METHOD FOR LAPAROSCOPIC ULTRASUBERVATION EXCISION OF PROSTATE ADENOMA Russian patent published in 2019 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to urology. In lifting of anterior abdominal wall, performed using laparolift, pneumoperitoneum is created and endopters – optical and two working trocar – are installed. Then in the area of the transient fold of the parietal peritoneum, the parietal peritoneum is incised and the bladder wall is opened by way of its transverse incision within 5–7 cm, after what its cavity and ureter mouths are inspected, as well as presence or absence of stones in the urinary bladder cavity, in the presence of which they are removed. Further, above the adenomatous nodes extending into the lumen the bladder mucosa are dissected, with simultaneous coagulation of the bleeding vessels, the caudal incision is continued, and the laparoscopic desector is inserted into the space between the adenomatous nodes and the surgical capsule of the adenoma – the peripheral prostate. Following the surgical layer lumen, the adenomatous nodes are separated from the surgical capsule, which are then excised by the acute manner with their subsequent extraction from the bladder cavity, with simultaneous coagulation of the bleeding vessels along the entire surface and in the urethra at the bladder apex. Thereafter, a remote adenoma bed is inspected and haemostasis is controlled. Finally, the bladder is drained by placing a three-way Folley catheter in the urethra in its cavity of at least No. 18 CH with inflation of the catheter balloon in the bed of the removed adenoma with irrigation of the bladder cavity. Wound of the bladder wall is closed with one row of vicryl sutures, also a one-row vicryl suture closes a peritoneal defect. Operation is completed by installing the insured tube drainage into the abdominal cavity.

EFFECT: method enables reducing operative injuries, shortening the rehabilitation period, reducing bleeding from the wound and prostate tissue, preserving the pre-tubercular space integrity, reducing the probability of forming the postoperative urethral stricture, allows removing of stones from the bladder cavity and removing the bladder wall diverticula with removing of the adenomatous nodes.

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