METHOD FOR SUTURING THE UTERINE WALL DURING ORGAN-PRESERVING SURGERIES IN PATIENTS WITH PLACENTAL INGROWTH Russian patent published in 2021 - IPC A61B17/42 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to obstetrics and gynecology. After the bottom caesarean section, temporary bilateral occlusion of the common iliac arteries is performed for no more than 20 minutes, for this use elastic silicone vascular turnstiles 0.15 cm wide in the form of a loop on the clamp, tighten the formed loop, passing the free ends of the harnesses through a tube with a diameter of 0.3- 0.4 cm from implantation-non-toxic polyvinyl chloride 5 cm long and fix the turnstiles with a clamp at the opposite end, impose from 10 to 12 provisional U-shaped sutures, delimiting the pathologically altered myometrium, excision of the uterus area inwardly from the sutures. Metroplasty is performed with separate U-shaped sutures in one row in two stages as follows: at the first stage, the first stitch of the U-shaped suture is applied in the part of the wound defect closest to the edge of the uterus, starting from its lower edge closer to the cervix, the needle is punctured in the upper the edge of the incision is made so that the angle of the seam in relation to the longitudinal line of the uterus is 30-35 degrees, on both sides, from 3 to 7 separate seams are applied with a step of 0.7-1.0 cm, so that when comparing the edges of the defect, the remaining part of the incision on the uterus is formed into a longitudinal linear wound of an oval shape; at the second stage, separate U-shaped seams are applied, starting from the lower edge of the incision in the longitudinal direction with a step of 1.0 cm.

EFFECT: method allows to restore the uterus with less pronounced deformation of the anterior wall, to reduce the deformation of the uterine cavity and, as a consequence, to reduce the number of complications in the postpartum-postoperative period, to reduce the invasiveness of the operation.

1 cl, 2 ex