METHOD FOR REPAIR OF DEFECT OF PELVIC FLOOR AFTER TOTAL EVISCERATION OF SMALL PELVIS WITH REMOVAL OF EXTERNAL SEX ORGANS Russian patent published in 2018 - IPC A61B17/00 A61B17/42 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to oncology, surgery, rehabilitation, and can be used for locally advanced tumors of the pelvis (cancer of the bladder, urethra, rectum, body and cervix, vulva, sarcoma of the soft tissues of the perineum) with total evisceration of the pelvis with extirpation of the rectum, removal of the external genital organs to close a large pelvic floor defect. For this purpose, after performing the exploring and ablative phase of the operation, a reconstructive stage is performed to close the perineal wound. Two skin-muscle flaps are formed along the inner surface of both thighs (adductor of the thigh) on the neurovascular bundle – the branches of the deep artery of the thigh, the anterior branch of the obturator nerve. Consistently a subcutaneous tunnel is formed on each side of the proximal part of the wounds on the hips to the perineal wound. Skin and muscle flaps are carried out through the formed subcutaneous tunnels into the perineal wound. From one skin-muscular flap the epidermis and flap are removed and placed in the pelvis. Its skin surface (without epidermis) forms the diaphragm of the pelvis by filing to the walls of the pelvis. And the second (superficial) flap is arranged with muscle tissue to the muscle tissue of the deep flap. Using the second skin-muscular flap, the skin defect of the perineum is closed, fixed with interrupted sutures to the soft tissues of the perineum and to the skin.

EFFECT: method ensures the closure of large defects of the perineum with the restoration of the anatomy of the diaphragm of the pelvis, reducing the frequency of early and late postoperative complications, thereby improving the quality of life of patients after evisceration of the pelvis.

3 cl, 5 dwg, 1 ex