are defined. A technical device was developed and implemented that provide low-traumatic repeated operations in the laparoscopic and open abdominal auditory mode. A clinical example of the use of the proposed method in the treatment of a patient with acute intestinal ischemia is given.