METHOD OF SURGICAL TREATMENT OF CYSTO - URETRO - ENTERO - AND PROCTOCELE AT DESCENSION OF PELVIC FLOOR WITH USE OF FIRM BRAIN TUNIC

摘要

FIELD: medicine.;SUBSTANCE: invention concerns medicine, in particular to operative gynecology, urology and a proctology. As a graft use a graft from the firm brain tunic, representing a connective tissue plate in the thickness of 0.8-1.0 mm. The plate includes 2-4 layers of cells with solitary fascicles of collagenic fibers in the thickness 20-90 microns between layers. Fascicles of collagenic fibers are focused in orthogonal planes with distance between fascicles 10 microns. Liquidate cysto - and-or urethrocele. Thus from an anterior wall of the vagina find the longitudinal flap corresponding to the form of defect. Separate the vagina mucosa in both sides. Form a tunnel between a mucosa of lateral walls of a vagina and pelvic a fascia. Place in a tunnel in a horizontal plane a graft, modelled under the defect form pelvic fascias. The size of a graft blocks defect pelvic fascias not less, than on 1 cm. A graft is fixed to subject tissues of a forward wall of a vagina with the allotendinous threads. The mucosa of the vagina is sewed after excising of surpluses. Then liquidate entero - and-or proctocele. Thus the triangular flap on the posterior wall of the vagina is found. Split a rectovaginal septum. Muscles of levators are allocated. Modelled under the form of defect a graft fix in a horizontal plane with allotendinous threads to subject tissues of the posterior wall of the vagina. The size of a graft blocks defect pelvic fascias not less, than on 1 cm. Over a graft stack levators. Take in them. Restore integrity of the posterior wall of the vagina. Form a perineum.;EFFECT: method allows to restore perineums architectonics at the expense of single-step liquidation of cysto - and-or urethrocele and entero - and-or proctocele, provides defect replacement with a regenerate, representing the dense issued connecting tissue on the structure, corresponding to a submucosa of walls of a vagina, prevents disease relapse.;4 dwg, 1 ex