METHOD FOR SURGICAL TREATMENT OF UTERINE PROLAPSE Russian patent published in 2017 - IPC A61B17/42 

FIELD: medicine.

SUBSTANCE: laparotomy as per Pfannenstiel is performed. After intra-facial hysterectomy and hemostasis of vaginal walls, the upper edge of the anterior vaginal wall in the region of its lateral third is stitched together with the pubic-cervical fascia using the first non-absorbable hypoallergenic ligature without mucosal entrapment. The second non-absorbable hypoallergenic ligature is used to stitch the stump of the sacro-uterine ligament, receding 2-3 mm down from the ligature superimposed thereon, and the back wall of the vagina without mucosal entrapment. Similarly, ligatures are imposed on the other side. Two rectangular flaps are formed from the cut with width corresponding to the distance between the first and second superimposed ligatures, each 12-14 cm long. The dome of the vagina is formed by edges suturing. Then one of the ends of the flap is fixed in the area of imposed ligatures by suturing one of its corners with the first ligature and the other with the second ligature. Then, an extra-peritoneal tunnel is formed, peeling the parametric fiber from the parietal peritoneum between the round and funnel-pelvic ligaments. The second end of the flap is passed through the tunnel. It is withdrawn to the anterior abdominal wall in the iliac region through the outer edge of the outer oblique abdominal muscle and fixed to the edge of the aponeurosis in the region of the incision angle of the corresponding side. The second flap is similarly fixed and conducted on the other side. Flaps tension is controlled using vaginal examination and is considered sufficient for a vagina length of 10-12 cm.

EFFECT: decreased number of relapses of genitals prolapse, exclusion of ventral hernias formation, providing a possibility of monitoring and correction of the degree of flaps tension during their fixation.

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