腹腔镜下子宫肌瘤旋切方法探讨

Exploration of the method of uterine morcellation in laparoscopic myomectomy

腹腔镜下子宫次全切除和子宫肌瘤切除已经成为常用的手术方式,子宫或肌瘤组织通过腹腔镜子宫粉碎器(laparoscopic power morcellation)旋切取出体外。由于子宫肌瘤有发生肉瘤变的可能性,恶变后的子宫肌瘤缺少特异性表现,术前常不能明确良恶性。如果在无隔离保护措施的情况下使用子宫粉碎器对肿瘤进行旋切粉碎,有导致肿瘤细胞脱落种植腹腔,肿瘤分期上升的可能。为了达到避免肿瘤细胞污染腹腔的目的,作者对子宫粉碎器(uterine morcellation)和粉碎的过程进行了改进,临床效果良好,值得推广应用。

Laparoscopic supracervical hysterectomy （LASH） and laparoscopic myomectomy have become a common surgical procedure.It takes uterus or fibroid tissues out of body by means of laparoscopie power morcellation, which has become a common way of operation.Because the uterine fibroids have possibly changed into sarcomas, and the uterine fibroid after malignant transformation has no manifestation of specificity, the benign and malignant nature usually cannot be defined before operation.Unprotected laparoscopic uterine morcellation poses a risk of spreading unsuspected cancerous tissue and causes tumor cells to fall off, which may increase tumor stage.For the purpose of preventing the unsuspected cancerous cells and tissues from contaminating abdominal cavity, the laparoscopic power morcellation has been improved and achieved good clinical effects, which is worthy of being popularized and applied.