METHOD FOR OPTIMIZING POSITIONING OF WORKING TROCARS IN VESICOSCOPIC URETER REIMPLANTATION IN CHILDREN Russian patent published in 2024 - IPC A61B17/94 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to paediatric surgical urology-andrology. Preoperative examination, cystourethrography, computed tomography, bladder catheterization and minimally invasive approach through bladder punctures, introduction of trocars into the abdominal cavity are performed. When performing cystoscopy with tightly filled bladder, a projection point of ureteral orifices is determined. They are projected onto the anterior abdominal wall by deflecting the end of the cystoscope directly from the orifice of the corresponding ureter and forcing the anterior wall of the bladder with it. Simultaneously, the surgeon palpates the bulging end of the cystoscope from the anterior abdominal wall and marks above this place a projection of the ureter orifice on the skin of the anterior abdominal wall, at 2 cm from this point in the cranial-lateral direction along the axis forming an angle with the median plane of body at 45°, a puncture is made for inserting a working trocar from one side and a similar manipulation is performed from the opposite side. A pathological ureter is separated, a submucosal tunnel is formed, into which the separated ureter is passed, and an artifactual orifice is created by ureterocystoanastomosis.

EFFECT: method enables improving the ergonomics of the surgeon’s work, simplifying the manipulations in the bladder cavity in a limited space and, in particular, reduce mucosal injuries and exclude its rupture during formation of submucosal tunnel and subsequent passage of ureter into it.

1 cl, 5 dwg, 1 ex