METHOD OF FORMING URETHROVESICAL ANASTOMOSIS DURING RADICAL PROSTATECTOMY Russian patent published in 2024 - IPC A61B17/00 A61M25/10 A61F2/04 

FIELD: medicine; operative urology; oncology.

SUBSTANCE: prostate gland is removed, the ureters are stented, followed by the formation of a urethrovesical anastomosis. Stenting of the ureters is performed with single-loop ureteral stents 6F, while a Foley catheter is inserted transurethrally into the pelvic cavity, then the first single-loop ureteral stent 6F is inserted through its lumen, with which the first ureter is retrogradely stented, then the Foley catheter is removed, fixing the installed stent with the hand and preventing its displacement, and installed transurethrally again parallel to the first stent. Next, a second 6F single-loop ureteral stent is inserted through its lumen, with which the second ureter is retrogradely stented, then the Foley catheter is removed again with control of both stents. Urethrovesical anastomosis is formed with two continuous threads with notches, starting from the posterior wall of the bladder and urethra from 6 o’clock on the conventional dial, in opposite directions until reaching 4 and 8 o’clock position on the conventional dial, while the needle is inserted into the wall of the bladder at a distance of at least 5 mm from its edge, and the needle is punctured from the wall of the bladder in a submucosal manner, without everting the mucosa. The needle is inserted into the urethra from the inside out, through the entire thickness of the urethral wall, capturing the Denonveliers fascia, after which, under visual control, a urethral catheter is passed parallel to the previously installed stents into the bladder cavity through the urethra. Next, the anterior semicircle of the urethrovesical anastomosis is formed by comparing the mucous membrane of the bladder and urethra with full-thickness injections, capturing the muscular and mucous membranes, then at 12 o'clock position on the conventional dial, the threads are tied together, placing the knot away from the area of the formed urethrovesical anastomosis. The distal ends of the ureteral stents are fixed with electrical tape to the urethral catheter and, together with the latter, are immersed in a urinal.

EFFECT: method eliminates the risk of involvement of the ureteric orifices in the anastomosis area, improves postoperative results and reduces the incidence of complications, thereby increasing the effectiveness of surgical intervention.

1 cl, 1 ex