举宫器在女性腹腔镜直肠切除术中的应用价值

Application of Uterine Manipulator in Female Laparoscopic Rectectomy

目的探讨举宫器在女性腹腔镜直肠切除术中显露过程中的应用价值。方法在38例女性腹腔镜直肠切除术中采用举宫器举起子宫协助显露子宫直肠窝办法,为直肠切除术创造良好的视野。结果 38例接受腹腔镜直肠切除术的病人取得成功,Dixon式34例(其中联合子宫肌瘤剔除2例、卵巢囊肿剔除2例、膀胱部分切除1例)、Miles式4例,术中阴道后壁损伤1例,术后吻合口出血1例,此外无其他围手术并发症。手术时间(170±40)min、术中出血量(35±10)ml、恶性肿瘤淋巴结清除数(14±4)枚、肠道恢复时间(42±12)h,术后住院天数(9±1)d,无中转开腹。结论在女性腹腔镜直肠切除术中采用举宫器举起子宫协助显露子宫直肠窝办法取代子宫悬吊,可为直肠切除术创造良好的视野,达到方便、灵活、创伤更小的目的。

Objective To investigate the application of the uterine manipulator in the female Laparoscopic rectectomy.Methods Using the uterine manipulator to raise the womb to expose the Douglas fossa in order to provide a good vision in 38 cases of female Laparoscopic rectectomy.Results The 38 cases treated by such operation were successful,including Dixon 34 cases（2 cases combined with hysteromyomectomy,2 cases of removal of ovarian cysts,1 case of partial resection of the bladder）and 4 cases of Miles,1 case of vaginal posterior wall injury,1 case of postoperative anastomotic bleeding,no other peri-operative complications.The average operation time was（170±40）min,the estimated operative blood loss was（35±10）ml,the number of removed matastatic lymph nodes were（14±4）,postoperative hospitalization term was（9±1）days,without conversion.Conclusion The approach using the uterine manipulator to replace the Uterine suspension can provide a better vision in female Laparoscopic rectectomy,and it is convenient,flexible and less traumatic.