有腹部手术史的妇科腹腔镜手术应用探讨

The discussion of laparoscopy in gynecology in patients with history of abdominal operation

目的:总结有腹部手术史的118例患者行腹腔镜妇科手术的经验与技巧。方法:避开原有切口慎重选择第1穿刺孔,必要时采用开放式置入Trocar,注意膀胱及肠管粘连区的分离技巧。结果:117例成功完成手术,1例因局部粘连严重中转开腹。结论:有腹部手术史并非是妇科腹腔镜手术的禁忌证,合理选择患者,注重术中操作技巧仍可使有腹部手术史的患者受益于微创手术。

Objective：To summarize the experience of laparoscopy in gynecology patients with abdominal operation history.Methods：Choose the stab site carefully,if necessary,open procedure can be applied to insert the first trocar.Pay more attention to the dissection of bladder and adhesion between intestine and omentum.Results：One hundred and seventeen cases were performed with laparoscope successfully.1 case was converted to open procedure because of the injury of bladder.Conclusions：Abdominal operation history is not the contraindication of laparoscopey in gynecology.By choosing appropriate patients and careful dissection of adhesion,patients with abdominal operation history can benefit from laparoscopy.