METHOD FOR INTRAOPERATIVE DIFFERENTIAL DIAGNOSTICS OF UTERINE MYOMA AND III DEGREE ADENOMIOSIS WITH UTERINE SIZE OF 12 AND MORE WEEKS OF PREGNANCY Russian patent published in 2017 - IPC A61B17/42 

FIELD: medicine.

SUBSTANCE: study is performed on day 7-14 of the menstrual cycle. A solution of contrast medium is prepared, for which 1 ml of a 1% solution of methylene blue is diluted in 200 ml of 0.9% NaCl solution. A two-lumen Foley catheter is installed in the uterine cavity through the cervical canal and its cuff inflated to seal the uterine cavity in the area of catheter insertion. The area of optical trocar introduction above the navel along the middle line is determined according to the formula: H=t-12, where H is the distance between the navel and the point of optical trocar installation, cm; T is the height of uterus bottom standing above the bosom, cm. Through the optical port, a laparoscope with a viewing angle of 30° is introduced, after which introduction of the prepared solution into the uterine cavity is started through the working channel of the Foley catheter at a pressure of 15-20 mmHg for 20 seconds. When the contrast solution enters through the uterine tube(s) into the abdominal cavity, its administration is continued under a pressure of 25-30 mmHg for 20 seconds. After that, laparoscopic examination of the outer surface of the uterus is performed and if the serous membrane stains blue in the area of the focus, a nodular form of adenomyosis of the third degree is diagnosed, and if the colour of the outer surface of the uterus is preserved, - uterine myoma is diagnosed.

EFFECT: informative intraoperative express diagnostics of uterine myoma and adenomyosis of III degree with uterus of large size, selection of optimal surgical tactics, reduction of intraoperative and postoperative blood loss, increased functional results of operation.

3 dwg, 2 ex