METHOD FOR PERFORMING LAPAROSCOPIC TOTAL ILEOURETEROPLASTY IN PATIENTS WITH EXTENDED URETERAL STRICTURE

FIELD: medicine.SUBSTANCE: invention relates to the field of medicine, namely operative urology. A Foley catheter is installed in the bladder, in the position of the patient on a healthy side, the surgical field is treated with a disinfectant, a carboxyperitoneum is created, an optical port and manipulation ports are installed. The mesentery of the colon is opened with the formation of a "surgical window" for subsequent manipulations, Gerota's fascia is opened, the pelvis is mobilized, and the place of urinary tract cutoff is determined. When ascertaining the possible formation of the pelvic-intestinal anastomosis, a fragment of the ileum is taken. An interintestinal isoperistaltic hardware anastomosis is formed. Additionally, the anastomosis line is strengthened with sutures, an internal stent is installed in the intestinal graft with the formation of a proximal helix in the renal pelvis, a distal one - in the bladder. The intestinal graft is fixed by fatty suspensions or elements of the mesentery with 2/0 Vicryl sutures to the perirenal or parapelvic tissue. An intracorporeal anastomosis is performed between the pelvis and the proximal part of the intestinal graft with a 4/0 Vicryl thread with an anastomosis tightness check, the patient is placed on his back, the bladder is mobilized at the site of anastomosis formation with the graft. An anastomosis is also formed between the distal part of the intestinal graft and the top of the bladder with a continuous suture with notched thread. The tightness of the anastomosis is checked, the abdominal cavity and small pelvis are drained with silicone drains, the trocars are removed under video endoscopic control, the carboxyperitoneum is resolved, the skin is sutured, and they are closed with aseptic stickers.EFFECT: method makes it possible to prevent failure of the pelvic-intestinal anastomosis in the early postoperative period when the patient switches to the orthostatic position.1 cl, 2 ex Изобретение относится к области медицины, а именно оперативной урологии. Устанавливают катетер Фоли в мочевой пузырь, в положении больного на здоровом боку обрабатывают операционное поле обеззараживающим средством, создают карбоксиперитонеум, устанавливают оптический порт и манипуляционные порты. Вскрывают брыжейку толстой кишки с формированием «хирургического окна» для последующих манипуляций, вскрывают фасцию Героты, проводят мобилизацию лоханки, определяют место отсечения мочевых путей. При констатации возможного формиров