METHOD FOR SURGICAL MANAGEMENT OF EXTENDED STRICTURES OF MIDDLE ONE-THIRD OF URETER WITH OBLITERATION AREA Russian patent published in 2025 - IPC A61B17/00 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, particularly to surgical urology. Cicatricial-stenotic portion is excised and a buccal mucosa autograft is repaired. Affected area of the middle one-third of the ureter is separated laparoscopically. Scar tissue is removed from its surface and the ureter is transected in the obliteration projection. Scar tissue is removed from the ends of the ureter until a lumen appears; the distal and proximal edges of the dissected ureter are spatulated along the posterolateral surface. Then, the ureter is separated in the distal and proximal direction within the healthy tissues to allow free alignment of the anteromedial edges of the resected ureter. Rhomboid autograft of the oral mucosa is taken; the length of the autograft is determined from the length of the ureter defect, which occurs when the anteromedial edges of the distal and proximal ends of the ureter are brought together, and the width is not more than 2.0 cm. Using 4/0 monocryl suture, the buccal autograft is fixed with a single suture to the angle of the distal edge of the ureter formed during spatulation with the psoas muscle being captured. Then the opposite end of the rhomboid flap is sutured to the angle of the proximal end of the ureter with a lumbar muscle. Thereafter, the buccal autograft is fixed with monocryl 4/0 single sutures with the epithelium outward on the ventral surface of the psoas muscle. One row of sutures along the entire length of the buccal autograft, leaving its edges free, is used to pass ureter stent 7 Ch up to the pelvis. Anastomosis of the ends of the ureter is performed along the anteromedial surface with two single 4/0 monocryl sutures. Then both edges of the buccal autograft are sutured with the dissected edges of the ureter by a continuous monocryl suture 4/0 on each side.

EFFECT: method enables reducing the number of surgical injuries and the number of postoperative recurrences in the patients with recurrent strictures with a region of obliteration of a middle one-third of the ureters.

1 cl, 1 ex