METHOD FOR SURGICAL TREATMENT OF EXTENDED STRICTURES OR OBLITERATION OF PELVIC URETER

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, particularly to urology. Under the endotracheal narcosis, pneumoperitoneum is created and 4-5 trocars are installed. Parietal peritoneum is opened above the ureter. Stricture or obliteration zone and a healthy part of the ureter are separated by 1–2 cm above the stricture or obliteration; a ureter crosswise is transected, a bladder is mobilized, and flap 2–4 cm wide and 10–12 cm long is cut out from its anteriolateral wall. Flap is sutured into the tube with interrupted sutures of vicryl 3.0, ends of ureter and formed tube connect "end-to-end" on inner stent using antireflux protection. If the width of the ureter is more than 2 cm, a complete papilla is created; if the width of the ureter is less than 2 cm, then half-papilla is created as in fig. 3.;EFFECT: method enables effective and safe treatment of long strictures or obliteration of pelvic ureter with using laparoscopic technique, in which it is impossible to perform ureterocystoanastomosis due to the presence of a large defect between the bladder and ureter, and reduces the length of recovery of operability and reduced medical and economic costs of treatment.;1 cl, 1 ex, 5 dwg