如何减少腹腔镜骶骨阴道固定术手术时间？

如何减少腹腔镜骶骨阴道固定术手术时间？
How to reduce the operative time of laparoscopic sacrocolpopexy?

Abstract
Objective
摘要
目的
Laparoscopic sacrocolpopexy (LSC) has been reported to achieve lower recurrence rates, shorter recovery time, and less dyspareunia. However, as a pelvic organ prolapse (POP) surgery, LSC is problematic because it requires specific techniques and it takes a comparatively longer operative time. In this study, we present our surgical techniques of LSC and their effectiveness for shortening operative times and raising safety.
腹腔镜骶骨阴道固定术（LSC）已报告，以实现较低的复发率，。然而，为盆腔器官脱垂（POP）手术，LSC是有问题的因为它需要特定的技术，它需要一个相对较长的手术时间。在这项研究中，我们提出我们的LSC及其有效性的外科技术缩短手术时间、提高安全性。

Methods
方法
Thirty-four women with stage 2 or greater POP who underwent LSC in our hospital between September 2014 and October 2015 were enrolled in this study. The notable points of our operative procedures are as follows: (1) fixing the sigmoid colon to the left lateral abdominal wall for a clearer visualization of the sacral promontory, (2) making a retroperitoneal tunnel (not opening the peritoneum) from the sacral promontory to the Douglas pouch, (3) dissection of the vaginal wall after transvaginal hydrodissection, (4) fixation of mesh to the vaginal wall by using absorbable tacks, and (5) limiting usage of posterior mesh for the patients with posterior vaginal wall descent.
在2014年9月至2015年10月期间，在我们医院接受LSC的34名2期或更多POP患者被纳入本研究。 我们的手术过程的显着点如下：（1）将乙状结肠固定到左侧腹壁以更清楚地观察到骶骨岬，（2）从骶骨岬形成腹膜后隧道（不打开腹膜） 到道格拉斯小囊，（3）经阴道水分离后阴道壁的解剖，（4）通过使用可吸收的针将网固定到阴道壁，和（5）限制对后阴道壁下降的患者的后网的使用。

Results
结果
The median operative time was 140 (range, 90–255) minutes, and blood loss was 50 (range, 10–1600) mL. The operative time decreased as the surgical techniques improved through experience. No major intra- or postoperative complications occurred. The mean follow-up period was 4 (range, 1–14) months, and only one patient presented a recurrent grade 2 cystocele.
手术时间中位数为140（范围，90 - 255）分钟，出血量为50（范围，10 - 1600）ml。手术时间减少，因为手术技术的改进经验。无大的内或术后并发症发生。平均随访时间为4（范围，1–14）个月，只有一个病人复发的2级膀胱膨出。

Conclusion
结论
Our unique procedures will help shorten operative times and reduce complications of LSC.
我们独特的程序将有助于缩短手术时间、减少术后并发症的LSC。

Keywords
absorbable tack; laparoscopic sacrocolpopexy; pelvic organ prolapse; short operative time; surgical technique
关键词
可吸收钉；腹腔镜骶骨阴道固定术；盆腔器官脱垂；手术时间短；手术技术

如何减少腹腔镜骶骨阴道固定术手术时间？

Figure 1. Retroperitoneal tunnel.
图1.腹膜后隧道。

如何减少腹腔镜骶骨阴道固定术手术时间？

Figure 2. The anterior mesh with the nonabsorbable suture at the distal tip.
图2.在远端的不吸收缝线的前路。

如何减少腹腔镜骶骨阴道固定术手术时间？

Figure 3. The schema of sagittal view after laparoscopic sacrocolpopexy (LSC). Sacral promontory, uterine cervix, and distal point of anterior vaginal wall were fixed by nonabsorbable sutures. Absorbable tacks were used at anterior vaginal wall.
图3.后腹腔镜骶骨阴道固定术矢状面图式（LSC）。骶骨岬，子宫颈和阴道前壁远点用不可吸收缝线固定。可吸收钉用于阴道前壁。

如何减少腹腔镜骶骨阴道固定术手术时间？

Figure 4. The operative time (black line) and intraoperative blood loss (gray bar). a Number 18 had a huge myoma. b Numbers 28 and 33 underwent double mesh laparoscopic sacrocolpopexy (LSC).
图4.手术时间（黑线）和术中出血（灰棒）。一个18号有一个巨大的子宫肌瘤。B数字28和33例行腹腔镜骶骨阴道固定术（LSC）双重网格。

英文原文：
How to reduce the operative time of laparoscopic sacrocolpopexy-.pdf (794.44 KB, 下载次数: 0, 售价: 99 香叶)

2016-10-13 19:42 上传

点击文件名下载附件
如何减少腹腔镜骶骨阴道固定术手术时间？