METHOD FOR INTRAOPERATIVE COORDINATION DURING PERINEAL PROSTATE BIOPSY AND A KIT FOR ITS IMPLEMENTATION Russian patent published in 2022 - IPC A61B17/00 A61B8/12 A61B17/34 

FIELD: medicine.

SUBSTANCE: group of inventions relates to medicine, namely urology. The patient is placed in a lithotomic position, the skin of the perianal zone is treated with an aqueous solution of chlorhexidine or betadine and the surgical access is marked, determining the needle insertion point 1.5 cm laterally and above the edge of the anal ring. An ultrasound rectal sensor is inserted into the rectum and diagnostic transrectal ultrasound is performed. A set for intraoperative coordination is used during perineal prostate biopsy, including a metal needle and a casing that provides the possibility of inserting an 18G biopsy needle into it. It additionally includes an incision film with a cream applied containing a local anesthetic. The film is made with a sleeve for fixing the scrotum, a horseshoe-shaped plastic base is fixed on the film, equipped with two holes for performing a biopsy, a hole for inserting an ultrasound sensor and a holder for fixing it. The casing is made as a plastic tube with a funnel-shaped expansion at the distal end and is equipped with a lock of the Luer type. At the same time, an incision film with a plastic base is glued to the perineum in such a way that the holes in the sticker correspond to the marks on the perineum, and the long sleeve of the film fixes the scrotum to the anterior abdominal wall, while the exposure time until the anesthetic effect is achieved is 10 minutes, and diagnostic transrectal ultrasound is performed by inserting a transrectal biplane ultrasound sensor into the rectum through a hole in the film intended for the sensor. Then, in the area of the hole in the plastic base, an incision film is punctured using an assembled biopsy device: a steel needle inserted into a plastic tube and connected to a syringe with a local anesthetic. Next, intra- and subcutaneous layer-by-layer anesthesia of soft tissues is performed up to the capsule of the prostate gland under the control of transrectal ultrasound, while the biopsy device is fixed to an ultrasound sensor. After 3-5 minutes, the steel needle is removed from the plastic tube together with a syringe with an anesthetic, and the plastic tube with a funnel-shaped expansion at the distal end is left in the perineal tissues. Then, the needle of the loaded biopsy gun is inserted into a plastic tube to the capsule of the prostate gland under the control of transrectal ultrasound. After the needle is pointed, systemic injections are performed into the prostate tissue and the biopsy is taken under the control of transrectal ultrasound, the prostate tissue is placed in special containers after each needle puncture, which are sent to the pathomorphological department; after taking all the biopsies, the biopsy needle together with the biopsy gun is removed together with the tube. The manipulation is repeated on the other side of the perineum to access the other lobe of the prostate gland; at the end of the manipulation, the film with the sticker is removed from both sides, and sterile bandages are applied to the injection sites.

EFFECT: method makes it possible to reduce the time of the procedure, the number of punctures of the skin and soft tissues of the perineum to provide anesthesia, to reduce the traumatic nature of the procedure by reducing damage to the soft tissues of the perineum.

2 cl, 1 dwg, 1 ex