METHOD FOR PREVENTION OF INTRAOPERATIVE BLEEDING DURING ENDOVIDOSURGICAL ADENOMECTOMY Russian patent published in 2021 - IPC A61B17/94 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to urology. After the implementation of retropubic access to the prostate by introducing an optical trocar and two working trocars into the retropubic space and insufflation of carbon dioxide into the retropubic space. The anterior surface of the prostate is isolated with the transition to the pelvic fascia laterally on both sides, the pelvic fascia is dissected along the lateral surface of the prostate gland to the puboprostatic ligaments on one side and the other, the area of ​​the dorsal vascular-venous complex of the prostate is mobilized, on which a vascular clamp inserted through 10 mm trocar. Then a cross section of the anterior surface of the prostate capsule is made 1.5-2 cm below the proximal to the puboprostatic ligaments, 5-7 cm long, a layer is isolated between the capsule and the adenomatous tissue of the right and left lobes of the prostate. Adenomatous nodes are cut off bluntly and with the help of the THUNDERBEAT apparatus, the nodes are immersed in a container. Then small vessels are coagulated by bipolar coagulation, after removal of adenomatous tissues, the posterior wall of the bladder with the urethra is fixed 1 cm proximally of the vas deferens with a continuous V-Loc thread with a 5/8 needle 15 cm long, produce "trigonization" of the posterior wall of the bladder, followed by puncture of the needle on the anterior surface of the upper leaf of the prostate capsule and suturing along the right semicircle of the capsule of the prostate with the capture of the bladder wall along the lateral, with the transition to the anterior surface, symmetrically suturing the tissues on the left side. The vascular clamp is removed from the dorsal complex; control the tightness of the anastomosis. The container is removed. A tubular drainage is installed in the retropubic space. Sutures are applied to the skin, iodine treatment and an aseptic bandage are applied.

EFFECT: method allows to reduce volume of patient's surgical blood loss associated with profuse bleeding from prostate tissue as a result of dissection of its surgical capsule.

1 cl, 1 ex