METHOD OF VAGINAL METROPLASTY OF INCONSISTENT UTERINE SCAR AFTER CAESAREAN SECTION SURGERY Russian patent published in 2025 - IPC A61B17/42 A61B17/04 

FIELD: medical science.

SUBSTANCE: invention refers to medicine, namely to obstetrics and gynaecology. Inconsistent uterine cicatrix is separated, dissected and the defect is closed. Surgical intervention is performed from a vaginal approach under spinal anaesthesia that is ensured by inserting a self-locking speculum and an elevator into the vagina. Uterine cervix is grasped with bullet forceps; the uterine cavity is probed; a cervical canal is dilated with Hegar dilators up to 9, and a hysteroscope is inserted into the uterine cavity. Inspecting uterine cavity, area of scar on anterior wall, area of its defect and inconsistency. Anterior colpotomy is performed with scalpel 1 cm above an external orifice of uterus. That is ensured by making a transverse arched incision of the vaginal mucosa of a size corresponding to the size of the postoperative inconsistent uterine suture; using a blunt and sharp technique, the bladder is brought upwards. Vicryl ligatures 70 cm long, 0 mm thick with a cutting and cutting needle 30 mm in diameter are applied on the anterior lip of the uterine cervix by which the uterine cervix is tightened, and the uterine scar is brought out by re-ligating. Defect and thinning area is visualised; two Vicryl ligatures 70 cm long and 0 mm thick with needle of 30 mm diameter in front of and behind the cicatrix are applied. And pulling up the threads, the cicatrix itself is taken out, the cicatrix is excised with a scalpel in the transverse direction, pulling up the applied ligatures. Cicatrix region is closed with vertical separate Vicryl sutures. That is followed by checking the cicatrix integrity under hysteroscope control, and the vaginal mucosa is closed by separate Vicryl sutures.

EFFECT: method enables providing more effective vaginal metroplasty of the inconsistent uterine scar following the caesarean section surgery, reducing a risk of negative effects and simplifying the operation for the surgeon at the same time.

1 cl, 1 ex