METHOD FOR LAPAROSCOPIC REPAIR OF ISTHMUS UTERUS AFTER CESAREAN SECTION Russian patent published in 2016 - IPC A61B17/42 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, particularly to obstetrics and gynaecology. After cesarean section metroplasty is done when thinning of the myometrium is up to 3 mm in the area of postoperative scar and its location is at the level of internal orifice and above it. During hysteroscopy the area of abortive scar from the side of uterine cavity is visualized and the distal end of the hysteroscope is put in the specified area. Laparoscope is inserted into the abdominal cavity and transillumination of the postoperative scar is done with highlighting on the side of the uterine cavity and visualization of the area of abortive scar from the side of the abdominal cavity. Thinning myometrium in the area of abortive scar is excised. First, the excising part of myometrium is visualized from the side of the abdominal cavity using transillumination, then it is seized by tool, inserted into the abdominal cavity. After that it is excised with the help of laparoscopic techniques. Stages of visualization and excision are alternated till complete excision of thinning myometrium. Then the defect edges are sutured together. When applying the first row of sutures a doctor starts to apply a ligature from its angles to its center. Ligatures are put outside through troakar, located on the side of their application. Applied ligatures are tied together, starting from the lateral ligatures. Second row of stitches is applied in extracorporal way, staggered in relation to the stitches of the first row, above them. Line of stitches is pericontinentalled with vesico-uterine fold.

EFFECT: method prevents the occurrence of complications during repeated pregnancies after caesarean section accompanied by thinning myometrium.

1 cl, 1 ex