纯超刀单孔腹腔镜全子宫双输卵管切除术

Laparoendoscopic single site surgery for total hysterectomy plus double salpingectomy by simply using Ultracision Harmonic Scalpel

手术采用气管插管全身麻醉,患者取截石位,采用经脐单孔腹腔镜术式,二氧化碳(carbon dioxide CO_(2))人工气腹,压力13 mmHg(1 mmHg=0.133 kPa),进入腹腔后分离粘连,合理运用超刀max键、min键以及高级止血键(绿键)凝切双侧输卵管系膜、卵巢固有韧带、双侧阔韧带、膀胱反折腹膜、宫旁组织以及主韧带、部分骶韧带、双侧子宫动静脉等。更换举宫杯,沿杯缘使用超声刀切开阴道前穹窿、侧穹窿及后穹窿离断子宫。自阴道取出子宫及双输卵管,普通可吸收线缝合阴道残端,可吸收线缝合脐孔筋膜层及皮肤并进行脐孔整形。

The surgery used tracheal intubation general anesthesia.Patients adopted lithotomy position,and received transumbilical single hole laparoscopic surgery,and CO_(2) artificial pneumoperitoneum with a pressure of 13 mmHg(1 mmHg=0.133 kPa).After the instrument entered the abdominal cavity,adhesion was separated.With reasonable use of superknife max key,min key and advanced tournistatic key(green key),we performed coagulation of bilateral fallopian tube membrane,ovarian inherent ligament,bilateral broad ligament,bladder retroperitoneal membrane,intrauterine tissue,the main ligament,some sacral ligament,bilateral uterine moving vein,etc.Then we replaced the raised cup and cut the anterior vaginal fornix,side vault and posterior vault from the broken uterus with an ultrasonic knife.The uterus and double fallopian tube were removed from the vagina,the vaginal residue were sutured with ordinary absorbable line,the umbilical hole fascia layer and skin were sutured with absorbable cord,and umbilical hole surgery were performed.