METHOD OF RETROPUBIC MONOPORT ADENOMECTOMY, SUPPLEMENTED BY CONTINUOUS URETHROVESICOANASTOMOSIS WITH DIPLICATION Russian patent published in 2023 - IPC A61B17/94 

FIELD: medicine, surgical urology.

SUBSTANCE: endovideosurgical removal of prostate adenoma is carried out by extraperitoneal access through one puncture on the anterior abdominal wall. A 3 cm long skin incision surrounding the navel is made, the aponeurosis of the rectus abdominis muscle is bluntly and sharply isolated, then a 4.5 cm long aponeurosis incision is made along the midline. Mobilization of the posterior surface of the rectus abdominis muscles is performed bluntly, then a troacar-dissector is introduced into the space limited by the rectus abdominis muscles anteriorly and the peritoneum posteriorly, then a cavity is formed in the prevesical space. Next, a monoport is installed in the projection of the previously performed access, carbon dioxide is insufflated, and then three following instruments are inserted into the monoport: a video laparoscope with a bent distal end, a curved clamp, and an electrolytic instrument with the possibility of performing ultrasonic dissection. Then, the anterior surface of the prostate capsule is isolated, after which, using an ultrasonic dissector, the prostate capsule is opened with a transverse incision, after which the adenomatous nodes are enucleated with simultaneous coagulation of the vessels. After that, urethrocystoanastomosis is performed using one self-tightening thread with the formation of a continuous circular suture, starting and ending at 9 o'clock position of the conditional dial. Further, from the starting point, the suture is directed in the opposite direction, forming a duplication on the anterior wall of the prostate capsule.

EFFECT: method allows to reduce postoperative pain and reduce the period of rehabilitation of the patient.

1 cl, 1 ex