METHOD FOR URETEROPYELOPLASTY WITH BUCCAL FLAP WITH STRICTURE OF UPPER ONE-THIRD OF URETER AND URETEROPELVIC JUNCTION SEGMENT IN PATIENTS WITH SINGLE KIDNEY IN CHRONIC KIDNEY DISEASE Russian patent published in 2025 - IPC A61B17/00 

FIELD: medical science.

SUBSTANCE: invention refers to medicine, particularly to urology. An involved portion of the ureter, a ureteropelvic junction and a portion of a pelvis are dissected laparoscopically with covering healthy tissues 0.5 cm from each side. A graft up to 5 cm in size is cut out from the buccal mucosa, which is further processed and split as shown in Fig. 3. Through the working channel, the graft is delivered to the operation area, with preliminary extracorporal sutures on both edges of the graft, as shown in Fig. 3. Then the graft is fixed with the mucosa inside to a proximal edge of the urinary incision: with one thread it is sutured to the lateral edge of the incision with a continuous suture with monofilament suture 4/0, after which the urinary tract is drained with an internal stent catheter N7, and the second suture is to the medial wall of the dissected ureteropelvic junction above the internal drainage stent by a continuous external suture with monofilament suture 4/0. Then, the omentum flap is cut out on the pedicle with a width corresponding to the length of the buccal graft, brought to the anastomosis and placed tension-free over the entire surface of the graft, omentum flap is fixed with single monofilament sutures 4/0 on the periphery of the graft with covering ureter tissue and with single monofilament sutures 4/0 directly to the graft.

EFFECT: method allows to replace extended sections of the stricture of the upper one-third of the ureter up to 8-10 cm with single-stage replacement of the ureteropelvic junction segment and part of the pelvis, increase efficiency of single-stage reconstruction of upper third of ureter and ureteropelvic junction segment, reducing intraoperative injuries, reducing the length of the surgical intervention, reducing the number of postoperative complications and recurrences in the patients with strictures of the upper one-third of the ureter of the ureteropelvic junction segment.

1 cl, 5 dwg, 1 ex