Seam Floor-by-floor

The staged technique or "stepped suture" is one of the most common methods of suturing in surgical practice. This method is characterized by sequential suturing after each stage of the operation. To perform this method, special tools are used for each stage, such as interrupted sutures, removable and removable scissors, imaging aids, and surgical meshes.

The issue of surgical treatment of peptic ulcer remains relevant in surgery for many years. An important component is ways to close damage to the gastrointestinal tract and promote restoration of the wall of the stomach and duodenum. Among modern methods of layer-by-layer closure of ulcerative defects during gastric resection, the “Layered” suture should be noted, which helps to increase the functionality of the remaining tissues after gastric resection.

Staged closure requires coordinated motor input and action across a large number of healthy areas of the gastric wall. This form of suture limits the mobility of adjacent tissues, tightly closing the sutures at the level of the upper parts of the stomach, which can cause displacement of the diaphragm and serous membrane and reduces potential complications of the suture: perigastritis, mediastinitis, esophagitis, internal hernias. The “Stage by Floor” suture is used mainly for gastric resections of more than 20 cm. Long laparotomy using the double-layer or steppe technique is a complex operation aimed at lengthening the incision and limiting the subcutaneous area. The laparotomy incision begins on the anterior wall of the abdomen along the midaxillary line, approximately an arm's length from the navel. The forearm is inserted into the incision from the front and back to prevent tearing of the tissue. The incision extends to the groin, borders the inner surface of the ilium and reaches the lumbar column. The incision then encircles the area of ​​the lumbar column and passes through the groin to the opposite side of the abdomen. After this, the incision is closed laterally using a knife and follows the shape of the peritoneal wall. It should be noted that the advisability of using “For each segment” and “Honorable” sutures remains a subject of discussion between surgeons. In my opinion, it is necessary to use only what is necessary for a given operation.