METHOD FOR SURGICAL TREATMENT OF AGGRESSIVE AND MALIGNANT NEOPLASMS WITH BILATERAL LESIONS OF PATIENT'S PUBIC BONES Russian patent published in 2023 - IPC A61B17/56 

FIELD: traumatology and orthopedics.

SUBSTANCE: invention can be used for surgical treatment of aggressive and malignant neoplasms with bilateral damage to the patient’s pubic bones. Before performing surgical treatment, the spatial visualization of the pubic bones affected by the neoplasm is determined using multilayer spiral computed tomography; the condition 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 treating the surgical field three times with an antiseptic solution with the patient in the supine position, a skin incision is made and subcutaneous fat along the projection of the pubic symphysis, the upper branches of the patient’s pubic bones, the fascia is dissected and the neoplasm is visualized. The rectus abdominis and adductor muscles are cut off from the pubic bones. The pubic bones are isolated laterally to the acetabulum. The position of the obturator neurovascular bundles is determined with their alternate isolation and retraction to the side. Two guards are brought into the area of the obturator foramina. An osteotomy of the upper branches of the pubic bones, lateral to the neoplasm, is performed at the acetabulum in turn. Two guards are placed behind the lower branches of the pubic bones, and an osteotomy of the lower branches of the pubic bones is performed alternately with an indentation from the neoplasm. The resected branches of the pubic bones are cut off along with the neoplasm from the remaining tissues. The wound is washed with antiseptic solutions. The upper and lower branches of the pubic bones remaining after the osteotomy are inserted into the acetabulum with one anchor clamp. Anchor clamps are placed on the upper surfaces of the cuts of the branches of the pubic bones through the cortical layer, then, using threads of anchor clamps, a synthetic prolene mesh is fixed to them to create support for the patient’s pelvic organs and the adductor muscles and rectus abdominis are fixed to the synthetic prolene mesh. One silicone drain is placed, and the wound is sutured in layers. Skin staples. Active aspiration. Aseptic bandage. In this case, polypropylene, polydioxanone or polytetrafluoroethylene mesh is used as a synthetic prolene mesh. In this case, an antibacterial coating can be applied to the prolene mesh. 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.

4 cl, 3 ex