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The monograph is devoted to improving the efficiency of total separation of the gastroesophageal collector in patients with portal hypertension syndrome. Analysis of the effectiveness of the original TRHEC technique in patients with hepatic hypertension syndrome made it possible to verify the main causes of unsatisfactory results and improve the technical aspects of performing this type of intervention. The modification of the uncoupling operation introduced into clinical practice is aimed at reducing the risk of developing various specific complications in the immediate and long-term periods, reducing the mortality rate and, in general, improving the effectiveness indicators of this type of intervention in the surgical treatment of portal bleeding. The improved technique of TRHEC on a frame prosthesis made it possible to reduce the risk of developing complications specific to this type of surgery, to increase the effectiveness of treatment and prevention of bleeding from ERVP.