METHOD FOR FORMING VESICO-URETHRAL ANASTOMOSIS IN RETROPUBIC PROSTATECTOMY Russian patent published in 2024 - IPC A61B17/11 A61M25/10 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to surgical urology. Urethra and urinary bladder wall are sutured with eversion of bladder mucosa and matching it with urethral mucosa. Bladder neck and urethra are stitched with monofilament absorbable suture 3.0, at that, the continuous non-traumatic suture is started with the bladder neck suturing in the direction from the outside to inside at 2 o'clock, picking up the inner muscular layer, the submucosal layer and the mucous membrane into the suture. Suture is tightened by inverting the mucous membrane, then the same suture is transferred to the urethra, suturing it from the inside out at 2 o'clock. Urethra is positioned with the help of urethral metal bougie, suture with needle is delivered under previous stitch. Repeatedly suturing the bladder and urethra at 12, 10 o'clock, forming the posterior wall of the vesico-urethral anastomosis from the right to the left, the end of the suture with the needle is drawn while simultaneously pulling the bladder to the urethra. Then the suture end is pulled up without a needle and the mucous membranes of the bladder and urethra are matched; the tip of the metal bougie is brought into the bladder. Further, the continuous non-traumatic suture is continued in the same sequence, forming the anterior wall of the vesico-urethral anastomosis, suturing the bladder and urethra at 8, 6 and 4 at o'clock, the stitches are tightened, bladder mucosa is everted and aligned with urethral mucosa. Anastomosis is completed by suturing the bladder wall, picking up the adventitious and muscular membranes into the suture at the first prick of the bladder needle. Sutures are tied, then the metal bougie is replaced with a Foley catheter, the cuff of the Foley catheter is inflated in the bladder to volume of 10 ml. Saline 150.0 ml is introduced into the bladder cavity, and if there is no leakage, a drainage tube is delivered to the anastomosis, and the wound is closed.

EFFECT: method enables to reduce the length of the operation, reduce the length of the patient’s anaesthesia, which also has a positive effect on the patient, reducing the risk of longitudinal urethral eruption, reducing the probability of urine extravasation between the suture stitches, removing the urethral catheter on the fifth postoperative day, reducing the number of bed days required for postoperative recovery.

1 cl, 4 dwg, 2 ex