METHOD FOR REINFORCING ANASTOMOSIS OF ACTIVE UTERUS AND NEOVAGINA IN ADOLESCENT GIRLS SUFFERING FROM VAGINAL APLASIA ACCOMPANYING ATRESIA AND CERVICAL CANAL APLASIA

摘要

FIELD: medicine.SUBSTANCE: uterine body is fixed to perineal muscles with the use of biological implants. After atheneovagina min 5 cm long has been formed from a laparoscopic approach, 4 Permacol strips are attached to anterior and posterior lateral uterine surfaces and fixed with Etibond sutures throughout 4 cm above the natural or conditionally labelled isthmic portion. Distal free ends of the implant are ligatured with Etibond Exelna sutures at 1, 5, 7 and 11 o'clock on a conditional clock face. The perineal skin is incised 0.5-0.7 cm at 4 cm from the perineal body to insert a suture Glover's needle through the thickness of muscles alternately until its proximal end is penetrated into the abdominal cavity. The free ends of the ligatures of each of 4 implants are retained in turns in the Glover's needle. They are separately pulled out through the skin incisions and tightened with implant strips traction through the perineal muscles; the uterus is brought down; the ligatures are tightened together subcutaneously.EFFECT: method enables forming an artificial vulva socket to decrease the distance of the uterus and neovaginal vault, reducing a risk of circular one-row suture cutting between the uterus and neovaginal walls and promotes creating favourable conditions for the adequate tissue fusion, preserving the uterus and makes it possible to implement the reproductive function in the future.2 ex