Robotic radical trachelectomy by uterine artery sparing for cervical cancer

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13 Dec 2017

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Этапы операции: 1. Установка троакаров 2. Положение пациентки а Транделенбурге 3. Тазовая лимфоаденэктомия ( общих, внутренних и наружных подвздошных, обтураторных групп лимфатических узлов) 4. Вскрытие клетчаточных пространств Lazko и Okobayashi 5. Скелетирование маточных артерий и вен, выделение глубокой маточной вены 6. Выделение тазового сплетения и гипогастрального нерва 7. Мобилизация и тунелирование мочеточников 8. Вскрытие параректального и паравезикального пространства. 9. Сохранение маточной артерии и выделение мочеточника до его впадения в мочевой пузырь. Мобилизация прямой кишки, вскрытие ректовагинального пространства. Диссекция бокового и заднего параметрия. 10. Резекция медиальной фиброзной части маточно-крестцовой связки, сохраняя латеральную часть. 11. Мобилизация мочевого пузыря 12. Выделение ветви левой маточной артерии в перешейке 13. Кольпотомия 14. Резекция шейки матки 15. Церкляж 16. Формирование маточно-влагалищного анастомоза

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