腹腔镜乙状结肠代阴道成形术的手术改进及文献回顾

目的:探讨腹腔镜乙状结肠代阴道成形术的方法、可行性及其效果。方法:腹腔镜下闭合切割器切断乙状结肠近端,经会阴与尿道、膀胱与直肠之间造穴,将降结肠远侧断端牵拉出造穴口(或腹壁切口),将钉钻置入断端,荷包缝合固定后送回腹腔。闭合切割器切断乙状结肠远端,经肛门入吻合器行肠吻合;将游离的乙状结肠远端牵至造穴口,完成阴道成形。结果:2例手术均获成功,无并发症发生,成形的阴道长度和宽度充分,性生活满意。结论:腹腔镜乙状结肠代阴道成形术是完全可行的,较开腹手术的效果更理想。

Surgical Improvement of Laparoscopic Sigmoid Colpopoiesis and Literature Review

Objective: To explore the procedure,feasibility and effect of laparoscopic sigmoid colpopoiesis.Methods:Two cases underwent laparoscopic sigmoid colpopoiesis.Under laparoscope,dissected the proximal portion of sigmoid colon with endoscopic linear cutter.After the space between the bladder and the rectum was detached,the distal cut end of descending colon reached the perineum(or abdominal incision).The cut end was placed with the anvil and made a purse-string suture, then it was put back into the peritoneal cavity.Dissected the distal portion of sigmoid colon with endoscopic linear cutter.The intraluminal curved stapler was put in from the anus to anastomose the stump of the rectum and the descending colon.The isolated sigmoid transplant reached the perineum and was sutured to the vaginal entrance.Results:The operations for two cases were successfully completed and no complications were observed.The neovagina was adequate in length and diameter.Moreover,two cases had pleasant sexual intercourses.Conclusion:The laparoscopic sigmoid colpopoiesis is viable and more ideal than the traditional laparotomy.