腹腔镜；万能杆；子宫内膜异位症；粘连分离_

腹腔镜下万能杆分离中重度子宫内膜异位症粘连的应用

http://www.100md.com 《腹腔镜外科杂志》 2006年第6期

腹腔镜；万能杆；子宫内膜异位症；粘连分离,,腹腔镜；万能杆；子宫内膜异位症；粘连分离,1资料与方法,2结果,3讨论,参考文献：

     【摘要】目的：探讨万能杆在腹腔镜下分离中重度子宫内膜异位症粘连的临床效果。方法：对46例中重度子宫内膜异位症粘连患者行腹腔镜手术，均有卵巢、子宫、输卵管、阔韧带、直肠、大网膜粘连，合并子宫直肠陷凹部分封闭18例，子宫直肠陷凹完全封闭6例。应用万能杆行盆腔粘连分离。其中行卵巢子宫内膜异位囊肿剥除术36例(单侧26例，双侧10例)，单侧附件切除术4例，子宫次全切除术3例，筋膜内子宫切除术3例。结果：46例均在腹腔镜下应用万能杆分离粘连后完成手术。粘连分离的手术时间为40~160min，平均(55±38)min，术中出血量为50~160ml，平均(83±46)ml,无中转开腹手术，无手术并发症发生。结论：万能杆集钝性分离、电切、电凝、冲水、抽吸等多功能于一体，操作简单、方便、安全、缩短手术时间，是一种实用、高效的腹腔镜下分离粘连的方法，值得临床推广。

    【关键词】腹腔镜；万能杆；子宫内膜异位症；粘连分离

    Application of the versatile bar in laparoscopic adhesiolysis of moderate or severe endometriosis adhesion

    LU Yonxin，WANG Chong,SHI Xinfeng.

    Nantong Rich Hospital,Dept.of Obstetrics and Gynecology,Nantong 226010,China

    【Abstract】 Objective:To evaluate the efficiency of the versatile bar in baparoscopic adhesiolysis of moderate or severe endometriosis adhesion.Methods:46 cases which included adhesions of ovary,uteinnne,broad ligament,epiploon,rectum and rectouberine pouch were performed operative laparoscopy,and the versatile bar was used for adhesiolysis.There were subtotal rectouberine pouch adhesion in 18 cases,total rectouberine pouch adhesion in 6 cases.Of these cases.There were subtotal rectouberine pouch adhesion in 18 cases,total rectouberine ouch adhesion in 6 cases.Of these cases,26 cases underwent signal oophorocystectomy,10 bilateral oophorecystectomy,4 signal adnexectomy,3 laparoscopic subtotal hysterectomy,3 classical intrafascial supracervical hysterectomy.Results:46 cases were successfully managed by laparoscopy after adhesiolysis with the help of the versatile bar.The operating time was 40160min with a mean time of (55±38)min,the intraopration blood loss 50160ml and average blood loss was (83±46)ml.There was no operation complication.Conclusions:There were many advantages with the versatile bar,such as adhesiolysis,electric cutting,electric coagulating,rregation and suction.Using it in laparoscopic adhesiolysis is a practical,simple,very effective and safe method.It is worth popularizing. ......

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