METHOD FOR TREATMENT OF APICAL ENTEROCELE USING A POLYPROPYLENE IMPLANT Russian patent published in 2023 - IPC A61B17/42 A61B17/34 A61F2/02 

FIELD: medicine; operative urogynecology.

SUBSTANCE: longitudinal incision is made in the posterior wall of the vagina and the underlying fascia from the posterior fornix to the perineal body. The hernial sac is mobilized under the rectovaginal fascia. Pararectal canals are formed to the right and left ischial spines with exposure of the anterior surface of the sacrospinal ligaments. Using a transsacrospinal trocar, the sacrospinal ligaments are punctured in the region of its inner third. Conductors are passed through the punctures, skin punctures are made in the gluteal regions in the middle of an imaginary line drawn between the ischial tuberosity and the anus on both sides. Punctures are formed pararectally through these punctures into the wound of the vagina on both sides using the anterior transobturator trocar. A four-arm prosthesis is fixed proximally with non-absorbable ligatures to the stumps of the sacro-uterine ligaments or to the isthmus of the uterus in the presence of the latter, distally — to the perineal body, the proximal sleeves of the prosthesis are carried out transsacrospinally, distal — through the gluteal punctures. Then the back wall of the vagina and the underlying fascia are restored with a continuous suture, the sleeves of the prosthesis are stretched, while the uterus and the back wall of the vagina take a normal anatomical position.

EFFECT: method proposed ensures restoration of pelvic floor anatomy, adequate urination and defecation, increases the effectiveness of treatment, reduces the trauma of surgical treatment, and improves the quality of life of patients.

3 cl, 1 ex