Urology / / August 12, 2017
(method of operation)
bladder wall sutured with extra- and intraperitoneal ruptures.
horizontal position of the patient, sometimes give the Trendelenburg position.
course of operations. Whatever the nature of the gap (extra- or intraperitoneal) operation starts with laparotomy, which is accessed from the section drawn from the symphysis pubis to the navel.After opening the peritoneum produce an audit of the abdominal cavity.
intraperitoneal rupture of the bladder urine after extraction from the abdominal cavity of the intestine is removed upwards.Peritoneum adjacent to the bladder, capture clips Mikulic and cut after peeling it blunt the tip of the bladder.After cutting off the peritoneum bladder is defective on the rear wall to the heart is removed.The edges of the defect is sutured peritoneum continuous catgut suture, a large cloth is removed the peritoneum to the upper edge of the wound.At the top of the bladder wall, and it is opened to the cavity of the bladder is int
epitsistostomiey operation ends.Drainage tube inserted through an incision in the bladder apex.The wound was sutured in layers.To drain tube located in the tissue paravezikalnoy immediately after surgery connect active aspiration system.
If rupture of the urinary, bladder extraperitoneal, is focusing on the peritoneum, release the top of the bladder, and it is applied provisionally seams.The bladder is opened between the two previously imposed taped and produce an audit of the walls of the bladder from the inside, as usual paravezikalnaya fiber from the gap is infiltrated.After determining the size of the defect produce mobilization of the bladder wall by rupture.This necrotic changes in tissue must be removed.Outside on the bladder defect impose bunk nodal catgut sutures №4.If you want to make an audit of the abdominal cavity.To sum this place drainage tube of sufficient diameter for the subsequent active suction.The operation ends epitsistostomiey.