FIELD: medicine.
SUBSTANCE: invention refers to medicine, namely to oncology, urology, and can be used for the purpose of radical treatment of bladder cancer. Optical, three robotic and two assistant trocars of the Da Vinci surgical system are installed, identification and dissection of ureters, apical dissection, interintestinal anastomosis and Bricker uroleostomy are formed. Optical trocar is positioned at the middle of the distance between the umbilicus and the xiphoid. First robotic trocar R1 is installed in the area of further removal of uroleostomy, the second robotic trocar R2 is installed at distance of 8 cm from the first, above the right iliac spine, the third robotic trocar R3 – on the left at distance of 8 cm from the optical trocar at the navel level. First assistant 12 mm As1 trocar is placed 2 cm above the left iliac spine in the anterior axillary line, second assistant 5 mm As2 trocar – along the anterior axillary line above the third robotic line. Sacral and bifurcation lymphadenectomy are performed by placing the instruments in a parallel position. Intersection of ureters is performed after complete mobilization of urinary bladder, and intestinal anastomosis is applied by endoscopic stapling apparatus through 12 mm assistant trocar.
EFFECT: using the invention provides reducing the length and blood loss of the operation, improving the surgeon's convenience, preventing the formation of a "bad stoma".
1 cl, 7 dwg, 1 ex
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Authors
Dates
2020-04-01—Published
2019-08-30—Filed