METHOD FOR RECONSTRUCTING RECTOVAGINAL SEPTUM AT SURGICAL TREATMENT OF DESCENSUS AND PROLAPSE OF POSTERIOR VAGINAL WALL AND RECTOCELE Russian patent published in 2006 - IPC A61B17/42 A61L27/06 

FIELD: medicine, operative gynecology.

SUBSTANCE: one should cut and remove a triangular fragment out of posterior vaginal wall, against the top of separated triangle it is necessary to make a longitudinal median incision of vaginal wall up to posterior arch, then one should conduct maximal separation of posterior vaginal wall laterally to the walls of small pelvis along opening overstretched anterior rectal wall covered with rectovaginal fascia up to lateral walls, with either one or two purse-string sutures applied onto rectovaginal fascia at capturing anterior rectal wall. One should reconstruct a muscular-fascial rectal sheath during the whole length of rectovaginal septum with separate more surface sutures onto rectovaginal fascia with adjacent muscular elements. Reconstructed muscular-fascial sheath should be sutured with super-elastic ligature out of titanium nickelide. Moreover, sutures should be applied at stitch length of about 5-6 mm and distance between sutures being 5-6 mm in longitudinal and cross-sectional directions by netting-type against external rectal sphincter up to posterior vaginal arch and lateral rectal walls. One should isolate and suture muscles lifting anus and muscular-fascial perineal foundation. Then it is necessary to suture the edges of vaginal wound, subcutaneous layer and perineal skin. The innovation in question enables to reconstruct normal anatomo-topographic position of anterior rectal wall and posterior vaginal wall.

EFFECT: higher efficiency of reconstruction.

8 dwg, 2 ex