METHOD FOR INTRAOPERATIVE MEASUREMENT OF INTRAPELVIC PRESSURE DURING SURGICAL TREATMENT OF NEPHROLITHIASIS IN ADULTS

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, specifically to urology. Immediately before the operation, the patient is calibrated for measurement equipment with zero pressure values and sensitivity of the sensor. Electromanometer is connected to system filled with physiologic saline, which is connected to ureteral catheter, wherein the position of the intracorporeal end of the ureteral catheter with the lateral holes is corrected under X-ray control so as to achieve the most central position relative to the cavity of the pelvis. Initial parameters of the intraluminal pressure are measured and recorded for 5 minutes before the pelvicalyceal system is punctured in the patient's position on the back. Further, the line of the hydrostatic system is switched over to the sensor of the instrument to perform contrasting and puncture of the calyxes. Then at the final stage of formation of access to the concrement to the ureteral catheter, the hydrostatic system is again connected with a pressure sensor. After that, the computer program records on the "pressure map" the occurring events: lithotripsy, opening and closing the outflow valve in the nephroscope tube, lithoextraction, movement of the endoscopic instrument in remote from access departments of pelvicalyceal system, occurrence of complications and relates them to results of intraoperative record of intrapelvic pressure. During the entire intervention, the intrapelvic pressure is continuously monitored, which must not exceed the reflux threshold of 30 mm Hg for a total length of 60 s.;EFFECT: method enables performing well-timed interventions to bring values of intrapelvic pressure to a low-risk area of complications and provides high effectiveness in terms of prevention of unfavorable course of the nearest postoperative period associated with exacerbation of urinary tract infection.;1 cl, 2 ex, 4 dwg