METHOD FOR INCREASING LENGTH OF SUBMUCOSAL TUNNEL IN PNEUMOVESICOSCOPIC URETER REIMPLANTATION IN CHILDREN WITH OBSTRUCTIVE MEGAURETER Russian patent published in 2024 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to operative urology. Ureter reimplantation is performed with application of fixing ligature on ureter orifice area. A fixing suture 2 cm laterally and above the previously located ureter orifice in the depth of detrusor is applied on the ureter brought out from the paravesical space into the bladder. Further, submucosal tunnel 3 cm long is created horizontally above the contralateral orifice, after which a neo-orifice is formed 2 cm above and lateral to the contralateral orifice. Then separated ureter is delivered in submucosal tunnel, and interrupted fixing suture with Vicryl 4\0 suture is applied between ureter neo-orifice and bladder detrusor from contralateral side. At that, the ureter is in an extended position relative to the first fixation point, the neo-orifice is formed with a continuous suture with 5\0 vicryl suture, the bladder mucosa is connected with a continuous suture, after which the ureter and kidney are drained with an external ureteral J stent, which is installed along a string inserted into the bladder through an additional puncture in the wall with a puncture needle, bladder wound within the orifice is closed with interrupted 4\0 vicryl suture and continuous 5\0 vicryl suture, and the bladder mucosa is closed; the operation is completed by inserting a urethral catheter and removing trocars.

EFFECT: method allows forming a submucosal tunnel of maximum length and reliably fixing the ureter, as well as preventing the orifice sliding outwards; reduce the incidence of vesicoureteral reflux in the postoperative period; reduce the occurrence of vesicoureteral reflux in the postoperative period; apply this method in pneumovesicoscopic ureter replantation; increase the length of the submucosal tunnel in reimplantation of the ureter according to Politano-Leadbetter, Glenn-Anderson and Lich-Gregoire.

1 cl, 7 dwg, 1 ex