FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to gynecology. For surgical treatment of uterus prolapse, parietal peritoneum is opened between round and infundibular-pelvic ligaments throughout 2.5–3.5 cm, posterior leaf of broad uterine ligament in area of uterosacral ligaments from each side and uterovesical fold. Two synthetic flaps of rectangular shape with length of 12–14 cm, width of 2.0–3.0 cm are cut out. Each flap is cut longitudinally within 8–9 cm. Then an extraperitoneal tunnel is formed, peeling parametrical fiber from parietal peritoneum between round and infundibular-pelvic ligaments. Non-split end of the flap is introduced through the tunnel and brought out on the anterior abdominal wall in the iliac region lateral to the external abdominal oblique muscle. Flap is fixed with nonabsorbable ligatures to the edge of the aponeurosis within the incision angle of the corresponding side. Similarly, the second flap is taken and fixed on the other side. Free end of one of the sections formed on the other end of the flap is performed extraperitoneally under a round ligament of uterus and fixed with nonabsorbable ligatures to pubic-cervical fascia and anterior wall of cervical uterus of the corresponding side. Free end of the second portion is extraterritally extended through a posterior leaf of the wide uterine binder and fixed with nonabsorbable ligatures to the uterosacral ligaments of the corresponding side. Second flap sections on the other side are drawn and fixed similarly. Tension of the flaps is regulated using a vaginal examination.
EFFECT: method enables reliable correction of uterine descent and prolapse and reduced number of recurrent genital prolapse.
1 cl, 1 ex
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Authors
Dates
2019-04-01—Published
2018-04-03—Filed