METHOD OF PERCUTANEOUS PUNCTURE MINI-PERCUTANEOUS TREATMENT OF LARGE, GIANT AND MULTI-CHAMBER KIDNEY CYSTS IN LIQUID MEDIUM

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, namely to urology. Percutaneous puncture of paranephric fiber is performed directly on a cyst capsule under ultrasound control. Following sequence of operations is performed. Distal end of the drawn main conductor is folded in close proximity to the cyst wall. Expansion of puncture stroke by means of plastic bougie with diameter of not more than 10 SR to a coiled portion of the distal end. Removal of plastic bougie, installation of double metal bougie, removal of inner part of double metal bougie. Insurance string is installed on the lumen of the outer part of the double metal bougie in a manner similar to the main string. Outer part of double metal bougie is removed. Puncture is inverted by a metal dilator of the nephroscope tube along the main string. Metallic tube 16.5 mm is installed on metal dilator without lock, removal of metal dilator of mini-nephroscope tube and main conductor string. Endoscopic inspection of the distal portion of the puncture stroke is carried out, the bottom of which is Gerroth's fascia, opening by endoscopic scissors of Gerrot's fascia and a renal capsule, mechanical extraction with the help of a mini-nephroscope and endoscopic forceps, as well as irrigation fluid of the renal cyst dome. Cyst wall is incised and excised by means of a laser and endoscopic scissors, a laser coagulation of an end of a cyst wall with bleeding vessels, a paranephrenic insured silicone drainage installation of 10–12 SR, removal of a nephroscope tube and an insurance guide string, fixation of the suture drain to the skin.;EFFECT: method combines minimum invasiveness of the procedure with maximum effectiveness, in which all surgical intervention is performed through a single mini-access using a metal reusable nephroscope tube, there is no need to use insufflation, since the operation is performed in liquid medium (0_9 % NaCl), the resected cyst wall provides radical treatment, and laser coagulation of the cyst wall edges minimizes the possibility of bleeding.;1 cl, 1 ex