FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to operative urology. Described is a method for percutaneous cystolithotripsy in patients with bladder obstruction, which includes sequential introduction of a trocar into the bladder under ultrasound guidance, installation of the Amplatz sheath along a safety wire. Further, under the control of a nephroscope, a laparoscopic bag is carried out, followed by placing a stone inside the bag, crushing it and washing off stone fragments inside the bag. In this case, a 4x16 "blown" Khachin basket is placed on the patient, with the help of which a stone is grasped and placed in a laparoscopic bag, and the stone is crushed inside the basket. In this case, a laparoscopic bag with a memory string is used. In addition, before the operation, a cystostomy 3-way Foley catheter Ch 20 is installed in the patient. 3-5 days before and after surgery, the combined gel Coletex-ADL and sodium hyaluronate are installed daily into the bladder with an exposure of 30 minutes. 3 hours before the operation and 24 hours after the operation, a solution of fosfomycin is taken orally.
EFFECT: method allows to reduce the risk of damage to the bladder wall during cystolithotripsy, which will reduce the risk of hematuria, postoperative inflammatory process in the bladder; not to immerse the patient in anesthesia or to carry out spinal anesthesia, which allows the proposed surgical aid to be carried out for patients with a burdened history; increase the effectiveness of cystolithotripsy; reduce the operation time due to the absence of the need for regular washing of stone fragments; no need for a second session of cystolithotripsy, no risk of injury to the urethra after the operation.
1 cl, 3 ex
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Authors
Dates
2022-01-12—Published
2021-07-22—Filed