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中华腔镜外科杂志(电子版)

中华腔镜外科杂志(电子版) ›› 2019, Vol. 12 ›› Issue (03): 176 -178. doi: 10.3877/cma.j.issn.1674-6899.2019.03.011

所属专题： 经典病例； 文献资源库；

病例报告 上一篇    下一篇

经阴道单孔腹腔镜子宫肌瘤剔除术的应用
吴纯华 1, 符华影 1, 李钰彦 1, 刘启煌 1, 关小明 2, 刘娟 1 , †( )   
  1. 1. 510150 广州医科大学附属第三医院妇产科
    2. 77030 德克萨斯，美国德克萨斯州休斯顿贝勒医学院妇产科
  • 收稿日期:2019-04-18 出版日期:2019-06-30
  • 通信作者: 刘娟
  • 基金资助:
    国家自然科学基金(81671440)

The application of transvaginal single port laparoscopic hysteromyomectomy

Chunhua Wu 1, Huaying Fu 1, Yuyan Li 1, Qihuang Liu 1, Xiaoming Guan 2, Juan Liu 1 , †( )   

  1. 1. Department of Obstetrics & Gynecology, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China
    2. Department of Obstetrics & Gynecology, Baylor College of Medicine, Houston, Texas 77030, USA
  • Received:2019-04-18 Published:2019-06-30
  • Corresponding author: Juan Liu
  • About author:
    Corresponding author: Juan Liu, Email:
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目的

经阴道单孔腹腔镜手术是新兴的经自然腔道内镜手术之一，它具有无体表瘢痕、术后疼痛减轻等特点，它在妇科领域的应用越来越广泛。本文旨在探究经阴道单孔腹腔镜子宫肌瘤剔除术的手术技巧及应用难点。

方法

选取广州医科大学附属第三医院1例子宫肌瘤病例，逐步讲解经阴道单孔腹腔镜子宫肌瘤剔除术的手术步骤及方法，演示手术技巧。

结果

手术顺利完成，术中出血量少，术后病理提示坏死性肌瘤。患者的左下腹疼痛得到了缓解。术后随访3个月，患者恢复良好，无并发症。

结论

经阴道单孔腹腔镜子宫肌瘤剔除术是可行的，可以有效地清除病灶。但该术式对手术医师的技术提出了更高的要求，学习曲线延长，并且需要远期随访及进一步研究来评估其安全性。

关键词: 经阴道单孔腹腔镜, 子宫肌瘤剔除术, 微创腔镜
Objective

Transvaginal single port natural orifice transluminal endoscopic surgery is one of the most novel transvaginal endoscopic surgeries, which has the characteristics of no body scar and less pain after surgery. The purpose of this study was to explore the operative techniques and difficulties of transvaginal single-port laparoscopic hysteromyomectomy.

Methods

A case of uterine fibroids in the Third Affiliated Hospital of Guangzhou Medical University was selected, and the surgical procedures and methods of transvaginal single-port laparoscopic myomectomy were gradually explained to demonstrate the surgical skills.

Results

The operation was completed successfully, the amount of blood loss was low, postoperative pathology suggested necrotizing fibroids. The pain in the patient′s left lower abdomen was relieved. After 3 months of follow-up, the patient recovered well without complications.

Conclusions

Transvaginal single port laparoscopic myomectomy is feasible and can effectively remove the lesion. However, this procedure requires a higher level of skill from the surgeon, a longer learning curve, and long-term follow-up and further study are required to evaluate its safety.

Key words: Transvaginal single port natural orifice transluminal endoscopic surgery, Myomectomy, Minimally invasive laparoscopy
图1 切开前穹窿
图2 切开肌瘤
图3 剔除肌瘤
图4 缝合创面
图5 大C取标本
图6 缝合前穹窿
图7 关闭前穹窿
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