RU2231378C1 - Method for treating hydrocele - Google Patents

Abstract

FIELD: medicine, urology.

SUBSTANCE: the present method deals with scrotal access made with the help of a scalpel, dissecting both testicles and evacuation of dropsical liquid followed by suturing the wound. Moreover, after evacuation of dropsical liquid vaginal membrane should be affected with plasma flow of argon gas at the distance of 2 mm and current power of 30 A and excessive gas pressure of 0.1 atm. till the appearance of "shagreen skin" effect. Before suturing one should drain the wound. The method enables to inhibit plasmorrhagia and shorten the number of relapses.

EFFECT: higher efficiency of therapy.

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Description

The invention relates to medicine, namely to operative urology, and can be used in the treatment of dropsy of testicular membranes.

There is a method of treating hydrocele with a CO ₂ laser, when in a typical Bergmann operation, resection of the testicle shells is carried out by a focused laser beam. The technique of surgery is as follows. Under local anesthesia, access from the inguinal incision made with a surgical scalpel mobilizes the spermatic cord. With a significant amount of dropsy, a puncture is preliminarily performed, then the spermatic cord along with the testicle is removed into the wound. A focused laser beam with a power of 15 W is applied to a point hole in the membranes, through which a tool for dissecting the walls of hollow organs is inserted, and under compression conditions a longitudinal dissection of the membranes is performed on the side opposite to the spermatic cord. The resection of the membranes is carried out with a focused laser beam with a power of 10-20 W using a tool, retreating 0.5-1 cm from the testicle and spermatic cord. The testicle and spermatic cord are immersed in the scrotum, and the skin wound is sutured in layers (A.D. Nikolsky, B.V.Dmitriev in the manual "Lasers in Surgery" under the editorship of Prof. O.K. Skobelkin).

The disadvantage of this method is the possibility of recurrence of the disease and the relative invasiveness of the method (resection of the testicles). In addition, with this technique there is no effect on the pathogenetic mechanisms of the development of hydrocele.

The essence of the proposed method consists in the fact that after scrotal access with a scalpel, dissection of the testicle membranes and evacuation of the hydroponic fluid, the vaginal membrane is exposed to a plasma flow from a distance of 1-2 mm with a current strength of 30 A and an excess gas pressure of 0.1 atm until the “shagreen” effect skin ", after which the wound is drained through contraperture for 24-48 hours and sutured.

Due to the effects of plasma, small vessels are compressed and thrombosed - hemostasis is carried out, the liquid part of the tissue evaporates. Drainage ensures the outflow of wound contents. Under the influence of plasma on the testicle shells, morphological changes occur that provide not only vascular thrombosis, but also inhibition of plasmorrhagia processes, which, from our point of view, are the main source of fluid accumulation between the parietal and visceral sheets of the testicular vaginal membrane.

The method is as follows: after scrotal access and dissection of the membranes, the testicle is evacuated and the vaginal membrane is exposed to argon plasma from a distance of 2 mm at a current strength of 30 A and an excess gas pressure of 0.1 atm until the effect of "shagreen skin" appears, after which the wound is drained through contraperture for 24-48 hours. The testicle is immersed in the scrotum and the wound is sutured in layers.

Example. Patient I. (case history No. 21368) was hospitalized in the male urological department of the Special Clinical Hospital of Smolensk from 04/18/2002 to 04/26/2002. Examination revealed dropsy of the right testicle.

04/19/2002 Surgical treatment was performed according to the following method: after access to the testis and evacuation of hydropodic fluid, the vaginal membrane was treated with a stream of argon plasma from a distance of 2 mm at a current strength of 30 A and an excess gas pressure of 0.1 atm. The wound is drained for 24 hours and sutured in layers. On the second day after the operation, lamellar drainage was removed. Sutures were removed on the 7th day after surgery. Discharged in satisfactory condition. When observed after 6 months, no recurrence of the disease was found.

The proposed method was applied in 16 patients with hydrocele. All patients operated on using the described technique were discharged with good clinical results (no complications, good wound healing). When observed for 6 months, no one had a relapse of the disease. Clinical trials have shown that the proposed method for the treatment of hydrocele is effective, less traumatic and does not relapse.

The proposed method has the following advantages:

- the introduction of the proposed method for the treatment of hydrocele improves treatment results;

- treatment of testicular membranes with a plasma stream inhibits the phenomena of plasmorrhagia;

- the proposed method for the treatment of hydrocele reduces the number of relapses of the disease;

- a method for treating hydrocele using a plasma scalpel can be widely used in surgical urology.

Claims (1)

A method for the treatment of hydrocele, including scrotal access with a scalpel, dissection of testicular membranes and evacuation of hydropodic fluid, suturing of a wound, characterized in that after evacuation of hydropic fluid, the vaginal membrane is exposed to a plasma flow of argon gas from a distance of 2 mm at a current of 30 A and an excess gas pressure of 0 , 1 atm until the “shagreen skin” effect appears and the wound is drained before suturing.