Biktimirov Rafael Gabbasovich,Биктимиров Рафаэль Габбасович,Martov Aleksej Georgievich,Мартов Алексей Георгиевич,Kaputovskij Aleksej Alekseevich,Капутовский Алексей Алексеевич,Biktimirov Timur Rafaele
申请号：
RU2017106619
公开号：
RU2667612C2
申请日:
2017.02.28
申请国别(地区):
RU
年份:
2018
代理人:
摘要：
FIELD: medicine.SUBSTANCE: invention relates to surgery and can be used for extraperitoneoscopic adenomectomy of the prostate of more than 80 cm. 2 cm incision of skin, subcutaneous tissue and aponeurosis is performed below the umbilical ring along the median line, in which a cavity is formed by a forefinger in the preperitoneal space in the direction of the pubic articulation, formation of the cavity is completed using a balloon-dissector. After the balloon-dissector is removed into the formed cavity, a 10 mm optical trocar is installed in the pre-peritoneal space. Z-shaped suture is applied on the incision of aponeurosis and tighten. Through the installed 10 mm optical trocar in the preperitoneal space, carbon dioxide is supplied at a pressure of 12–14 mm Hg and an endoscope with a video camera is introduced, providing control over the course of surgical intervention, the image from which is displayed on monitors. Without damaging the lower epigastric vessels, the 10 mm trocar is placed on the left side of the midclavicular line 2–4 cm below the installed 10 mm optical trocar, and an ultrasound dissector is placed therein. Three 5 mm instrumental trocars are additionally installed with the possibility of installing a laparoscopic clamp in the upper trocar, aspirator – in the lower trocar. Anterior surface of the prostate is mobilized from fat using the ultrasound dissector. 5–7 cm incision of the prostate capsule is performed in the middle part of the prostate in the transverse direction with simultaneous ultrasound coagulation of small vessels and bipolar coagulation of large vessels. Along the length of the incision of the capsules, a space is formed between the capsule of the prostate and the adenoma nodes with vessel coagulation and visualization of the surgery field using the aspirator. Consistent enucleation of adenomatous nodes is performed from the base, lateral surfaces and top of the capsule of the prostate from its right and left sides with coagulation
