应用超声刀行腹腔镜下全子宫切除术103例分析

Analysis of 103 Cases of Total Laparoscopic Hysterectomy Using Ultrasonic Scalpel

【目的】探讨应用超声刀进行腹腔镜下全子宫切除术的方法及优点。【方法】对103例使用超声刀进行腹腔镜下全子宫切除的患者进行回顾性分析。患者年龄38～60岁,平均45.5岁,其中难治性功能性子宫出血7例,子宫内膜不典型增生3例,子宫肌瘤69例,子宫腺肌症24例,36例患者既往曾有下腹剖腹手术史。【结果】103例患者中,全子宫加双侧附件切除术8例,加单侧或双侧卵巢囊肿剔除术16例,需行盆腔粘连分解及盆腔子宫内膜异位症术中处理者14例,单纯全子宫切除术65例,所有患者均经腹腔镜下完成手术,无中转开腹患者,无手术并发症发生。【结论】使用超声刀进行腹腔镜下全子宫切除术是一种安全、快捷的手术方式,值得推广应用。

Objective] To investigate the methods and advantages of total laparoscopic hysterectomy(TLH) with ultrasonic scalpel. 103 cases of TLH using ultrasonic scalpel were analyzed retrospectively. The average age of the patients was 45.5 years old(38～ 60). Of the 103 cases, 7 had refractory dysfunctional uterine bleeding, 3 had atypical endometrial hyperplasia, 69 had uterine myoma, 24 had adenomyosis. 36 cases had history of surgery on lower abdomen . Of the 103 women who had total Laparoscopic Hysterectomy, 8 had bilateral salpingo oophorectomy, 16 had oophorocystectomy, and 14 had adhesiolysis simultaneously. All the procedures were performed under laparoscopy. No case was converted to laparotomy. No complication occured during the operations. [ Conclusion] TLH using ultrasonic scalpel is a safe, reliable procedure to remove uterus.