METHOD FOR ENDOVIDEOSURGICAL MODELING OF URETER IN PNEUMOVESIOXOPIC REIMPLANTATION IN CHILDREN WITH MEGAHOURETER Russian patent published in 2020 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely urology-andrology of childhood. Reimplantation of ureter is started from applying fixing ligature on ureteral orifice region with obstructive megoureter, ligature is tightened by clamp and coagulation hook to extract orifice by edging incision, ureter is gradually mobilized with consecutive coagulation of vessels throughout 7 cm and simulation of ureter is started, for this purpose in region of neck of bladder needle is introduced with bending at end, wherein ligature of monofilament material is left in the needle lumen and from the ligature, and an end of the separated ureter is placed into the created ligature loop, after which the ligature is pulled and the ureter is fixed along the entire length, then by continuous plication suture 4/0 of vicryl performing ureter modeling, reducing its diameter twice over 6 cm, and a maximum retracted from the paravesical space in the urinary bladder ureter is applied a fixing suture in the proximal segment, attaching it to the wall of the bladder within the incision, then forming submucous tunnel 5 cm long in the horizontal direction above the contralateral orifice, recovered ureter is performed in a submucosal tunnel and a ureteral orifice resection is performed by removing the contracted dysplastic tissues, after which the ureter is additionally fixed with an interrupted suture to the bladder wall in the formation of a new ureteral orifice, further ureter and bladder mucosa are connected by a continuous suture, and ureter and kidney are drained with external J stent, which is installed along string introduced into bladder through additional puncture in wall with puncture needle, bladder wound in the area of the separated orifice is closed with a suture, the bladder mucosa is closed with a continuous suture; the operation is completed by the installation of a urethral catheter and extraction of trocars.

EFFECT: proposed method enabled ureter blockage to be ensured by point punctures in urinary bladder and to create more reliable antireflux mechanism in pancreatic ureter's layer and prevent the onset of vesicoureteral reflux as the most frequent complication of ureter reimplantation in children with obstructive megoureter.

1 cl, 1 ex, 9 dwg