METROPLASTY METHOD FOR REPEATED CAESAREAN SECTION USING AN ABSORBABLE ANCHOR THREAD AND SEALING SEAMS WITH AMNIOTIC SHELLS Russian patent published in 2023 - IPC A61B17/42 

FIELD: medicine; obstetrics.

SUBSTANCE: invention can be used for suturing a uterine wound after performing metroplasty during a second caesarean section. Excision of the thinned tissue of the scar is made. Interrupted sutures are applied at the corners of the incision on the uterus. After stretching the sutures at the corners of the uterine incision, the centre of the incision on the uterus is determined. At this point, the tissues of the upper and lower edges of the uterine wall are sutured with an anchor absorbable thread with two needles at the ends. The distance to the needles is aligned so that it is the same, and a simple double knot is tied. From the centre sequentially to each corner of the wound, a continuous suture is applied with an anchor thread, sewing up the wound on the uterus. Upon reaching the corners of the wound, the anchor thread is tied to the fillet suture thread, forming a knot. 1 cm and 3 cm from the centre of the wound, two supporting U-shaped absorbable sutures are placed in each side. A flap is cut out from the placental part of the amniotic membrane and placed on the seam with the fruit surface, fixed with an absorbable thread in the corners and in the centre of the sutured wound. Peritonization of vesico-uterine fold is carried out.

EFFECT: method ensures reliable co-option of myometrial tissues, additional sealing of the suture on the uterus, creates conditions for full tissue regeneration, which contributes to formation of a full-fledged scar.

1 cl, 2 tbl, 7 dwg, 2 ex