手助腹腔镜手术及其在妇科中的应用

手助腹腔镜手术及其在妇科中的应用
Hand-assisted laparoscopic surgery and its applications in gynecology

Abstract
Laparoscopic surgery has been used extensively since it was first applied in the 1980s. The advantages are generally accepted and include less pain, smaller incisions, faster recovery, and shorter hospital stays. However, several limitations associated with standard laparoscopic surgery (SLS) have become apparent and include the loss of tactile sensation, problems with the removal of bulky and intact specimens, and the restriction of visualization of the entire operating field. These problems with SLS helped to inspire the development of laparoscopically assisted surgery followed by hand-assisted laparoscopic surgery (HALS). In a hand-assisted laparoscopic procedure, an incision is made in the patient’s abdomen. Then, a uniquely designed appliance is introduced into the abdominal cavity through the incision to maintain pneumoperitoneum. With the inserting hand, surgeons can provide manual exposure, traction, palpation, and dissection because of the feedback of tactile sensation. HALS has gained acceptance for a wide range of abdominal procedures in general surgery and urology and is now feasible for complicated surgeries such as splenectomy, nephroureterectomy, and colectomy. It has been demonstrated in numerous specialties that HALS is a safe and efficacious technique that combines the benefits of laparoscopy with the advantages of a conventional laparotomy. Standard laparoscopic surgery also has limitations in gynecological surgery. A patient may have high risks with conventional laparoscopic surgery when she has deep invasive endometriosis, multiple or massive myoma, or dense pelvic adhesions from prior surgery. HALS overcomes many of the aforementioned limitations, has less conversion to open surgery, and broadens the indications for minimally invasive surgery, not only for benign tumors but also for pelvic malignancies.
摘要
腹腔镜手术自20世纪80年代首次应用以来，已被广泛应用，其优点是疼痛小，切口小，恢复快，住院时间短，是一个很有应用的问题。然而，与标准腹腔镜手术相关的一些局限性（SLS）已经变得很明显，包括触觉丧失，随着庞大而完整的标本的去除问题，和整个操作场可视化的限制。SLS这些问题有助于激发发展腹腔镜辅助手术后用手辅助腹腔镜手术（HALS）。在一个手辅助的腹腔镜手术中，一个切口是在病人的腹部。然后，设计独特的器械进入腹腔通过切口维持气腹。与插手，外科医生可以提供手动曝光，牵引，触诊和夹层，因为触觉反馈。哈尔斯已在普通外科和泌尿科各种腹部手术范围得到认可，现在可行的如脾切除、肾输尿管全长切除复杂的外科手术，结肠切除术。它已在许多专业，哈尔斯是安全和有效的，结合传统的开腹手术腹腔镜技术优点好处了。标准腹腔镜手术在妇科手术中也有一定的局限性。一个病人可能有高风险，传统的腹腔镜手术时，她有深部浸润性子宫内膜异位症，多个或巨大的子宫肌瘤，或密集的盆腔粘连，从以前的手术。哈尔斯克服了前述的限制，具有开放手术转换较少，拓宽了微创手术的适应症，不仅为良性肿瘤，但也为盆腔恶性肿瘤。

Keywords
gynecology; hand-assisted; laparoscopic
关键词
妇科；手助；腹腔镜

英文原文：
Hand-assisted laparoscopic surgery and its applications in gynecology.pdf (228.92 KB, 下载次数: 0, 售价: 99 香叶)

2016-10-10 19:08 上传

点击文件名下载附件
手助腹腔镜手术及其在妇科中的应用