妇科腹腔镜手术170例分析

Analysis of 170 cases of Laparoscopic Surgery in the Treatment of Gynecologic Diseases

目的:探讨妇科腹腔镜手术的临床应用价值。方法:170例腹腔镜手术病例均采用全麻,主要器械为单极双极电凝,异位妊娠术式为输卵管切开取胚术、输卵管切除术;卵巢囊肿手术采用囊肿剥除术及卵巢成形术、患侧附件切除术;子宫手术采用肌瘤剥除术、改良CISH术、子宫次全切除术、子宫全切术及LAVH术。结果:腹腔镜手术占同期妇科手术的45.09%,手术成功率98.8%,中转开腹率1.2%,并发症发生率2.9%,包括皮下气肿2例,皮下血肿1例,脐部切口裂开1例,盆腔血肿1例。结论:掌握好适应证,妇科大部分手术可在腹腔镜下完成。

Objective： To explore the value of laparoscopic operation in the treatment of gynecologic diseases. Methods： 170 patients with benign gynecologic diseases were successfully managed by laparoscope without major intraoperative or postoperative complications： All of these operations were performed with monopolar and bipolar electrosurgery, Patients with ectopic pregnancy underwent hparoscopic salpingotomy, salpingectomy or embryo removed from fimbrla. For ovarian, cyst, oophorocystectomy adnexectomy and ovary forming technique were performed. Improved LM （ laparoscopic myomectomy ） CISH, LSH （ laparoscopic supracervical hysterectomy ）, LTH （ laparoscopic total hysterecotomy ）, LAVH （ laparoscopically assisted vaginal hysterectomy） were performed for uterine problems. Results：45.09% of the gynecologic operations in our hospital were performed laparoscopically, with the success rate of 98.8%. Five showed complications, the rate being 2.9% ,2 subcutaneous emphysema, 1 subcutaneous hematoma, 1 umbilical wound split open, 1 pelvic hematoma. Conclusion：The results suggest that laparoscopic operation is safe and feasible in treating most gynecologic diseases if the indications are well selected.