METHOD FOR LAPAROSCOPIC COLPOFIXATION AT HYSTERECTOMY Russian patent published in 2007 - IPC A61B17/94 A61B17/42 

FIELD: medicine, surgical and laparoscopic gynecology.

SUBSTANCE: after hysterectomy due to applying a vaginal access from one side being about 10-15 mm against free edge of every stump one should suture the stumps of cardinal and sacro-uterine ligaments with nonabsorbable ligature by capturing a vaginal wall. One end of ligature after tightening the knot should be cut, another one should be placed into abdominal cavity; similarly one should suture the stumps of cardinal and sacro-uterine ligaments from another side, after that it is necessary to form a vaginal cupola. Then, under laparoscope's control one should introduce lateral trocars into abdominal cavity by puncturing anterior abdominal wall being about 2-4 cm medially against the upper anterior iliac spine from each side. Moreover, for the purpose to form extraperitoneal canal one trocar should be removed to introduce into the developed canal an uterine guide-probe with a foramen at its working end ("the probe" below) but not reaching the peritoneum to move it under laparoscope's control extraperitoneally being under the bottom of the stump of round ligament of uterus of the same side, then one should perforate peritoneum with the probe in area of the stump of sacro-uterine ligament and direct the probe into abdominal cavity. With the help of a manipulator introduced through lateral trocar of the opposite side one should apply a free end of ligature through the probe's foramen that fixes the stumps of ligaments at the side of the developed extraperitoneal canal to remove it with the probe's back passage out from abdominal cavity. Similarly, it is necessary to remove another end of ligature from the opposite side and then with the help of a guide one should apply one end of ligature above aponeurosis of external oblique muscle of abdomen in subcutaneous fatty fiber towards the site of removal of another end of ligature, the ends of ligatures should be tightened up and bound to complete vaginopexy. The innovation enables to fix vaginal cupola in physiological position and carry out reliable prophylaxis of descensus and prolapse of internal reproductive organs after vaginal hysterectomy.

EFFECT: higher efficiency.

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