LAPAROSCOPIC RETROPUBIC ADENOMECTOMY SUPPLEMENTED BY URETHROCYSTOANASTOMOSIS AND TEMPORARY CLAMPING OF THE INTERNAL ILIAC ARTERIES Russian patent published in 2022 - IPC A61B17/94 A61M25/04 

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to operative urology. Under general anesthesia in the paraumbilical region, a carboxyperitoneum is created using a Veress needle and an optical port is installed. A laparoscopy is performed. Working trocars are installed pararectally in the right and left iliac regions. The peritoneum is dissected in the projection of the bifurcation of the external iliac artery and the VPA on the right, in the region of the intersection of the common iliac artery and the ureter. The VPA is mobilized, they are taken on a silicone holder, hemostasis is performed in the work area. The same is performed on the left. The anterior and lateral surfaces of the prostate gland are mobilized. Vascular clamps of the "Bulldog" type are applied to the VPA on the right and left. After dissection of the prostate capsule and identification of the layer between the adenomotous nodes of the right and left lobes of the capsule and its inner surface, the nodes are isolated as a single block, the bladder neck is displaced with a predominance of blunt dissection, the bleeding vessels are coagulated, then urethrocystoanastomosis is performed. After identifying the bladder neck, an anastomosis is performed with two V-lock 3/0 threads between the urethra and the bladder neck with a continuous suture, starting from the back wall, from 6 o'clock of the conventional dial, in opposite directions, until crossing on the anterior surface of the anastomosis, at 12 o'clock of the conventional dial. After that, an N20 Foley urethral catheter is installed, 150 ml of saline is injected into the bladder. solution. The prostate capsule is sutured with a continuous suture with a V-lock 3/0 thread, wound revision, hemostasis. The container with macropreparations is removed through supraumbilical access.

EFFECT: method provides accelerated recovery of the mucosa of the prostatic urinary tract and, accordingly, the best functional result of treatment, significantly reduces the amount of postoperative blood loss, while the hospital stay is reduced to 3-4 days, as a result, improving the quality of life of patients.

1 cl, 6 dwg, 1 ex