| 摘要 |
FIELD: chemistry.SUBSTANCE: invention relates to medicine, surgery. A lyre-shaped incision of the vaginal mucosa and the skin of the perineum with an apex at the posterior fornix is made. A flap, limited by the incision, is separated by an acute method. The separated muscles of the levators are exposed in a blunt and sharp way to the lateral sides of the wound. A ring of the wound-extender "Mini-Assistant" with retractors is installed. An excessive anterior wall of the ampullar part of the rectum is corrugated by means of separate interrupted vicryl sutures. The levators are cut at the level of the border between the posterior and middle third of the vagina by means of a harmonic scalpel. The obtained muscle portions are transferred from the sagittal to the frontal plane. An H-shaped transplant is cut out according to the defect size. The transplant is installed in the area of the rectovaginal septum to the pelvic peritoneum with the letter "H" top. The lower part of the letter "H" bridge covers the sutured levators. Up to 3 cm long flaps are cut out from the deep transverse perineal muscle. The flaps on a feeding pedicle are transferred into the frontal plane. The flaps are sewn to each other with an absorbable suture material above the mesh transplant. The long retractors are removed. The mesh is fixed to the underlying muscular tissues by two monofilament material sutures. Instruments of the wound-extender are removed. The vaginal mucosa is sutured with an uninterrupted suture.EFFECT: method makes it possible to improve functional results of the surgical treatment of the third-degree rectocele.2 ex, 3 dwg |
