Gynecological procedures under gasless laparoscopy  

无气腹腹腔镜下的妇科手术(英文)

作　　者：李斌[1] 郝京宁[1] 高秀珍[1] 刘陶[1] 张军[1] 王虹[1] 陈颖[1] 伍冀湘[1] 

机构地区：[1]北京安贞医院妇产科,北京100029

出　　处：《Chinese Medical Journal》2001年第5期66-68,108,共4页中华医学杂志（英文版）

摘　　要：Objective To evaluate gasless laparoscopy in treating gynecological conditions.Methods With Kirschner wire lifting, transversely or longitudinally introduced into abdominal wall subcutaneously, we exposed the operative field and pelvic organs with routine operative instruments under epidural anesthesia. When a dense pelvic adhesion was confronted, we used the temporarily low-pressured pneumolaparoscopy to dissect it.Results All procedures were carried out without organ injury, hematorna, or other complications. The operative field can be clearly seen with this method. The mean time for appendagectorny was one hour and for laparoscopic assisted vaginal hysterectomy 80 minutes.Conclusion Gasless laparoscopy avoids the complications which occur in the routine laparoscopy such as subcutaneous or mediastinal pneurnatoma, hypercarbonernia, air embolism, cardiopulmonary dysfunction.Our lifting method is simple, convenient, time and money saving, as well as more flexible for treating gynecological conditions.目的　探讨无气腹手术的优越性。方法　采用克氏针一根横向或两根纵向插入下腹部皮下提拉腹壁 ,暴露术野 ,术中用普通外科器械进行操作。共施行无气腹腹腔镜妇科手术 2 1例。其中 4例盆腔有粘连者辅以低压气腹 ,分离粘连后再以无气腹法完成手术。结果　 2 1例手术均顺利完成 ,无脏器损伤 ,无腹壁皮下出血及其他并发症。附件手术平均 1小时 ,腹腔镜辅助阴式子宫全切平均 1小时 2 0分钟。结论　无气腹腹腔镜气手术避免了二氧化碳气腹带来的皮下及纵膈气肿、高碳酸血症、空气栓塞、心肺功能障碍等并发症。硬膜外麻醉即可完成手术。克氏针提拉腹壁 ,可清晰地暴露手术野 ,术中不需担心漏气及吸引时气腹的消失。亦不需要等待充气 ,经济省时。另外 ,操作灵活 ,对于粘连甚的病例术中短时辅以低压气腹 ,有利于缩短手术时间 ,病人亦无气腹的不适感。

关 键 词：gasless laparoscopy  ·   laparoscopy  ·  laparoscopic assisted vaginal hysterectomy 

分 类 号：R713[医药卫生—妇产科学]