Stages of a lip-like gastrostomy by Toprover’s method - Этапы губовидной гастростомии по Топроверу.

Surgical gastrostomy. «Lip-like» gastrostomy according to G.S. Toprover in a patient with advanced esophageal cancer. The abdominal cavity is opened by a median or transrectal incision on the left and the anterior wall of the stomach is removed in the form of a cone; two sutures are applied to the top of the cone. Below the top of the cone, three purse-string sutures are concentrically applied at a distance of cm from one another. The ends of the pouch threads are not tightened. The stomach cavity is opened at the top of the cone between the holders, a rubber drainage tube with a diameter of 1 cm is inserted into the hole, and the threads of the purse-string sutures are successively tightened. Thus, three folds-valves are formed around the inserted tube. To preserve the formed channel, the stomach cone is fixed to the layers of the abdominal wall incision: at the level of the deepest pouch, the wall of the cone is fixed to the parietal peritoneum, the higher located section is fixed to the edge