GASTROTOMY (grech, gaster a stomach + tome a section, a section) — operation of opening of a gleam of a stomach.
It is shown for removal of the foreign bodys of a stomach swallowed accidentally it is deliberate or formed in a stomach (see. Bezoar ); for removal of single polyps of a mucous membrane and benign tumors of a wall of a stomach; for a stop of intragastric bleedings, especially at Mallori's syndrome — Weiss, and as palliative menacing bleedings operation, connected with portal hypertensia, and also at helcomenias in the presence of contraindications to operations of bigger volume; at profuse went. - kish. bleedings when survey and palpation of a stomach and all went. - kish. a path do not allow to reveal a bleeding point.
It is more often made in the direction, longitudinal to a long axis of a stomach, in the avascular site of a front wall. Longitudinal G.'s advantage is an opportunity if necessary to prolong a section of a wall of a stomach as kranialno, up to subcardial department, and distally, for a duodenum with a section of the gatekeeper. On a front wall of a stomach, in the place of alleged pathological changes, impose silk seams handles, between to-rymi cut serous and muscular covers, alloy vessels of a submucosal layer and open a gleam of a stomach after preliminary isolation of a surgery field. Contents are deleted with suction machines. Parting edges of a wound of a stomach with blunt retractors, examine its inner surface and necessary manipulations.
For more careful and reliable survey of a back wall and small curvature of a stomach it is possible to open a gastrocolic sheaf and the palm of the left brush entered into an omental bursa under a stomach consistently to bring and stick out a back wall in the gaping gastrotomichesky section.
During removal of narrow and long foreign bodys (a nail, a needle, etc.) it is reasonable to bring previously one end of a foreign body to a front wall of a stomach and over it to open with a small section the evaginated site of a wall through which and to remove it.
Operation G. is finished with mending of a wound of a stomach two rows of seams in lengthwise direction. If G. was made in peloric department and prolonged for a front wall of a duodenum with a section of the gatekeeper (gastroduodenotomiya), mending of a wound is made in transverse direction, i.e. finish G. with a pyloroplasty across Geyneka — to Mikulich.
See also Stomach , operations.
Bibliography: Bir A., Brown and Kummel. Operational surgery, the lane with it., t. 3, M. — L., 1929; To about shch e r I. I. and Sudakov of M. V. Gastrotomiya at some diseases of a stomach, Klin, hir., No. 10, page 36, 1964, bibliogr; L and TT of m and N of N And. Belly surgery, a per „with it., Budapest, 1970.
B. S. Rozanov.