UTERUS EXTIRPATION METHOD Russian patent published in 2024 - IPC A61B17/42 A61B17/94 

FIELD: medicine; oncogynecology; gynecology.

SUBSTANCE: method involves mobilizing the uterus from the right side, which involves stretching the medial portion of the right round ligament of the uterus in the direction of the spleen to visualize the anterior surface of the uterus. A round ligament of the uterus is coagulated and transected, a wide ligament of the uterus is transected towards a vesicouterine ligament and a infundibular-pelvic ligament. Thereafter, a proximal uterine tension is created, a vesicouterine fold is dissected, it is lifted along an anterior abdominal wall towards a navel, and a bladder-vaginal space is dissected for separation of a bladder. Then, the uterus is stretched towards the spleen and the anterior abdominal wall to visualize the posterior surface of the uterus, and the infundibular-pelvic ligament is coagulated and transected; then the uterus is stretched towards the spleen and up, the posterior peritoneum is dissected. Further, uterine vessels, a cardinal ligament on the right are coagulated and transected. Then the uterus is mobilized from the left side, in which the uterus is pulled by the medial part of the left round ligament towards the liver and the round ligament is transected on the left, after which the uterus is elevated to the anterior abdominal wall, infundibular-pelvic ligament is coagulated and transected, a posterior peritoneum is dissected, uterine vessels are coagulated and transected, then a sacro-uterine ligament is coagulated and transected on the left. Before dissection of vagina, creating tension of uterus in direction of spleen and upwards with provision of access to right sacro-uterine ligament, after which it is coagulated and transected, a hole is formed in the vagina on the right side in a projection of the transected sacro-uterine ligament, the uterus is dissected from the vaginal vaults along the cervix, the uterus is removed from the abdominal cavity, the vagina is closed.

EFFECT: method enables uterine extirpation without using a manipulator, which eliminates risks of uterine perforation during hysterectomy while reducing time of operation and minimizing blood loss.

1 cl, 7 dwg, 2 ex