METHOD OF A SURGICAL OPERATION IN CHILDREN WITH THE VESICOSCOPIC APPROACH IN THE TREATMENT OF LESIONS OF THE VESICOURETERAL JUNCTION AND BLADDER Russian patent published in 2021 - IPC A61B17/00 A61B17/94 

FIELD: medicine.

SUBSTANCE: invention relates to medicine and namely to operative urology. During the operation, the patient is laid on the back with legs spread apart which are additionally placed on holders with a flexion angle in the knee joints of 100-110 °. In this case, the position of the body is fixed with a roller placed under the buttocks so that the angle between the surface of the anterior abdominal wall in the area between the navel and the bosom and the horizontal plane is 45 °. Next, cystourethroscopy is sequentially performed with a tight filling of the bladder with a sterile solution, the bladder is temporarily fixed to the anterior abdominal wall by sewing. Under cystoscopic control, three trocars are installed through the anterior abdominal wall into the bladder cavity. The first trocar is 6 mm for an endoscope with a 5 mm camera. The trocar is inserted into the bladder through its dome and a skin incision in the middle of the distance between the navel and the wame. Two working trocars of 3.9 mm (for manipulators - 3.5 mm) are inserted symmetrically through skin punctures in the inguinal regions, entering the bladder through its anterolateral surfaces, the cystoscope is removed, the liquid is replaced with carbon dioxide, the affected ureter is isolated by electrocoagulation to the required length. Then the ureter is reimplanted, the bladder wounds are sutured with an absorbable suture, the bladder is drained with tubular drains, trocars are removed together with ligatures imposed to temporarily fix the bladder to the anterior abdominal wall, trocar punctures are closed by suturing only the skin with a subepidermal suture.

EFFECT: method makes it possible to simplify the approach and also to reduce the likelihood of injury to internal organs during the operation by simulating the position of a patient on the operating table in a certain way as well as by obligatory movement of a surgeon relative to the operating table with a patient from right to left and/or vice versa depending on the side of the focus of the operative attention.

3 cl, 1 ex, 7 dwg