COMBINED METHOD OF LAPAROSCOPIC HYSTERORRHAPHY AND VAGINOPEXY COMBINED WITH RECTOPEXY, CORRECTION OF HIGH RECTOCELE, ENTEROCELE

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to operative gynecology and coloproctology. Laparoscopy is performed with installation of 2 lateral trocars 5 cm above symphysis and 8 cm lateral medial line. According to the parietal peritoneum of the recto-uterine ligaments, an arch-shaped incision is made with a vertex facing the posterior wall of the vagina with subsequent separation of the pre-rectal cellulitis between the rectum and the posterior wall of the vagina downwards to the level of levators on both sides and subsequent formation through a left lateral puncture from an external left outer muscle oblique muscle side of an extraperitoneal tunnel between leaves of the left wide master bony ligament, left and right recto-uterine ligaments, between the plates of the right broad uterine ligament, the outer edge of the right external oblique muscle and the right lateral puncture, a synthetic T-shaped flap sized 4×6 cm and the size of two bands 3×5 cm is made. Flap is fixed in two places: at the projection point of the recto-uterine ligaments from uterus, with preserved uterus, or back wall of vagina, in absence of uterus, and to levators with removal of tapes on aponeurosis on each side and leaving them free.;EFFECT: method provides physiological relationship of uterus, vagina, rectal by applying minimally invasive technology, that promotes preservation of functions of organs, reduces intraoperative injuries by reducing synthetic materials in the wound and reducing the amount of intervention, reduces a risk of intraoperative and infectious complications, "posterior sling" does not affect the choice of surgical approach in subsequent surgical interventions.;1 cl, 3 ex