METHOD OF LAPAROSCOPIC MYOMECTOMY

摘要

FIELD: medicine.;SUBSTANCE: invention relates to field of medicine, in particular to operative gynecology, and can be used for organ-preserving treatment of patioents with uterine myoma. In aseptic conditions under general endotracheal anesthesia into abdominal cavity through cut in paraumbilical region Vertess needle is introduced. Laparoscope connected to videocamera, is introduced under control of laparoscope in right and left iliac areas. Two 10-millimetre trocars for manipulators are introduced. Parietal peritoneum above bifurcation of right common iliac artery is opened, way of external and internal iliac arteries and way of ureter are traced, ureter is moved into lateral side with application of dissector and soft clamp. Internal iliac artery is exposed from surrounding tissues, after which into abdominal cavity by means of clamps through right and left trocars. Soft vascular clamps are introduced for temporary occlusion of internal iliac artery on the right and on the left, ensuring possibility of temporary blocking of blood flow in uterine vessels, in conditions of good visualisation by means of monopolar coagulation husking of myoma nodes is carried out with minimal blood loss. Wound on uterus is sewn with two-layer or three-layer suture, after which wound on uterus is covered by anti-commissure barrier "Interceed", myoma nodes are removed from abdominal cavity by means of morcellator, soft vascular clamps are removed from both uterine arteries and from abdominal cavity.;EFFECT: method allows to reduce blood loss during laparoscopic myomectomy.;2 ex