Rajkotia

Rajkotia - dissection connecting branches between the spinal cord and the edge of the sympathetic trunk, or between him and somatic nerves, or between sympathetic with ganglia vertically and between sympathetic trunks left and right side (see Autonomic nervous system, the Spinal cord).
Make rajkotia pain of different localization, do not respond to medical treatment.

Rajkotia (ramicotomia; from lat. agent often, ramicis - branch and Greek. tome - dissection) - dissection connecting branches between the spinal cord and the edge of the sympathetic trunk, between the sympathetic trunk and somatic nerve, between sympathetic ganglia vertically and between sympathetic trunks right and left sides (see Autonomic nervous system, the Spinal cord).
Rajkotia is the procedure less traumatic than gaglietole (see Sympathectomy). Clinical and physiological observations showed that the preganglionarnah rajkotia more effective than postganglionarnyh. Operations on the sympathetic nervous system are widely produced with pain syndromes of autonomic and somatic types of different origin and different localization, beyond the conservative pharmacological and balneophizioterapevticheskoe exposure, and in the absence of effect from procaine blockade on the nodes. More narrow application of rajkotia received in bronchial asthma, gastric ulcer, spasm of the esophagus and the pylorus, diseases of the blood vessels, disease, Raynaud's disease, obliterating endarteritis, thrombophlebitis, Takayasu, hypertension, damage nerves, spastic paralysis, epilepsy, impaired trophic, injury, closed trauma of various parts of the nervous system.
Crucial to the effectiveness of rajkotia has not only the right choice of a place of crossing connecting branches, but also the accuracy, detail, and strict anatomical procedure the surgeon. To prevent regeneration sympathetic fibers after rajkotia must repetirovali at a sufficient period.
The technique of the operation. Rajkotia branches of the upper cervical sympathetic site. Incision of soft tissues from the mastoid process to the thyroid cartilage along the edge of the sternoclavicular-liners muscles, the opening of the front wall of her vagina divert muscle in the side. On the dissection of the posterior wall of the vagina neurovascular bundle assign to the midline of the neck. The opening predposlednii fascia raise the hook edge of the sympathetic trunk, with cross-stretched connecting branches. Put layers of stitches for the wound.
Rajkotia connecting branches of the starry host sympathetic nerve. Cut into 2 cm above and parallel to the collarbone from the rear edge of the sternoclavicular-liners muscles to the front edge of the trapezius muscle. Cut through the skin, subcutaneous tissue, and superficial fascia of the neck, subcutaneous muscles in the neck, crossed the external jugular vein, and after dissection of the second and third fascia bare trunks of the brachial plexus. Subclavian artery divert down. Naked star-site and connecting branches between the host and V and VIII of the cervical and I thoracic nerve trunks. Make rajkotia and then stitches.
Rajkotia connecting branches of vermehrung Department. A cut parallel to the spinous processes or obliquely from the spinous apophysis VI cervical vertebra in the direction of the inner edge of the blade. On the dissection of soft tissues skeletonize
cross appendices II and III of the thoracic vertebrae and the areas around them ribs during 4-5 see Gauze pad prepare the chin intrathoracic the fascia with the pleura and repetiruyut transverse processes with the heads and tails of the ribs. Allocate II and III intercostal nerves and find II and III breast sympathetic nodes with connecting branches. Gradually cross the final layers and sew the wound.
Rajkotia connecting branches in the lumbar spine. The patient on the back or on the side. The incision line, by depth of 1.5-2 cm, pair rectal, from the bottom of a costal arch, the length of 12-15 see Cut through the skin, subcutaneous tissue, superficial fascia. Stupidly lengthwise rasslaivath external and internal oblique and transverse muscle. In the outer edge of the wound index finger tear cross the fascia. Prepare the chin parietal peritoneum to the spine. Deep hooks assign it with the contents of the abdominal cavity to the middle line. Open predposlednee the fascia and between lumbar muscle and the aorta to the left or the inferior Vena cava to the right in the tissue on the front-side surface of the vertebrae allocate the edge of the sympathetic trunk with connecting branches. After crossing these branches layers sew the wound. The question about the indications to rajkotia should be solved taking into account emerging new pharmaceuticals, which can be achieved off reflex arc without operative intervention.