FIELD: medicine.
SUBSTANCE: invention refers to medicine, namely urology and andrology. Surgical approach in cavity of the scrotum, visual inspection and visually controlled biopsy of scrotum organs in conditions of air medium and atmospheric pressure are performed. Scrotum organs are not brought into incision wound, and surgical approach in cavity of scrotum, scrotum organs and the scrotum organs is performed inside scrotum using endoscopic video equipment and tools. Local optical space inside scrotum is formed using internal expansion tool. After opening of cavity of scrotum by linear incision of 5 mm and applying Haemostatic sutures on wound edges of scrotum through wound channel into cavity of scrotum simultaneously introduced optical tool and extension Hachine or Dormia "basket" or "Tulip" guide in closed form. Then expander basket is opened to diameter of 1.5-2 cm, afterwards endo video scope inspection of scrotum organs within available space is performed, then between strings of reamer head scrotum cavity is punctured in upper one-third of testicle at medium-lateral surface of scrotum with Dufaut needle with gap of 1.5 mm or No. 16G 1.6×40, through which cavity of scrotum bellied probe is inserted and, serially moving expander with expanded basket and using bellied probe thorough endoscopy inspection and endo-palpation of all scrotum organs are performed. Then through Dufaut needle puncture needle is introduced and puncture biopsy of epididymis or testis is performed: PESE, TESA (TEFNA), wherein after completion of all stages of operation quality of scrotum organs puncture point haemostasis is evaluated. In case of bleeding puncture point electric coagulation is performed through Dufaut needle; latter is removed. Quality of haemostasis of scrotum wall in puncture point is evaluated, if case of bleeding from wall Z-shaped suture is placed. Under visual control dilator-"basket" is closed and removed from wound, and optical system is removed lase under visual control, hole is tightened with catgut without drainage.
EFFECT: method of less traumatic, enables optimum selection of place of sampling, minimising risk of haemorrhagic complications.
1 cl, 2 dwg, 1 ex
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Authors
Dates
2016-04-10—Published
2015-05-07—Filed