From Big Medical Encyclopedia

LEFORA-NEYGEBAUERA OPERATION (L. Page of Le Fort, fr. surgeon, 1829 — 1893; F. L. Neugebauer, Polish gynecologist, 1821 — 1890; a median colporrhaphy) — gynecologic operation on creation of an obstacle for the dropping-out uterus by sewing together of walls of a vagina.

The indication to operation are a frank prolapse at the women at advanced age who are not leading sex life and a recurrence of a falling of the vagina after a vulval hysterectomy. Contraindications to operation: patol, changes of a neck of uterus (the erosion deforming gaps), insufficiency of a sphincter of a bladder.

The preparation for surgery is similar that at colporrhaphies (see). In case of inflammatory diseases of a vagina or neck of uterus it is necessary to carry out local antiinflammatory therapy before achievement of the I—II degree of purity of vulval contents.

Anesthesia local. The neck of uterus is taken nippers to Myuza and reduced out of limits of an entrance to a vagina; at this vagina turn out outside. From front and back walls of a vagina find and otseparovyvat in the acute way symmetric rags of a trapezoid form within a mucous membrane, so that the top of a trapeze was turned to area of an ostium of the uterus (an outside pharynx of a neck of uterus) approximately at distance of 1 — 1,5 cm from it, and the basis — to vaults of the vagina. A line of a section of the basis of a trapeze shall be drawn 1 — 1,5 cm below than an outside opening of an urethra. The refreshed parts of a vulval wall are sewed among themselves. Since a top of a trapeze put stitches, its connecting edges, and then with one and on the other hand serially put knotty stitches. The basis of a trapeze is taken in in the last turn continuous or knotty sutures. At consecutive symmetric suture the refreshed surfaces connect and roll inside; in a vagina the narrow side courses are formed, the obstacle in a way of the dropping-out uterus is created. This operation is recommended to be combined with plastics of muscles of a pelvic bottom (see. Colpoperineoplasty ).

Operation, as a rule, yields the favorable long-term results. Nek-ry modifications of operation, including L. S. Persianinov's modification were offered; essential a wedge, they do not matter.

Bibliography: Davydov. N, Khromov B. M. and Sheyko V. 3. Atlas of gynecologic operations, L., 1973, bibliogr.; Persianinov L. S. Operational gynecology, page 306, M., 1976; L e F about t, Chute delamatrice, traitement par le cloison-nement du vagin, Practicien (Paris), t. 6, p. 53, 1883; Neugebauer F. tiber die mediane Vaginalnaht (Kolporrhaphia mediana) als Mittel zur operativen Beseiti-gung des Gebarmuttervorfalles, Arch. Gy-nak., Bd 22, S. 173, 1883 — 1884.

N.D. Seleznyova.