腹腔镜下全子宫切除术65例临床分析

目的探讨杯状举宫器、超声刀在腹腔镜全子宫切除术中的技术要点及临床应用价值。方法2006年10月~2007年9月,使用超声刀、杯状举宫器完成腹腔镜下全子宫切除术65例,包括子宫肌瘤48例,子宫腺肌病12例,宫颈上皮内瘤变Ⅲ级5例。使用超声刀完成全子宫切除,沿杯状举宫器穹隆杯上缘切开阴道前壁并沿宫颈环形切断阴道壁,完整切除子宫颈。结果65例均成功完成,无中转开腹手术。手术时间75~135min,平均102min。术中出血量50~300ml,平均150ml。术中无阴道残端出血及输尿管、膀胱、直肠损伤。术后住院4~6d,平均5.2d。65例术后随访2~4个月,阴道残端愈合良好。结论使用超声刀、杯状举宫器行腹腔镜下全子宫切除术,提高了手术的安全性且操作简捷,有利于腹腔镜子宫切除术的普及推广。

Experience on Total Laparoscopic Hysterectomy: Report of 65 Cases

Objective To investigate the clinical value and surgical skill of laparoscopic hysterectomy (TLH) using uterus lifting cup and ultrasonic scalpel. Methods From October 2006 to September 2007, TLH was performed on 65 patients using uterus lifting cup and ultrasonic scalpel. Among the patients, 48 had hysteromyoma, 12 had adenomyosis, and 5 had grade CIN Ⅲ. After the uterus was resected completely using ultrasonic scalpel, the anterior wall of vagina was cut circularly along the upper margin of the uterus lif...