METHOD OF SURGICAL TREATMENT OF AGGRESSIVE AND MALIGNANT NEOPLASMS OF THE UPPER BRANCH OF THE PUBIC BONE OF THE PELVIS OF A PATIENT Russian patent published in 2023 - IPC A61B17/56 

FIELD: medicine; traumatology; orthopedics.

SUBSTANCE: invention can be used for surgical treatment of aggressive and malignant neoplasms of the upper branch of the pubic pelvic bone. The spatial visualization of the affected pubic bones with the location of the neoplasm is determined by the method of multilayer spiral computed tomography, the state of the surrounding soft tissues, vascular and nervous structures that are not visualized when performing multilayer spiral computed tomography is assessed using magnetic resonance imaging. After performing anesthesia and three times processing of the surgical field with an antiseptic solution in the position of the patient on the back with a bent and abducted leg, an incision is made in the skin and subcutaneous tissue along the projection of the right or left upper branch of the patient's pubic bone from the projection of the lateral end of the upper branch to the projection of the pubic symphysis, then down along the projection of the inferior branch of the pubic bone. The fascia is dissected and the neoplasm is visualized. The rectus abdominis and adductor muscles are cut off from the pubic bone, the pubic bone is isolated laterally to the acetabulum, medially to the pubic symphysis and distally to the lower branch. The position of the obturator neurovascular bundle is determined with its isolation and retraction to the side. The pubic symphysis is dissected, two protectors are brought into the region of the obturator foramen. Osteotomy of the upper branch of the pubic bone lateral to the neoplasm is performed at the acetabulum. Two protectors are inserted in the region of the pubic symphysis, an osteotomy of the lower branch of the pubic bone is performed with an indent from the neoplasm. The resected upper branch of the pubic bone is cut off together with the neoplasm from the remaining tissues. The wound is washed with antiseptic solutions. One anchor fixator is introduced into the part of the pubic bone remaining after the osteotomy at the acetabulum, into its lower branch and into the opposite pubic bone. Using threads of anchor fixators, a synthetic support mesh is fixed to them to create a support for the patient's small pelvic organs, the adductor muscles and the rectus abdominis muscle are fixed to the synthetic mesh, and one silicone drain is placed. The wound is sutured in layers, the following is used: staples on the skin, active aspiration, aseptic dressing. A synthetic support mesh made of prolene is used. A morphological study of the preparation of the removed neoplasm is performed.

EFFECT: method ensures the restoration of the patient's functional and motor capabilities, as well as an increase in the patient's quality of life by maintaining the anatomical position of the pelvic organs.

3 cl, 2 ex