RETROGRADE RADICAL HYSTERECTOMY TECHNIQUE

摘要

FIELD: medicine.;SUBSTANCE: patient with locally advanced cervical carcinoma undergoes radical hyperectomy including upper vagina, fatty tissue that surrounds neck of uterus, and pelvic lymphadenectomy. After round and infundibulopelvic ligaments transected, peritoneum of Douglas pouch is opened, rectum is separated from posterior wall of neck of uterus and vagina; and sacrouterine and sacrovaginal ligaments are transected. Then the lateral paravaginal tissue is clamped as lateral as possible and cut off, with separating thereby lateral walls of vagina to be clamped. Hereafter a macropreparation is tightened behind wall of vagina with transecting deep layer of vesicouterine ligament, thereby separating vaginal tube to the level of prospective resection. The preparation previously fixed in small basin, acquires mobility and deliverability to a wound without tightening to uterus and tumour. There is an easy approach to ureter and pelvic vessels. The preparation is removed en bloc with the surrounding infiltrated fatty tissue.;EFFECT: method allows mobilising the large cervical tumours fixed in small pelvic and ensuring eradication of the preparation together with the infiltrated fatty tissue, without intraoperative disintegration of the removed preparation.;7 dwg, 3 ex