METHOD OF LAPAROSCOPICALLY-ASSISTED TRANSVAGINAL HYSTERECTOMY AND NOZZLE FOR MORCELLATOR FOR METHOD REALISATION Russian patent published in 2016 - IPC A61B17/32 A61B17/42 

FIELD: medicine.

SUBSTANCE: group of inventions relates to medicine, surgery. A nozzle to a reducer unit of a morcellator is used for transvaginal hysterectomy. It is used to realise the displacement of the uterus for its mobilisation. At the beginning of the operation a protective tube is introduced into the vagina. A guiding instrument with closed reverse bullet forceps, which are opened and fixed in the uterus, is introduced into the cervical canal through the vagina. The vaginal wall is dissected by an introduced morcellator knife at the level of the fornices. The uterus body is transferred by means of the fixed bullet forceps with the provision of an optimal mutual location of the uterus and the knife of the morcellator nozzle. The cervix and a part of the uterus body are cut out. The knife is re-introduced into the vagina. The remaining part of the uterus body is caught by a clamp and extracted. Haemostasis is carried out by a bipolar coagulator. The vaginal wall is sutured from the side of the abdominal cavity. Peritonisation is carried out. The nozzle to the morcellator is made with a possibility of rigid fixation in its reducer unit. The device contains the protective tube with a flange, a case in the form of a tube-knife, a tube-piston with a thread on the proximal end. Inside placed is the guiding element, provided with a tip in the form of the reverse bullet forceps and a handle, and a rod passes between the reverse bullet forceps and the handle. Sharpened ends of the forceps jaws contact in a closed state. The case of the guiding element with an outer shell is provided with the flange. A spring, interacting with the case butt end and the handle, is placed inside the shell. Bushings of the device are made of an anti-friction polymer material.

EFFECT: application of the device in the method of transvaginal hysterectomy provides the reduction of time for the dissection and crushing the uterus of any dimensions and configurations, increases the operation safety.

5 cl, 5 dwg