FIELD: medicine.
SUBSTANCE: invention refers to medicine, particularly to urology. Laparoscopic dissection of involved portion of ureter with surrounding tissue along distal boundary of stricture or obliteration. Involved segment of the middle one-third of the ureter is mobilized together with the altered tissue to healthy tissues. Ureter is withdrawn through the laparoscopic port, the altered portion is dissected, the ureter is spatulated along its front-medial surface of 1 cm. Buccal graft is fixed throughout the proximal end of the ureter, with a continuous suture of monocryl 4/0. Internal drainage stent No. 7 Ch is inserted, monocryl suture 4/0 is applied on the free end of the graft and a knot is inserted, a buccal ureter transplant is immersed through the laparoscopic port into the abdominal cavity, intraperitoneal spitting of the distal end of the ureter is made on its front-medial surface, fixing the free edge of the buccal graft with a continuous suture of monocryl 4/0 pre-applied along the entire length of the distal end. Then the buccal transplant is fixed with internal single monocryl sutures 4/0 with the epithelium outward on the ventral surface of the lumbar muscle by 1/3 of its diameter, stent is delivered into urinary bladder through distal end of ureter, buccal graft is closed above stent with continuous external monocryl suture 4/0.
EFFECT: method enables replacing the entire middle one-third of the ureter in the patient, reduces the possibility of recurrence by completely removing the involved tissue, tubularisation of the flap and improved vascularisation thereof.
1 cl, 2 ex
