From Big Medical Encyclopedia

KYUSTNERA-PIKKOLI OPERATION (O. E. Kustner, is mute. gynecologist, 1849 — 1931; G. Piccoli, the ital. doctor) — operation of reposition of a uterus at its ectropion. Operation is made at puerperal ectropion of a uterus (see) if conservative actions for its reposition were unsuccessful, and also at the onkogenetichesky ectropion caused by loss of a benign tumor of a uterus. If the ectropion is caused by a malignant tumor, the hysterectomy is shown.

the Diagrammatic representation of stages of operation of Kyustner — Piccoli: 1 — introduction of a finger to a cavity of the uterus through a back kolpotomny opening; 2 — a section of a back wall of the twisted uterus on the centerline; 3 — sewing up of a section of a uterus knotty catgut seams after its reversing; 4 — reposition of the taken-in body of the womb in an abdominal cavity.

Position of the patient — as for vulval operations. Process alcohol and tincture of iodine external genitals, a vagina and a mucous membrane of a uterus. At a puerperal ectropion of a uterus delete an afterbirth, at the ectropion caused by a benign tumor in the beginning — nodes of submucous myoma. The body of the womb is taken bullet nippers in the field of pipe corners, delay kpered and do cross section of a back wall of a vagina (see. Colpotomy ), the Finger entered into a kolpotomny opening feel the funnel formed by the twisted uterus, take aside loops of intestines and appendages of a uterus (fig., 1). Then cut a back wall of a uterus on the centerline to the bottom (fig., 2). The body of the womb is turned out and take away kzad. The section of a uterus is sewn up with layer-by-layer muscular and muscular and serous and muscular seams (fig., 3). The uterus is set in an abdominal cavity through a back kolpotomny opening (fig., 4), enter a drainage tube, the opening is taken in by separate catgut seams. The drainage tube is removed on 3 — the 4th day at an uncomplicated current of the postoperative period, in the presence of an infection — on 5 — the 6th day. Allow to rise the patient on 5 — the 8th days. The extract is made on 15 — the 16th days in the absence of complications.

To. — The item of the lake can be made also through a front kolpotomny opening.

The postoperative current can be complicated by an endometritis (see. Metroendometritis ), especially at the old infected eversions of a uterus. At the same time performing infusional, disintoxication and antibacterial therapy is shown.

To. — The item of the lake gives a favorable effect concerning recovery of menstrual function and possible pregnancy.

Bibliography: The multivolume guide to obstetrics and gynecology, under the editorship of L. S. Persianinov, t. 6, page 544, M., 1961; Persianinov L. S. Operational gynecology, page 322, M., 1976; To ust-py. Die blutige Reinversion des Uterus durch Spaltung der hinteren Wand nach Eroffnung des hinteren Douglas, Verh. Ges. dtsch. Nuturf., med. Abt., Bd 73, Hft 2, S. 202, 1902; Piccoli G. Nuovo processo conservatore per la cura della inversione dell’utero (colpo-isterotomia posteriore), Arch. Ostet. Ginec., v. 5, p. 136, 1898.

C.H. Kopshev.