Operations with occlusive lesions of the bifurcation of the aorta and its branches
Cardiovascular Diseases / / August 12, 2017
angioplasty and heart
(method of operation)
bifurcation prosthesis produced in atherosclerotic lesions of the aortic bifurcation and both iliac arteries.
The patient - on the back.
Anesthesia - endotracheal anesthesia.
Tools: general surgical suite, Vascular set Fogarty probe, abdominal retractors, bifurcation set of dentures.
preoperative conduct a thorough preparation of the patient: drug preparation of the cardiovascular system (especially the elderly), a thorough bowel movements, hygienic bath with a change of clothes, shaving all skin of the abdomen, pubis, groins and upper third of the thighs.
processing the surgical field. treatment is carried out from the nipples to the knees and alcohol tincture of iodine, or three times the potassium yodonatom or diotsidom and others. Especially carefully treated inguinal region.After treatment, isolate operating three fields: the median line of the abdomen from the xiphoid process to the symphysis pubis and the two projection femoral
course of operations. longitudinal section through the femoral arteries projection length of 10-12 cm layers isolated femoral vessels, which are taped, the wounds are covered with wet wipes.Produce median laparotomy from the xiphoid process to the pubis.Small intestine eventriruyut right and close the wet, warm towels, sigmoid colon pushed back to the left side of the channel.The next stage of the aorta is opened longitudinally rear piece of the parietal peritoneum, sharp and blunt isolated aorta and iliac arteries.After that, the aorta impose anastomosis with prosthesis, check the tightness of the anastomosis and the impregnation of the prosthesis with blood.Branche prosthesis is carried out through the retroperitoneal space formed in the tunnels on the thigh and anastomoses with the femoral artery.
At all stages of the operation necessary to carry out a thorough hemostasis.
In cases where the pathological process is limited to the common iliac arteries, cuts on the hips do not produce and impose anastomosis with the external iliac artery.Wounds sutured in layers tightly.