METHOD OF LAPAROSCOPIC CORRECTION OF PELVIC ORGAN PROLAPSE IN AN OBESE WOMAN Russian patent published in 2023 - IPC A61B17/42 A61B1/313 A61F2/02 

FIELD: medicine; gynecology.

SUBSTANCE: surgery using a single laparoscopic access is performed. Dissection of the vesico-vaginal space is performed. A T-shaped implant is formed, the vertical section of which has a length of 5–6 cm, a width of 4–5 cm, and the lateral segments of the horizontal section have a length of 16–18 cm, a width of 2–2.5 cm each. The implant is passed into the abdominal cavity and the free edge of its vertical section is fixed to the anterior wall of the vagina or the anterior walls of the vagina and cervix or its stump. Four interrupted sutures from non-absorbable material and 3–4 interrupted sutures from absorbable material are applied. Then a lateral colpopexy is performed. A skin incision is made on each side in the area located 4 cm posterior to the superior anterior iliac spine and 2 cm above the iliac crest. The aponeurosis is perforated through the incision. An extraperitoneal canal is formed at an angle of 45° to the round ligament of the uterus above it to the area of dissection of the vesico-vaginal space. The lateral segment of the horizontal section of the T-shaped implant is passed from the abdominal cavity along the formed channel and its free end is fixed to the aponeurosis on the corresponding side. Then dissection of the rectovaginal space is performed to the level of the levator muscles and 4–6 interrupted sutures are applied from absorbable suture material to the posterior wall of the vagina without capturing the levator muscles.

EFFECT: method allows to simultaneously fully stabilize the apical, anterior and posterior compartments of the pelvic floor, reduce the incidence of recurrent forms due to adequate restoration of the pelvic floor structure.

1 cl, 2 ex