FIELD: medicine.
SUBSTANCE: posterior wall of bladder is separated from an anterior wall of vagina and uterus in an area free from adhesions. The adhesions are dissected in the medial direction from lateral portions to a median line of the uterus. Round ligaments of the uterus, uterine tube ends, ovarian branches of uterine arteries, anterior and posterior leaves of broad ligaments of the uterus are coagulated and dissected. Paravesicular spaces are separated from both sides up to the level of an anterior fornix of the vagina; uterine vessels are coagulated, transected from both sides; the posterior wall of the bladder is separated by a retrograde blunt technique from the anterior fornix of the vagina and an anterior surface of the uterine neck in the area free from the adhesions.
EFFECT: method allows avoiding the risk of bladder wall perforation and reducing intraoperative blood loss.
1 ex, 12 dwg
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Authors
Dates
2016-01-10—Published
2014-12-01—Filed