RU2011154242A - METHOD FOR SURGICAL TREATMENT OF PREVENTION OF THE FRONT VAGINAL WALL IN WOMEN WITH A HIGH RISK OF RECIDENCE AFTER EXTERNATION OF THE UTERUS - Google Patents

Abstract

 A method for surgical treatment of prolapse of the anterior vaginal wall in women with a high risk of recurrence after hysterectomy, including reconstruction of the pelvic floor by installing the implant with vaginal access, characterized in that the anterior and apical parts of the pelvic floor are reconstructed, using a mesh implant, which consists of an isthmus, the front part, including four sleeves for fixation, and the rear part, including two sleeves for fixation, while the implant is made of non-rass a nesting mesh cut out by a single block made of a material with polypropylene monofilaments with a diameter of not more than 0.07 mm, surface porosity of less than 40 g / m2 and volume porosity of 98; carry out a longitudinal incision of the vaginal mucosa, retreating 2.5-3 cm proximal to the external opening of the urethra and dissect the vaginal mucosa and the underlying fascia; four sleeves of the front part of the mesh implant by means of conductors are passed through the locking membrane along the tendon arch of the pelvic fascia and two sleeves are placed on the perineal skin on each side; two sleeves of the posterior part of the mesh implant by means of conductors are passed through the medial sections of the sacro-spinous ligaments to the perineal skin laterally and below the anus; the isthmus between the front and rear parts of the mesh implant is fixed for its edges in its middle part to the sacro-uterine ligaments on both sides using non-absorbable threads; the implant expanded in this way in the sagittal projection has the form of a “poker”, with its short rear part facing p

Claims (1)

A method for surgical treatment of prolapse of the anterior vaginal wall in women with a high risk of recurrence after hysterectomy, including reconstruction of the pelvic floor by installing the implant with vaginal access, characterized in that the anterior and apical parts of the pelvic floor are reconstructed, using a mesh implant, which consists of an isthmus, the front part, including four sleeves for fixation, and the rear part, including two sleeves for fixation, while the implant is made of non-rass a nesting mesh cut out by a single block made of a material with polypropylene monofilaments with a diameter of not more than 0.07 mm, surface porosity of less than 40 g / m ² and volume porosity of 98; carry out a longitudinal incision of the vaginal mucosa, retreating 2.5-3 cm proximal to the external opening of the urethra and dissect the vaginal mucosa and the underlying fascia; four sleeves of the front part of the mesh implant by means of conductors are passed through the locking membrane along the tendon arch of the pelvic fascia and two sleeves are placed on the perineal skin on each side; two sleeves of the posterior part of the mesh implant by means of conductors are passed through the medial sections of the sacro-spinous ligaments to the perineal skin laterally and below the anus; the isthmus between the front and rear parts of the mesh implant is fixed for its edges in its middle part to the sacro-uterine ligaments on both sides using non-absorbable threads; the implant expanded in this way in the sagittal projection has the form of a “poker”, with its short back part facing the rectum; after the front and back parts of the implant are straightened and the isthmus is fixed, the excess free ends of the sleeves of the back of the implant are cut subcutaneously, and the sleeves of the front part are sutured subcutaneously to each other without tension with non-absorbable threads, the excess is cut and immersed in tissue; the vaginal wall is sutured with a continuous absorbable suture, cuts of the skin in the perineal region are sutured with separate sutures.