FIELD: medicine.
SUBSTANCE: invention relates to medicine and surgery. Radical cystectomy of the bladder is performed. Ureters are transected in the lower one-third and intubated with drainages of corresponding diameter. Enteric section with the length of 35-40 cm is mobilized. Ureteroenteric intestinal anastomoses are applied, receding from the edge of the intestinal segment resection line to 2.5-3.0 cm on the right and left, from the mesenteric edge of the small intestine to 0.2-0.4 cm. Serous intestinal shell is incised to the size exceeding the diameter of the ureter by 0.2-0.3 cm. In the muscular layer of the intestine, towards the antimesenteric edge a 0.3-0.5 cm tunnel is formed. A hole is punctured in the bowel lumen. Ureters are intubated with catheters. Ureters are delivered through the tunnels into the lumen of the vessel and are fixed to the wall with two ligatures at the edges of the incision of the serous membrane. Anastomosis of urethra vessel is applied. Catheter of the left ureter is brought through the urethra. Blind ends of the vessel are sutured over the ureteroenteric intestinal anastomoses with a second line of sutures. To unload the artificial bladder, a hole is punctured in the right end area. Right ureter catheter is brought out through the hole and onto the anterior abdominal wall in right iliac region.
EFFECT: method enables to provide the reliable homeostasis, leak-tightness, valve function of the anastomosis, prevents the risk of reflux.
1 cl, 1 ex, 3 dwg
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Authors
Dates
2016-09-20—Published
2015-11-09—Filed