METHOD FOR LAPAROSCOPIC PROMONTOFIXATION

摘要

FIELD: medicine. ;SUBSTANCE: invention relates to medicine, namely to operative gynecology. Punctures of the anterior abdominal wall are performed in the paraumbilical region, in the epigastric region and along the line connecting the spine of the ischial bones. Trocars are inserted into the abdominal cavity, an incision of the parietal peritoneum is performed in the direction from the promontory of the sacrum to the isthmus of the uterus in the area of fixation of the sacro-uterine ligaments. A tunnel in the subperitoneal tissue is formed partly in a sharp, partly blunt way. A mesh implant is introduced into the abdominal cavity, which is previously cut out with a narrowed end, and it is fixed to the presacral fascia, peritonization of the implant is performed with peritoneal sheets. In this case, titanium silk material is used as a mesh implant. Preliminary measurements are made of the distances from the presacral fascia to the base of the sacro-uterine, voronic and round ligaments on both sides. Marks are made on the implant of these lengths, starting from the tapered end. After that, the implant is cut into six strips of the same width, to the length from the wide end of the implant, exceeding the distance by 1-3 mm to the marks made. In this case, after fixing the narrowed part of the implant with three separate vicryl sutures to the presacral fascia, the cut strips of the implant are sequentially fixed, starting with the fixation of the sacro-uterine, then the funnelled and round ligaments on one side, and then similarly on the other side, followed by strengthening with a vicryl thread between formed by the blocks of ligaments, following from the distal part of the ligaments to the central one.;EFFECT: method ensures the prevention of cicatricial adhesive process, reduces the frequency of infectious complications in the early and late postoperative periods, reduces the rehabilitation period while achieving a high therapeutic effect.;1 cl, 2 ex