METHOD FOR ENDOSCOPIC DRAINAGE-FREE MINIMALLY INVASIVE TREATMENT OF NEPHROLITHIASIS IN CHILDREN Russian patent published in 2021 - IPC A61B17/22 A61B17/94 

FIELD: medicine; pediatrics; operative urology-andrology.

SUBSTANCE: nephrolithotripsy and retrograde installation of an internal stent or an external ureteral intubator into the kidney are performed. The wounds are performed tightly in the absence of intense bleeding. A rigid guide string is inserted into the calices-pelvis system, an insurance string is installed along the guide string into the kidney cavity system, and the insurance string is localized in the access during the entire intervention. Small, less than 1.5 cm kidney stones are removed by percutaneous lithotripsy. Lithoextraction is performed under endoscopic and X-ray control. At the end of the operation, a nephroscopic examination of the access is performed for the presence and intensity of bleeding on the nephroscope. A rigid guide string 75 cm long with a soft tip 3 cm long is inserted into the kidney cavity system and ureter under visual and X-ray control, a hemostatic applicator is inserted along this guide string into the kidney pelvis and, guided by retrograde ureteropyelography, the applicator is installed 3 mm more superficially than the calices-pelvic system by nephrostomic access. Then a syringe with a hemostatic matrix with a thrombin SurgifloTM 2000 ME is connected to the applicator and a smooth gradual injection of the drug is carried out with simultaneous extraction of the applicator by access. The nephrostomy canal is completely filled with a hemostatic matrix to the level of subcutaneous fat tissue, without contacting the edge of the wound, the latter is sutured with separate sutures, after which X-ray control is performed by performing retrograde ureteropielography for the absence of contrast agent leaks, and in the absence of bleeding, the insurance string is removed and an aseptic bandage is applied.

EFFECT: method allows reducing the pain symptom in a child in the early postoperative period, which in turn reduces the need for the use of analgesics, reduces the time of the child’s stay in the clinic, contributing to the acceleration of rehabilitation of children’s age patients and reducing the economic costs of the hospital.

1 cl, 6 dwg, 2 ex