METHOD FOR LAPAROSCOPIC MYOMECTOMY Russian patent published in 2022 - IPC A61B17/42 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to operative gynecology. A Veress needle is inserted into the abdominal cavity under aseptic conditions under general endotracheal anesthesia through an incision in the paraumbilical region. Next, a laparoscope connected to a video camera is inserted. Then, under the control of a laparoscope in the right and left iliac regions, two 6 mm and one 12 mm trocars for manipulators are introduced. In this case, a 12-mm trocar is inserted along the midline 8-10 cm below the laparoscope. Next, the parietal peritoneum of the anterior leaf of the broad ligament of the uterus is opened in front of the round ligament of the uterus in the direction of the vesicouterine fold. The course of the uterine artery, deep uterine and superficial uterine veins is traced. The posterior leaf of the broad ligament of the uterus is opened lateral to the superficial uterine vein. Similar manipulations are carried out on the opposite side. The peritoneum of the vesicouterine fold is opened and the anterior lip of the cervix is ​​mobilized. A Foley catheter is introduced into the abdominal cavity through a 12-mm trocar, the proximal end of which is cut off with an anti-return valve, the Foley catheter is passed through the holes in the wide ligament of the uterus and a self-tightening knot is formed on the anterior lip of the cervix. The free end is brought out through a 12 mm trocar and the knot is tightly tightened around the cervix. Vascular clamps are inserted into the abdominal cavity and applied to the ovarian ligaments and round uterine ligaments. With the help of monopolar cutting, the fibroid nodes are peeled, the wound on the uterus is sutured with a two-row or three-row suture, the myomatous nodes are removed from the abdominal cavity, the vascular clamps are removed.

EFFECT: method allows to reduce intraoperative blood loss and perform organ-preserving surgery in patients with uterine myoma.

1 cl, 2 ex