METHOD FOR FIXATION OF VAGINAL STUMP ACCOMPANYING LAPAROSCOPIC UTERINE EXTIRPATION Russian patent published in 2020 - IPC A61B17/42 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to operative gynaecology. Uterus is dissected from the vaginal walls and removed from the abdominal cavity. Pelvic ligament is fixed with sutures to vagina and peritoneal autoplasty of vaginal stump is carried out. Before uterus is cut off from vaginal walls, uterus is mobilized to vaginal vaults of laparoscopic approach. Detection and extraction of uterus from abdominal cavity is performed from vaginal approach. Fixation of pelvic ligaments to vagina is performed by applying at least three purse-string sutures with one continuous long-absorbing suture. At the same time parametrical tissues, sacred-uterine, cardinal and vesicoureteral ligaments are caught in the first purse suture. Then thread ends are connected. Then the second purse-string suture is applied with the same suture, repeatedly grasping the same anatomical structures in the distal first suture, binding the ends of the suture. Third purse suture is applied with the same suture on the vaginal walls. End of the suture of the first purse-string suture is preliminarily removed by piercing the vaginal wall, and ends of the suture are tied. Peritoneal autoplasty of the vaginal stump is carried out from laparoscopic access with a purse-string suture of another long-absorbable suture, wherein the uterosacral ligaments are fixed to the vaginal stump.

EFFECT: method enables preventing the apical prolapse of vaginal walls following uterine extirpation and providing reliable haemostasis of the parameter tissues.

1 cl, 4 ex