SU944552A1

SU944552A1 - Method of separating urination

Info

Publication number: SU944552A1
Application number: SU802989152A
Authority: SU
Inventors: Николай Леонтьевич Кернесюк
Original assignee: Черновицкий Государственный Медицинский Институт
Priority date: 1980-10-03
Filing date: 1980-10-03
Publication date: 1982-07-23

Description

(54) СПОСОБ РАЗОБЩЕНИЯ МОЧЕОТДЕЛЕНИЯ(54) METHOD OF URINARY DISTRIBUTION

1one

Изобретение относитс к медицине, а именно к экспериментальной хирургии дл определени раздельной функции почек и мочеточников.The invention relates to medicine, in particular to experimental surgery for the determination of a separate function of the kidneys and ureters.

Известен способ разобщени мочеотделени , включающий хирургическое разделение мочевого пузыр по его телу, дну и щейке на две камеры, сообщающиес у верхущки, с наложением надлобкового свища 1.There is a known method of dissociating urine, including surgical separation of the bladder along its body, bottom and cheek into two chambers communicating at the apex, with superposition of the suprapubic fistula 1.

Однако известный способ не позвол ет сохранить нормальную функцию мочевывод щих путей и почек.However, the known method does not allow preserving the normal function of the urinary tract and kidneys.

Целью изобретени вл етс сохранение нормальной функции мочевывод щих путей и почек.The aim of the invention is to maintain normal function of the urinary tract and kidneys.

Цель достигаетс тем, что согласно способу разобщени мочеотделени , включающего хирургическое разделение мочевого пузыр по его телу, дну и щейке на две камеры, сообщающиес у верхущки, с наложением надлобкового свища, разобщение камер в области треугольника и щейки мочевого пузыр производ т за счет слизистоподслизистого сло , микроэпицистостому накладывают на камеру, изолированную в области щейки мочевого пузыр от мочеиспускательного канала.The goal is achieved in that according to the method of dissociating urine, including surgical separation of the bladder along its body, bottom and cheek into two chambers, communicating at the apex, with suprapubic fistula overlapping, the chambers in the region of the triangle and the cheek bladder produce disjuncture , microepicystomy is placed on the camera, isolated in the area of the bladder cheek from the urethra.

Способ осуществл ют на животном следующим образом,The method is carried out on an animal as follows.

У собаки под наркозом обнажают нижнесрединным разрезом брющной стенки мочевой пузырь и по его передней и задней стенкам нанос т разрезы через все слои: первый прот женностью от верхущки до щейки мочевого пузыр , второй - от верхущки до основани мочепузырного треугольника; от верхушки оба разреза отсто т на 1,5-2 см. Разрез задней стенки продол10 жают на треугольник мочевого пузыр , рассека лищь слизистую оболочку и располага его на середине между усть ми мочеточников , затем этот разрез продолжают в область щейки мочевого пузыр , рассека In a dog under anesthesia, a bladder is exposed by a lower-middle section of the wall break and cuts are made through its front and back walls through all layers: the first one from the top to the bladder cheek, the second from the top to the bottom of the bladder triangle; Both incisions are 1.5–2 cm from the apex. The posterior wall incision is extended to the triangle of the bladder, dissect the mucous membrane and position it in the middle between the orifices of the ureters, then this incision is continued to the bladder

15 лищь слизистую оболочку, по направлению к переднему сквозному разрезу. Чтобы не повредить усть и внутристеночные отделы мочеточников, в них завод т мочеточниковые катетеры и, начина от щейки, двухр дными15 Remove the mucous membrane, towards the anterior through incision. In order not to damage the mouth and intraparietal departments of the ureters, they have a plant and ureteral catheters and, starting from the cheek, two-fold

Claims

2, the front walls of the chambers are connected to the rear ones by means of gaps. The first row of unbroken catgut suture is exposed to the mucous-submucosal layer, and the second row of knotted catgut schm is the sero-muscular layer. In the area of the cheek and triangle of the bladder, where the muscle membrane is not dissected, the sero muscular layers of the anterior wall are fixed to their submucosal layer with a second row of sutures. Thus, the muscular membrane of the urinary triangle is intact. For the imposition of a microepicystomy on the bladder chamber isolated in the cervical area, an incision of 1 -1.5 cm is made through all the layers on its front surface, then 4-5 long-term catgut filaments are stitched with mucous-submucosal and more than 4 nitmes layers. From the main incision of the abdominal wall, the latter is punctured with a scalpel from the inside outward opposite the location of the insulated chamber. By clamping the thread, an additional incision is made from the abdominal cavity and the serous-muscular layer of the bladder is connected with the muscular aponeurotic layers of the abdominal wall, and its mucous-submucous layer is connected with the skin. At the same time or the second stage, one of the interventions on the ureter can be performed. 7-10 days after the operation, the indicators of the functional state and the abdomen and the left kidney are examined, and an intervention on the ureter is determined on the ureter in comparison with the opposite one. To do this, a catheter is inserted into one chamber:, a urinary b / b bladder through the urethra,: a canal, and into another chamber of the corresponding X {5phase. a metal or polyethylene catheter is inserted through a micropistostome. - Urine does not mix and is completely evacuated through properly installed (near the triangle) catheters in the bladder chambers. A study of experimental animals in the early and distant periods showed that the preservation of the muscles of the bladder triangle using the proposed method of dissociation of urine ensures normal function of the ureters, which is an extremely important condition for studying the degree of impact of the urological operation on it on the functional state of the kidney. This method can significantly reduce the risk of an upcoming infection, since during normal functioning of the ureteral orifices there is no reflux and other complications, it is also possible to exclude skin maceration, since outside the study it is provided close to the normal function of the bladder. Claims method of urine separation, including surgical separation of the bladder through its body, bottom and neck into two chambers, communicating at the apex, with suprapubic fistula overlay, characterized in that, in order to preserve normal function of the urinary tract and kidneys, chambers the areas of the triangle and the neck of the bladder are produced by the mucous-submucous layer, and microepiticostomy is placed on the camera, isolated in the area of the bladder neck from the urethra. Sources of information taken into account in the examination 1. Nazarishvili GI Questions of clinical and experimental urology. T. IV, Tbilisi, “Medicine, 1968, p. 177-184.