METHOD OF COMBINED SURGICAL MANAGEMENT OF IA-IB ENDOMETRIAL CANCER IN PATIENTS WITH MORBID OBESITY Russian patent published in 2020 - IPC A61B17/00 A61B17/42 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to oncology and gynecology. Prior to surgery, with the patient lying on his back, abdominal skin is pre-marked by umbilicus and upper anterior iliac spines. Two transverse downwardly curved lines are marked one above the other to connect said anatomical structures. Patient is placed on the operating table in the lithotomy position so that the hip and body are located in the same horizontal plane. After the surgical field is treated along the marking lines at the first stage, the skin is incised: a wedge-shaped excision of the fat flap is made in the transverse direction to the aponeurosis. Then open edges of subcutaneous fat are insulated; the flap is removed. Laparoports 10.5 cm are installed: 2 trocar with diameter of 11 mm in near-umbilicus and left iliac region, 2 trocar 5 mm – in right iliac and suprapubic areas. Patient on the operating table is moved to Trendelenburg position to 30°. Vessels of infundibular-pelvic and round ligament of uterus are coagulated and transected. Fallopian tube is coagulated. Then a mother manipulator is installed and after mobilization of uterine vessels they are ligated with subsequent colpotomy at level of arches. Uterus is transvaginally removed and vagina is closed with separate interrupted sutures.

EFFECT: method enables creating a larger volume of the abdominal cavity, avoiding an excessive Trendelenburg position and performing the entire operation volume in treating the endometrial cancer of the IA-IB stage.

1 cl, 3 dwg, 2 ex