METHOD FOR RECONSTRUCTING RECTOVAGINAL SEPTUM AT PROLAPSE OR DESCENSUS OF POSTERIOR VAGINAL WALL AND RECTOCELE

摘要

FIELD: medicine, gynecology.;SUBSTANCE: one should cut and remove a triangular fragment out of posterior vaginal wall, perform longitudinal median incision of vaginal wall from the top of separated triangle up to posterior arch, maximally separate vaginal walls laterally towards pelvic walls at opening a rectovaginal fascia, dissect opened rectovaginal fascia in longitudinal direction and separate it against anterior wall of rectum up to lateral walls, suture in anterior wall of rectum with either one or two purse-string sutures, remove rectocele at returning the rectum into natural anatomical borders, fix the netting out of super-elastic titanium nickelide ligature with separate sutures to restored anterior wall of rectum along the whole rectovaginal septum by capturing lateral walls of rectum, restore rectovaginal fascia with adjacent muscular elements with separate sutures, isolate and suture anus-lifting muscles and muscular-fascial foundation of perineum, suture the edges of vaginal wound, subcutaneous layer and perineum skin. The suggested innovation enables to restore normal anatomotopographic position of anterior wall of rectum and posterior vaginal wall, as well and prevent the relapse of posterior vaginal wall descensus and rectocele.;EFFECT: higher efficiency of reconstruction.;9 dwg, 2 ex