子宫脱垂的腹腔镜悬吊手术治疗方案的研究进展

A review of laparoscopic uterine suspension procedures for uterine prolapse

子宫脱垂是一种常见的妇科疾病。引起子宫脱垂的原因很多,但所有的因素最后均导致盆底筋膜的功能缺陷和神经肌肉功能障碍。传统手术以阴式手术为主,大多同时切除子宫。近年来,随着腹腔镜技术在妇科手术中的普及,技术的成熟,补片材料的进一步研发,使得子宫脱垂并保留子宫的微创手术在腹腔镜下实施成为可能,并出现了多种手术方式,如腹腔镜下子宫/阴道骶骨固定术、子宫圆韧带缩短悬吊术、子宫骶骨韧带缩短术等。因为腹腔镜手术在盆底重建手术中具有解剖部位暴露清晰,修复部位准确,术后治愈率高,复发率低,能更好地保留阴道功能对性生活质量的影响小,创伤小、术后恢复快、住院时间短等优点,使其成为近年研究的热点。

Uterine prolapse is a common gynecological diseases. The aetiology of prolapse is multifactorial, mainly due to neuromuscular dysfunction and pelvic floor dysfunction fascia. Traditional surgery is through the vaginal, while most of hysterectomy. The advent of laparoscopic instrumentation and surgical techniques for gynecologic procedures and surgical mesh has made uterine reservation true. It has many surgery approaches, such as laparoscopic uterus/vaginal sacral fixation, laparoscopic uterine suspension to round ligament, laparoscopic suture uterosacral ligament hysteropexy.Because laparoscopic surgery has the advantages of high accuracy, high recovery rate, low recurrence rate, less trauma,quicker recovery, shorter hospitalization time, it has been a hot research in recent years.