METHOD OF TRANSVAGINAL SURGICAL PREVENTION OF POST-HYSTERECTOMY PROLAPSE OF VAGINAL VAULT Russian patent published in 2018 - IPC A61B17/42 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, specifically to surgical gynaecology. Perform vaginal hysterectomy, including the separation of the vaginal walls. Form channels to the obturator membranes, secrete the sacrospinous ligaments on both sides, while leaving the sacrouterine and cardinal ligaments extraperitoneally on both sides. After peritoneal repair and the formation of the vaginal vault, channels are formed to the sciatic spines and the sacrospinous ligaments. Next, using a non-absorbable suture material fix to each of the above sacrospinous ligaments along the synthetic mesh implant element, retreating 1.5–2 cm from the ischial spine, at the final stage colpoperineolevatoroplasty and colporrhaphy are performed. After peritoneal repair and the formation of a vaginal dome, the sacrouterine and cardinal ligaments are stitched together, forming a ligament monoblock, which is slowly absorbed ligatures fixed to the upper third of the posterior wall of the vagina. As an implant, two pieces of mesh synthetic tape are used, and the end of each tape of the implant is fixed with non-absorbable ligatures to the corresponding sacrospinous ligament on each side. After that, the vaginal vault is placed in a physiological position, said implant ribbons are hemmed in the area of their intersection with slowly absorbable ligatures to the cardinal and sacrouterine ligaments sewn together and to the middle of the vaginal vault. Then with the help of conductors, the free end of one tape fixed to the right sacrospinous ligament. Bring it out through the left obturator opening into the left inguinal crease at the level of the clitoris, pulling up the tape with tension to provide support to the pelvic organs. Free end of the second tape fixed to the left sacrospinous ligament is brought out through the right obturator hole in the right inguinal crease at the level of the clitoris, pulling the tape with tension to provide support to the pelvic organs, the excess ends of the tapes are cut and removed, leaving the implant in the wound.

EFFECT: method allows to reduce the cost of the implant and the cost of its installation, reduce the possibility of intraoperative bleeding, minimize the intraoperative effects on the organs and tissues of the body, reduce the possibility of postoperative complications and recurrence of the disease.

7 cl, 2 ex