METHOD FOR PERFORMING ROBOT-ASSISTED RADICAL PROSTATECTOMY WITH ANTERIOR AND POSTERIOR PELVIC FLOOR RECONSTRUCTION

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to urology and oncology. Trocars are inserted. Resection of an apical part of the prostate and urethra, a posterior muscular-fascial reconstruction, an anterior reconstruction of the pelvic floor, forming a vesicourethral anastomosis with a continuous blanket suture. Three robotic trocars 8 mm and two assistant trocars 15 mm and 5 mm are installed, as shown in Fig. 1. Posterior muscle-fascial reconstruction is performed using a V-Lock suture with a loop at the suture end. First stitch is applied along the dissected legs of the prostate in the area of the transition of the prostatic vascular nerve bundle on the bladder on the right in the vesicoureteral angle with fixation of the stitch in the previously prepared loop at the end of the suture. Second stitch is applied with the capture of tissue of the resected edge of the bladder wall in the retrotrigonal region. Suture has the shape of an inverted U with an apex at the urethra, thus applying a continuous suture towards the urethra along the lateral edge of the Denonvillier fascia and the resected edge of the retrotrigonal region of the bladder towards the neck of the bladder, bringing the neck of the bladder closer to the urethra and fixing them in this position. It is followed by the same method in the reverse direction from the urethra and the neck to the vesicoureteral angle, followed by an anastomosis between the neck of the bladder and the urethra with a continuous blanket suture. Further, the intrapelvic fascia is repaired by applying a continuous suture between the bladder wall and the intrapelvic fascia.;EFFECT: method enables improving the reliability of the vesicourethral anastomosis.;1 cl, 6 dwg, 1 ex