腹腔镜全子宫切除术是什么 赵宏伟 山西省肿瘤医院 скачать в хорошем качестве

腹腔镜全子宫切除术是什么 赵宏伟 山西省肿瘤医院

腹腔镜全子宫切除术是什么 赵宏伟 山西省肿瘤医院 子宫切除要求切除全部的子宫体和子宫颈，其手术适应征为子宫体或者子宫颈良性疾病，或者子宫内膜或子宫颈的癌前病变，或者一部分早期的子宫恶性肿瘤，可视情况保留或切除单侧或者双侧的输卵管或卵巢，全子宫切除术有筋膜内、筋膜外之分，传统的全子宫切除术是指后者。腹腔镜下全子宫切除术的步骤一般包括：1、麻醉成功后，消毒、铺巾；2、选择置镜点，建立人工气腹，置入腹腔镜；3、腹腔镜直视下探查盆腔；4、凝切圆韧带、输卵管峡部、卵巢固有韧带等；5、凝切阔韧带前叶和膀胱反折腹膜，下推膀胱；6、凝切阔韧带后叶，暴露子宫血管；7、依次凝切子宫血管、子宫主韧带及骶韧带；8、沿阴道穹隆切开阴道壁，切除子宫；9、消除阴道残端，并缝合；10、清洗盆腔，彻底止血，排空腹腔气体，拔出所有穿刺导管，缝合腹壁。 What is laparoscopic total hysterectomy Hysterectomy requires the removal of the entire body and cervix, The indications of operation were benign diseases of uterine body or cervix, Or precancerous lesions of the endometrium or cervix, Or part of the early uterine cancer, The fallopian tubes or ovaries on one or both sides can be preserved or removed as the case may be, Total hysterectomy can be divided into intrafascial and extrafascial, Traditional hysterectomy refers to the latter. The steps of laparoscopic hysterectomy generally include: 1, Disinfect and spread towels; 2. Select the mirror setting point, Establish artificial pneumoperitoneum, Laparoscopy; 3. Laparoscopic exploration of the pelvis; 4. Coagulate and cut round ligament, isthmus of fallopian tube, inherent ligament of ovary, etc; 5. The anterior lobe of broad ligament and the retroperitoneal of bladder were coagulated, Push bladder down; 6. Coagulate and cut the posterior lobe of broad ligament, Exposure of uterine blood vessels; 7. The blood vessels, main ligament and sacrum ligament of uterus were coagulated and cut in turn; 8. The vaginal wall is incised along the vaginal vault, Hysterectomy; 9. Remove the vaginal stump, And suture; 10. Clean the pelvis, Completely stop bleeding, Empty the air in the abdominal cavity, Pull out all catheters, Suture the abdominal wall.