METHOD FOR SURGICAL TREATMENT OF DEEP INFILTRATIVE ENDOMETRIOSIS OF RECTOVAGINAL PARTITION

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, namely to obstetrics and gynecology, general surgery, urology. Provide laparoscopic access to the pelvic cavity. The post-uterine space is released from the uterine appendages, in which the ovaries and fallopian tubes are isolated from the adhesions, with their subsequent fixation to the anterior abdominal wall. The sigmoid colon is mobilized in the place of its physiological fixation to the area of the external iliac vessels on the left, anatomical landmarks are isolated along the retroperitoneal tissue by dissecting the right and left pararectal fossae from the level of the promontory of the sacral bone to the vaginal-rectal tissue, which is not involved in the focus of endometriosis, during which from the adhesions, the ureters along the length from the external iliac artery to the intersection with the uterine artery, hypogastric nerves, sacro-uterine ligaments, mobilize the rectum. The endometriosis focus is cut off from the posterior surface of the uterus, the cervix and the posterior wall of the vagina with the localization of the endometriosis focus on the rectum, followed by cutting off the endometriosis focus from the rectum. ;EFFECT: method allows reducing the number of complications associated with changes in the anatomical ratios of the pelvic organs caused by the infiltrative-adhesive process in the area of the rectovaginal septum (in which the uterus and rectum, ureters are involved), as well as increasing the percentage of relief of chronic pelvic pain syndrome.;1 cl, 2 tbl, 1 ex, 14 dwg