METHOD FOR SURGICAL RECONSTRUCTION OF THE PELVIC FLOOR AT DESCENT AND PROLAPSE OF THE CERVICAL STUMP AFTER SUBTOTAL HYSTERECTOMY Russian patent published in 2023 - IPC A61B17/42 

FIELD: medicine; gynecology.

SUBSTANCE: incision is made in the anterior wall of the vagina, a polypropylene mesh endoprosthesis tape of a macroporous structure is installed in the vagina and fixation of the endoprosthesis tape with 3–5 sutures to the cervix using a non-absorbable bioinert suture is carried out, then anterior colporrhaphy is performed by applying a continuous subfascial suture using a non-absorbable bioinert suture. The previously fixed polypropylene mesh endoprosthesis-tape is preliminarily rolled into a roller, on the free edge of which a loop of bioinert thread is formed, in this form it is brought to the pelvic peritoneum, after which laparoscopic access to the abdominal cavity is performed. The peritoneum is opened above the cervical stump and a mesh endoprosthesis-tape is inserted into the abdominal cavity. Next, the peritoneum is opened above the promontorium, tissues are dissected under the peritoneum with an endoscopic flexible blunt dissector up to the cervical stump and the mesh endoprosthesis-tape is grasped by the loop. The tape is passed under the peritoneum and fixed with a non-absorbable bioinert thread to the anterior longitudinal ligament of the spine, after which the loop is cut off, and the peritoneal defects are sutured.

EFFECT: method allows to reduce the invasiveness of surgical intervention, reduce the risk of complications resulting from damage to the rectum, bladder, lower gluteal vessels, pudendal nerves and vessels, sciatic nerve, reduce the risk of Mesh-associated complications, restore the normal structure of the pelvic floor, restore function pelvic organs and maintain a full sexual function.\

2 cl, 4 ex