腹腔镜下自裁Artisyn-Y型网片同时纠正中盆腔及后盆腔缺陷的术式报道

随着腹腔镜技术的发展,其在妇科盆底功能障碍性疾病诊治方面的作用越来越重要,在解决中盆腔和前盆腔缺陷方面效果确切,而对于后盆腔缺陷的腹腔镜诊治较少报道,且通过腹腔镜手术治疗中盆腔缺陷的同时诊治后盆腔缺陷更是鲜有文献描述。对1例盆腔器官脱垂定量分度法(POP-Q)评分:Aa-3,Ba-3,C+2,Ap+3,Bp+3,D+1,考虑子宫脱垂Ⅲ度合并直肠膨出Ⅲ度的患者,重庆市妇幼保健院妇科盆底与肿瘤科针对中盆腔合并后盆腔缺陷的患者设计一种新术式,可在纠正中盆腔缺陷的同时纠正后盆腔缺陷,且能够达到网片平铺、可调等优点,该术式即应用自裁Artisyn-Y型网片固定宫颈和悬吊子宫纠正中盆腔缺陷,同时加固阴道直肠筋膜从而纠正后盆腔缺陷。

Laparoscopic Self-Tailoring Artisyn-Y Mesh for Simultaneous Correction of Middle and Posterior Pelvic Defects

With the development of laparoscopy technology, it plays an increasingly important role in the diagnosis and treatment of gynecological pelvic floor dysfunction diseases. It has a definite effect in solving the problems of middle pelvic cavity and anterior pelvic cavity. Laparoscopic diagnosis and treatment of posterior pelvic cavity defects are rarely reported. There are few literatures describing the diagnosis and treatment of posterior pelvic cavity defects through laparoscopic surgery. A POP-Q score is given for a case：Aa-3, Ba-3, C+2, Ap+3, Bp+3, D+1. Considering the patients with uterine prolapse Ⅲ degree and rectocele Ⅲ degree, the gynecological pelvic floor and oncology department of Chongqing Maternal and Child Health Hospital designed a new operation for the patients with pelvic defect in the middle and posterior pelvic cavity. It can correct the posterior pelvic defect while correcting the middle pelvic defect, and can achieve the advantages of flat mesh and adjustable. Self-tailored Artisyn-Y mesh was used to fix cervix and suspend uterus to correct middle pelvic defect, and to reinforce vaginal rectal fascia to correct posterior pelvic defect.