METHOD OF CONVERSION OF LAPAROSCOPIC TUBOVARIECTOMY WITH PURULENT TUBOOVARIAN FORMATION Russian patent published in 2021 - IPC A61B17/42 

FIELD: medicine; gynecology.

SUBSTANCE: in the conditions of carboxyperitoneum 12 mm Hg, video laparoscopy and assessment of inflammatory changes in the pelvic organs are performed. With severe inflammatory changes, the impossibility of intracorporeal isolation of tuboovarian formation, fallopian tube and ovary, a horizontal mini-access is performed in the suprapubic area with a length of 7-8 cm. A mini-access device is installed in the wound, containing a wound retractor and a cover with a diaphragm for inserting the surgeon's hand. The operation is continued under the conditions of a carboxyperitoneum of 12 mm Hg under video laparoscope control. With the fingers of the left hand, the surgeon extracts the tuboovarian formation, the fallopian tube, and the ovary from the infiltrate. With the right hand, coagulation and intersection of the ligaments of the fallopian tube and ovary are performed and the fallopian tube is crossed with endoscopic scissors. Then sanitization and drainage of the pelvis is performed, the surgeon's hand is removed from the abdominal cavity. The tuboovarian formation, together with the fallopian tube and ovary, is removed from the abdominal cavity through an access device, the access device is removed from the mini-access wound, the wound is sutured in layers.

EFFECT: method allows speeding up the stage of isolation of tuboovarial formation in conditions of pronounced inflammatory-infiltrative changes, maintaining good visualization, reducing duration of the operation, providing prevention of intra-abdominal intra- and postoperative complications, can be carried out immediately and is less traumatic.

1 cl, 4 dwg, 2 ex