METHOD OF PERFORMING A NERVE-SPARING RADICAL HYSTERECTOMY IN CERVICAL CANCER IA2-IIA STAGE Russian patent published in 2019 - IPC A61B17/42 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to oncology and gynecology. At the first stage, bilateral iliac-obturator lymphadenectomy is performed. That is followed by dissection of the pararectal medial and lateral and paracystic medial and lateral spaces with bilateral tunneling of ureters and separation of cardinal, sacrouterine, vesicoureteral ligaments containing bipolar hypogastric nerves and branches of the lower hypogastric plexus. Water jet with diameter 0.1 mm at pressure 35 Bar is directed parallel to a plane of sacrouterine ligament with the help of water-jet dissector at distance of 3–5 mm from visualized nerve trunks. Branches of the hypogastric nerve are separated along the sacral cape to the point of intersection with the uterine vessels. A sacrouterine ligament is removed. That is followed by recovering and preserving the cervical branches of the pelvic plexus, the ureter being shifted laterally, the vesicoureteral ligament folded upward and medially. Water-jet dissector separates cervical branches of pelvic plexus from thickness of vesicoureteral ligament and cuts vesicoureteral ligament.

EFFECT: method enables to achieve the following therapeutic results: maintaining adequate urination following radical cervical cancer IA2-IIA stages, minimizing the length of catheterization of patients after extended operations to 2–3 days and maintaining a satisfactory sexual function following the extended hysterectomy.

1 cl, 2 ex