METHOD FOR COMBINED SURGICAL TREATMENT OF PATIENTS WITH PROSTATE ADENOMA WITH VOLUME OF MORE THAN 250 cm Russian patent published in 2022 - IPC A61B17/94 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to surgical urology. With the patient lying in the lithotomy position on the surgical table after the surgical site has been processed, two surgical teams perform the stages of the surgical intervention simultaneously. At the same time operator of the first brigade places a resectoscope in urethra, sequentially performs enucleation of adenomatous tissues of prostate, at the same time, the second surgical team provides access to the peritoneal cavity according to Hasson by layer-by-layer dissection of tissues in the paraumbilical region to the parietal leaf of the peritoneum. Opening of the latter and then insertion into the peritoneal cavity of port of 12 mm for the video laparoscope. Then, under visual control, focusing on the anterior upper iliac spines, performing the installation of two working ports 5 mm and 11 mm for instruments, placing 11 mm polymer container through the port, while the first team operator completes the stage of prostate adenoma enucleation. After performing hemostasis in the prostate adenoma bed, the irrigation fluid supply is stopped, the resectoscope is removed, at this moment, the second surgical team performs a longitudinal incision of the bladder wall, placing adenomatous tissues, bladder concrements, if any, into a polymer container, inspection of the bladder cavity, suturing the bladder wall with V-loc 3-0 suture material with 5/8 bend of the needle, checking the suture tightness by introducing 150 ml of normal saline into the bladder cavity; then the polymer container is removed through the extended access for the video laparoscope.

EFFECT: method enables to combine high efficiency with considerable reduction of time and complexity of surgical intervention due to absence of need for morcellation of hatched tissues, crushing bladder concrements in their presence and minor injuries in the urethral sphincter area due to better visual control of this area and minimization of time spent by resectoscope in urethral lumen and, as a result, reduced time of sphincter area ischemia.

1 cl, 1 ex