METHOD OF TREATING HYSTEROPTOSIS USING MESH POLYPROPYLENE IMPLANT Russian patent published in 2024 - IPC A61B17/42 A61F2/02 

FIELD: medicine; urogynecology.

SUBSTANCE: longitudinal incision of a posterior vaginal wall and an underlying fascia is performed, starting from a posterior fornix, with length of 25–30 mm, with a forefinger forming pararectal translator canals to ischial spines on both sides. Anterior surface of the sacrospinal ligaments is exposed. Rectum and pararectal fat are displaced medially, using a transsacrospinal trocar, according to the principle from the inside out, the sacrospinal ligament is punctured in the area of its inner one-third in the middle of its width, then along the trocar—the sacrotuberal ligament, gluteal muscles, subcutaneous fat and skin of the gluteal region, during puncture of sacrospinal ligament with index finger located between trocar and lateral wall of rectum, the latter is insured against damage, provisional guide suture is delivered through puncture. Trocar is removed; a similar manipulation is performed from the opposite side; a transverse incision of the anterior wall of the vagina is made at the level of the uterine isthmus. Using an anterior transobturator trocar, a provisional guide suture is delivered from both sides around the cervix. Then, having fixed the prosthesis to the sutures, it is carried out around the cervix, the middle part of the mesh prosthesis is fixed to the anterior surface of cervix for 3 cm with a non-absorbable continuous ethibond 1–0 suture. "Sleeves" of the prosthesis are delivered through the sacrospinal ligaments according to the in-out method onto the gluteal region in a state of tension, both vaginal incisions are closed with absorbable suture material 3–0. At the end of the operation, the implant tape sleeves are pulled up with simultaneous lifting and returning to their physiological positions of the uterus, posterior wall of the vagina and its dome.

EFFECT: method enables restoring the anatomy of the pelvic floor, adequate urination and sexual activity, as well as improving the quality of life in women in general.

2 cl, 2 ex