摘要
本手术方式对反复复发盆腔器官脱垂患者采取膀胱截石位,气管插管全身麻醉,常规消毒铺单后采用腹腔镜手术方式,举宫杯顶起阴道残端,用超声刀逐渐分离膀胱阴道间隙、直肠阴道间隙;打开直肠右侧旁间隙,确定骶骨岬位置,暴露骶前间隙。将自制的Y型网片头端平铺固定于阴道前后壁,网片尾端沿直肠侧间隙平铺,固定于骶骨岬。稀释的美兰溶液充盈膀胱确认无损伤后,连续缝合关闭腹膜。排空气体,常规缝合穿刺孔,完成腹腔镜阴道残端骶骨固定术。该手术方式通过Y型网片通过缝合阴道前后壁和固定骶骨前韧带,使盆腔脏器脱垂恢复正常结构,对反复复发脱垂有着很好的治疗效果。
In this surgical approach,patients with recurrent pelvic organ prolapse were placed in the cystotomy position under general anaesthesia by tracheal intubation.After routine disinfection and draping,laparoscopic surgery was used to lift the uterine cup up to the apex of the vaginal stump and the vesicovaginal and rectovaginal spaces were gradually separated with ultrasonic knives.The right pararectal space of the rectum was opened to determine the position of the sacral cape and expose the presacral space.The head ends of the homemade Y-shaped mesh were fixed flat to the anterior and posterior vaginal walls,and the tail end of the mesh was fixed flat along the lateral rectal hiatus and fixed to the sacral promontory.After filling the bladder with diluted melphalan solution to confirm there was no damage,the peritoneum was closed with continuous sutures.The gas was evacuated and the puncture holes were routinely sutured to complete the laparoscopic sacral fixation of the vaginal stump.
作者
贾秋成
蒋清
魏文慧
汤慧敏
陈婉莹
吴忆寒
魏炜炜
陈洁
陈继明
JIA Qiucheng;JIANG Qing;WEI Wenhui;TANG Huimin;CHEN Wanying;WU Yihan;WEI Weiwei;CHEN Jie;CHEN Jiming(Department of Gynecology,the Affiliated Changzhou Second People's Hospital of Nanjing Medical University,Changzhou,Jiangsu 213000,China;Department of Obstetrics and Gynaecology,Third People's Hospital of Xining City,Xining,Qinghai 810005,China)
出处
《手术电子杂志》
2023年第4期20-23,共4页
Electronic Journal of Medical Operations
基金
常州市“十四五”卫生健康高层次人才培养工程(2022CZBJ074)
江苏省妇幼健康重点人才项目(RC202101)
江苏省妇幼健康科研项目(F202138)
江苏省博士后科研资助计划(2019K064)
江苏省“333工程”科研资助项目(BRA2019161)
