METHOD FOR SIMULTANEOUS TREATMENT OF BLADDER DIVERTICULA BY TRANSVESICAL METHOD WITH FORMATION OF URETEROCYSTONE ANASTOMOSIS Russian patent published in 2023 - IPC A61B17/94 

FIELD: medicine; urogic surgery.

SUBSTANCE: perform US-guided puncture of bladder in the dome area when the patient is lying on the surgery table on his back after insertion of urethral catheter and filling the bladder with solution of 0.9% sodium chloride and the subsequent insertion of trocar with 12 mm diameter for video laparoscope directly into the bladder. Then empty the bladder with urethral catheter and block the latter. Insufflate bladder with CO₂ at a pressure of 12 mm Hg. Then insert laparoscope into the bladder through 12 mm trocar, place trocars and ports for operating instruments in the bladder: one port with a diameter of 5 mm is inserted with scalpel through skin puncture 3 cm to the right of the main access guided with iliac bones position. The second port of 11 mm diameter is placed 3 cm to the left of the main access, guided with iliac bones position. Then perform circular lamellar dissection of the bladder, departing from diverticulum neck 0.5 cm up to paravesical tissue. Then perform traction by the mobilized edge of diverticulum neck, carry out blunt and sharp dissection of paravesical tissue along the diverticulum wall until it is completely cut off. Then form ureterocystoneoanastomosis by suturing with a v-loc 3-0 thread with 5/8 needle bend. After that examine paravesical tissue and perform hemostasis. Remove excised tissue of the diverticulum in a single block in a container through 11 mm port, remove instruments and trocars, apply sutures by layers and aseptic dressing to the skin. EFFECT: method allows to exclude possibility of negative consequences of carboxyperitoneum developing and surgical actions in the abdominal cavity, which will improve results of patient treatment by reducing trauma of surgical intervention, as well as reducing risk of trauma to hollow organs and restoring urine passage through the ureter, and almost completely eliminate the possibility of damage to the main vessels or abdominal and pelvic organs.

1 cl, 12 tbl, 1 ex