妇科腹腔镜手术的临床应用

THE CLINICAL APPLICATION OF LAPAROSCOPIC OF SURGERY IN GYNECOLOGY

作者对本院1980.3～1991.12间的516例妇科腹腔镜手术进行了临床分析。重点讨论了输卵管妊娠保守性手术、抽吸腹腔液体、盆腔粘连分离、多囊卵巢激光打孔等手术的操作体会以及卵巢活检后发生内出血及肠穿孔并发症的预防。认为具备整套有效的腹腔镜手术器械与设备是开展腹腔手术的必要条件。只要循序渐进、技术熟练、操作仔细,绝大部分腹腔镜手术并发症是可以避免的。腹腔镜下行卵巢单极高频电流电凝止血需慎重。阐述了腹腔镜手术较常规妇科剖腹手术损伤小,木后痛苦少、恢复快、腹壁无明显疤痕、在手术中还尽可能保留器官的生理功能等优点。所以,妇科腹腔镜手术值得推广。

516 cages of gynecological laparoscopic surgery were performed between Mar. 1980 and Dec. 1991 in this hospital and the clinical data are analysed. The techniques of conservative surgery of tubal pregnancy, aspiration of abdominal fluid, pelvic adhesiolysis, and the laser punction of polycystic ovarian syndrome overies are discussed. The prevention of complications like bleeding after overy biopsy and perforation of intestine are also discussed. A whole set of effective equipment is considered necessary for further application of laparoscopic surgery. Most of the complications of laparoscopic surgery could be avoided with improved skills and careful operation. Endocoagulation of overy with unipolarhighfre-quency eletric flow under laparoscope should be carefully considered before utilization. The clinical value of laparoseopic surgery and its advantages over routine gynecological operations are discussed. Laparoscopic surgery is micro-invasive, only slightly painfull after operation, patients recover quickly after operation and there is no obvious scar on the abdomen, the physiological functions are preserved as most as possible during the operation, so the quality of life after operation could be raised. This technique should be widely advocated.