METHOD FOR EXTRAPERITONEAL LIGATION OF VAGINAL PROCESS OF PERITONEUM UNDER ULTRASOUND CONTROL IN CONGENITAL INGUINAL HERNIAS, HYDROCELE AND SPERMATIC CORD HYDROCYST IN CHILDREN AND INSTRUMENT FOR IMPLEMENTATION THEREOF Russian patent published in 2021 - IPC A61B17/62 A61B17/34 

FIELD: medicine.

SUBSTANCE: group of inventions refers to medicine, particularly to paediatric surgery. Operative imaging instrument is placed on an anterior abdominal wall and instrumentation is placed in right or left inguinal region depending on hernia location. Hydropreparation is performed in the projection of the spermatic cord elements, a puncture is made, through which the ligature instrument is passed along the medial side of the internal opening of the inguinal ring, bypassing the components of the spermatic cord, and the suture is left here. Then pass from the opposite lateral side, grasping it, withdrawing the suture outside and tying. Imaging means used is an ultrasonic device; the suture is equipped at the distal end with a magnet of the same polarity. When the instrument is drawn from the ligatured side along the medial side, deeper underlying tissues are extended in layers - subcutaneous fat, anterior wall of the inguinal canal. Vaginal process of the peritoneum is penetrated between the vas deferens and the testicle vessels, and by means of the hydraulic piercing it is bypassed from the medial side, for the suture grip, when entering from the lateral side, a magnet of opposite polarity is used, which is placed in the ligature instrument, extended by surgeon by means of a return mechanism in the instrument before mutual attraction of magnets and pulling by pulling the thread out, covering the vaginal process with a ligature, not penetrating into the abdominal cavity, taking both ends of one suture and ligating the vaginal tube. Extraperitoneal ligation instrument of the vaginal process is used under ultrasound control in congenital inguinal hernias, testis and seed cancers in children, including a ligature blunt needle having a semicircular distal end with a ligature and connected to a handle. Needle is hollow, the suture is placed in it and provided with a single-polarity magnet at the distal end, wherein needle with thread is arranged in handle, also made hollow in form of parallelepiped, having on one lateral side slot along its entire length, and inside - two parallel and adjacent lodgement - one for blunt needle with thread, second - for thin metal rod, equipped at distal end with magnet of opposite polarity. At the near end there is a holder attached to it - a return mechanism installed in the slot with the possibility of its being moved by the surgeon's hand along the slot from its full retraction into the handle before its extension to the end of the thread equipped with a magnet to the position of mutual attraction of the magnets and thus gripping the end of the thread with subsequent drawing by means of a rod with a magnet to the outside.

EFFECT: method enables improving ergonomics of the agents while reducing traumatism and reducing time consumption by enabling one passage.

2 cl, 2 dwg