女性生殖道的腹腔镜解剖学：腹腔镜的“经典”技术

使用 Veress 针进行腹腔镜检查的标准技术。 我们从创建气腹开始。


将气腹针插入脐部或刚好在脐部上方进行 CO2 充气。 一旦达到 20 mmHg 的压力，就可以插入套管针以限制进入并发症的风险。 CO2 充气被预先调整到 20 mmHg 的压力，以促进光学套管针的引入。 套管针插入后，压力调整为 12-14 mmHg。


一旦安全测试成功完成，光学套管通常通过脐端引入。


可以在左侧肋下区域的 Palmer 点进行充气。 这种方法主要适用于前腹部粘连风险高的患者（既往有开腹手术史），也适用于肥胖患者。


对于有脐下剖腹手术史的患者，也可以在脐上部位进行充气。

参考资料：：
1. CARRON PN, ANGUENOT JL, DUBUISSON JB. [Primary genital herpes with sacral meningoradiculitis]. J Gynecol Obstet Biol Reprod (Paris). 2004;33(1 Pt 1):43–6.
2. CHAPRON C, BARAKAT H, FRITEL X, et al. Presurgical diagnosis of posterior deep infiltrating endometriosis based on a standardized questionnaire. Hum Reprod. 2005;20(2):507–13.
3. CHAPRON C, CRAVELLO L, CHOPIN N, et al. Complications during set-up procedures for laparoscopy in gynecology: open laparoscopy does not reduce the risk of major complications. Acta Obstet Gynecol Scand. 2003;82(12):1125–9.
4. CHAPRON C, DUBUISSON JB, CHOPIN N, et al. [Deep pelvic endometriosis: management and proposal for a “surgical classification”]. Gynecol Obstet Fertil. 2003;31(3):197–206.
5. CHAPRON C, FAUCONNIER A, DUBUISSON JB, et al. Deep infiltrating endometriosis: relation between severity of dysmenorrhoea and extent of disease. Hum Reprod. 2003;18(4):760–6.
6. CHAPRON C, FAUCONNIER A, VIEIRA M, et al. Anatomical distribution of deeply infiltrating endometriosis: surgical implications and proposition for a classification. Hum Reprod. 2003;18(1):157–61.
7. DALLENBACH P, JUNGO NANCOZ C, EPERON I, et al. Incidence and risk factors for reoperation of surgically treated pelvic organ prolapse. Int Urogynecol J. 2012;23(1):35–41.
8. DALLENBACH P, KAELIN-GAMBIRASIO I, DUBUISSON JB, et al. Risk factors for pelvic organ prolapse repair after hysterectomy. Obstet Gynecol. 2007;110(3):625–32.
9. DALLENBACH P, KAELIN-GAMBIRASIO I, JACOB|S, et al. Incidence rate and risk factors for vaginal vault prolapse repair after hysterectomy. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(12):1623–9.
10. DUBUISSON JB. [How I perform... a laparo- scopic myomectomy]. Gynecol Obstet Fertil. 2006;34(6):526–8.
11. DUBUISSON JB. [How I perform... a laparo- scopic treatment of pelvic organ prolapse]. Gynecol Obstet Fertil. 2007;35(3):258–9.
12. DUBUISSON JB. [How I perform...the preventive occlusion of the uterine arteries before myomectomy or hysterectomy?]. Gynecol Obstet Fertil. 2007;35(12):1264–7.
13. DUBUISSON JB. [The limits of laparoscopic myomectomy. Gynecol Obstet Fertil 2005;33:44–9]. Gynecol Obstet Fertil. 2005;33(7–8):553–4.
14. DUBUISSON JB. [Surgical treatment for endometriomas]. J Gynecol Obstet Biol Reprod (Paris). 2003;32(8 Pt 2):S20–2.
15. DUBUISSON JB, CHAPRON C. [The endoscopic operating room OR 1]. Gynecol Obstet Fertil. 2003;31(4):382–7.
16. DUBUISSON JB, DE DYCKER Y, YARON M. The retroperitoneal approach in minimally invasive pelvic surgery. Ann N Y Acad Sci. 2006;1092:187–98.
17. DUBUISSON JB, DE GRANDI P. [Gynecology- obstetrics: a changing specialty]. Rev Med Suisse. 2005;1(40):2563.
18. DUBUISSON JB, DELALOYE JF. [And if it was necessary to convince...]. Rev Med Suisse. 2007;3(130):2379.
19. DUBUISSON JB, DELALOYE JF. [Prevention and screening are always a priority and in the agenda in gynecology-obstetrics...]. Rev Med Suisse. 2006;2(84):2387–8.
20. DUBUISSON JB, DUBE MJ, STUCKI D, et al. [Practice guidelines: conservative treatment of fibroids]. Rev Med Suisse. 2005;1(40):2591–7.
21. DUBUISSON JB, EPERON I, JACOB S, et al. [Laparoscopic repair of pelvic organ prolapse by lateral suspension with mesh: a continuous series of 218 patients]. Gynecol Obstet Fertil. 2011;39(3):127–31.
22. DUBUISSON JB, JACOB S, WENGER JM, et al. [Laparoscopic treatment of genital prolapse]. Rev Med Suisse. 2006;2(84):2422, 4–6.
23. DUBUISSON JB, YARON M, WENGER JM, et al. Treatment of genital prolapse by laparo- scopic lateral suspension using mesh: a series of 73 patients. J Minim Invasive Gynecol. 2008;15(1):49–55. 24. DUMONTIER I, CHAPRON C, CHAUSSADE S, et al. [Utility of rectal endoscopic ultrasonography for digestive involvement of pelvic endometriosis. Technique and results]. Gynecol Obstet Fertil. 2002;30(12):979–84.
25. FAUCONNIER A, DUBUISSON JB, FOULOT H, et al. Mobile uterine retroversion is associated with dyspareunia and dysmenorrhea in an unselected population of women. Eur J Obstet Gynecol Reprod Biol. 2006;127(2):252–6.
26. FEKI A, BOSMAN A, DUBUISSON JB, et al. Derivation of the first Swiss human embryonic stem cell line from a single blastomere of an arrested four-cell stage embryo. Swiss Med Wkly. 2008;138(37–38):540–50.