| 摘要 |
FIELD: medicine. ^ SUBSTANCE: middle abdominal incision is made, as well as lyrate discission of the pelvic peritoneum with dissection of the rear rectouterine pouch and exposure of uterosacral ligaments. The rectum is moved to the coccyx. Falling organs are held by a synthetic netlike implant with the shape of an inverted T, with vertical and horizontal parts. The implant is initially held to the sacrum on the centre line. Lateral edges of the vertical part of the implant are then held to the rectum. In the pubic region on each side of the laparotomy incision, an additional incision with length of not more than 2 cm is made in the front abdominal wall. Through the inscisions two subperitoneally lying channels are formed in the paravesical cellular tissue and parametria in the direction of the dissected rear rectouterine pouch to uterosacral ligaments. The ends of the horizontal part of the implant come out to the adominal wall through the formed channels. Adjacent sections of the implant are held to uterosacral ligaments. The ends of the implant coming out are pulled anteriad, moving the uterus and the bladder cephalad until elimination of the cystocele. The ends of the implant are fixed to the external sheath of the abdominal wall. After that the pelvic peritoneum and laparotomy incision are stitched. ^ EFFECT: method allows for elimination of combined prolapse of the rectum, uterus and bladder in a single surgical procedure, fixing the rectum, uterus and bladder in a single step, with restoration of their physiological rest position, reducing injuries of surgical treatment. ^ 1 ex |
