Minimally invasive surgery is to greatly reduce the loss of patients, is the 21st century surgical method, laparoscopic technology is this kind of minimally invasive surgery, has been widely used in gynecological clinical, to solve many problems that gynecology can not be solved before.So what are the clinical applications of laparoscopy in gynecology?What are the advantages?Let's see.
Clinical application of laparoscopy in gynecology:
Laparoscopic treatment of pelvic inflammatory disease and pelvic abscess
Most of the treatment of pelvic inflammatory disease by laparotomy surgery probe that inflammatory tissue edema, organization brittleness increases, the operation is easy to tear, tissues, blood capillary easy bleeding, bleeding is not ideal, therefore, often need a blood transfusion during operation, postoperative infections spread and incision infection of antibiotic dosage is bigger, the laparoscopic minimally invasive damage small, not necessary for blood transfusion, postoperative medication use is also reduced, is a small injury, has the good method of diagnosis and treatment effect, can be used for the diagnosis and treatment of pelvic inflammatory disease and pelvic mass.
Polycystic ovary syndrome
Polycystic ovary syndrome (PCOS) is a complex group of syndromes caused by abnormal hormone secretion and regulation between hypothalamus, pituitary gland and ovary.
Clinically appear menstrual disorders, obesity, hairy, the symptom such as bilateral ovarian increase, the traditional surgical treatment is surgery, ovarian wedge excision, laparoscopic treatment for polycystic ovary syndrome restore ovulation function can make 90% of the patients, postoperative pregnancy rate can reach 70%, and the operation is simple, less postoperative pelvic adhesions, at present, the laparoscopic treatment of polycystic ovary syndrome have replaced the laparotomy ovarian wedge resection.
Laparoscopic myomectomy
The only need to open a few 3 mm holes in abdominal surgery, need not operation, can be in front of the TV screen to obtain a clearer picture than the naked eye, clear the uterus disease status, implementation of minimally invasive surgery treatment, with little trauma, quick recovery, the bed activities, 3 to 5 days can be fully recovered from, and shall not affect the physiological function, etc.
Laparoscopic technology not only can clear diagnosis, treatment, can also be separated adhesions, help the pregnancy, and conducive to the operation safety and prevent recurrence, in the current international diagnosis and surgery of department of gynaecology have high adoption rates, it is not only for infertility women with no children for surgery, even have children, fibroids is bigger, more than 6 cm in diameter, menorrhagia, medicine conservative treatment is invalid, or there is oppression symptoms, fibroids grow more KuaiZhe, this technique can be used.
Tubal laparoscopy
This procedure is applicable to between fallopian tube and ovary and the attachment with pelvic wall and intestinal canal, such as retinal inflammation or endometriosis adhesion, postoperative prognosis is good, in laparoscopic tubal adhesion separation technique, the experts also can according to individual circumstance combined with hysteroscopy, to dredge the fallopian tubes, or proper injection drugs to prevent adhesion, etc.
Adhesion and pelvic cavity viscera tubal adhesion separation technique including ovarian tubal adhesion around separation, clinical distortion caused by adhesion is one of the more common fallopian tube, ovary and oviduct umbrella end adhesion, tubal adhesion with the ovary, the middle and the fallopian tubes and ovaries and bowel adhesion, such as edge of ovary and broad ligament of the adhesion, serious when can form a pocket wraps the ovaries, treatment of tubal blockage shall, according to the blocked parts of proximal plug generally adopt godet dredge, laparoscopy is used for distal jams, distal tubal seeper, adhesion can be treated by laparoscopic.
Laparoscopic treatment of ectopic pregnancy
Is unsolved for tubal pregnancy, pregnancy piece diameter < 3 cm to retain reproductive function, blood HCG 2000 iu/L or less, no abnormal liver and kidney function, no intraperitoneal hemorrhage, ruled out intrauterine pregnancy and can retain oviduct, laparoscopic tubal pregnancy in local drug injection, killing embryos, or removal of oviduct pregnancy abdominal cavity, will cut the fallopian tubes, clear the embryos, so as to retain oviduct, preserving fertility function.
Laparoscopic treatment of ectopic pregnancy after in order to better and faster recovery of the body, need to be compensatory and enough nutrition and keep good work and rest time, still need to remind women of childbearing age to develop good habits at ordinary times, do not smoke, drink, have gynecopathy early treatment heal, prepare well before inspection before conception, which can reduce the incidence of ectopic pregnancy.
Advantages of laparoscopy:
1. leaving small trauma: laparoscopic cuts in the belly button is a cm long, next abdomen side are respectively 0.5 centimeters wounds, in after the surgery, cuts usually one centimeter or do simple suture, at this time may use the absorption lines or an absorption line suture, if use an absorption line suture, then take out stitches should give seven days after the surgery, if take out stitches sewn up with absorption lines do not need;
For wounds of 0.5 cm, use a breathable adhesive tape to fit them, but sometimes a needle or simple suture may be used to increase the neatness of the wound healing.
2. in patients with postoperative recovery fast: laparoscopic surgery in the airtight basin in the abdominal cavity, far less trauma patients with abdominal surgery, in the past the traditional surgery such as ovarian cysts, ectopic pregnancy surgery, patients need to 24 hours to get out of bed, postoperative need analgesics, postoperative 3 to 7 days to move freely, but in the use of laparoscopic surgery, patients with postoperative ambulation, the vast majority of patients do not need to take painkillers, can move freely, the average postoperative 1, and there is no urination, exhaust barriers.
3. at the same time, both diagnosis and treatment: laparoscopic can replace most of the abdominal laparotomy, a typical example is the pelvic inflammatory adhesion bag piece, due to the use of laparoscopic, make the patient and the physician to avoid the blind open, on the other hand of laparoscopy in the diagnosis of at the same time to surgery, especially in diseases such as ectopic pregnancy, ovarian rupture, infertility, its superiority is more obvious.
4. Cosmetic effect of abdominal wall and less pelvic adhesion: Only 5-10mm puncture was performed in umbilical hole and lower abdomen during laparoscopic surgery, without long scar caused by abdominal surgery.
Compared with transabdominal surgery, there are fewer pelvic adhesions in patients after laparoscopic surgery. During transabdominal surgery, the surgical instruments and the operator's operation squeeze the tissues, the viscera are exposed to the air, and the tendency of excessive intraoperative suture of the omentum macroomentum and peritoneal adhesion wound surface are all inevitable factors for the occurrence of adhesions.
However, laparoscopic surgery has little interference to the pelvic cavity and no contact with tissues such as gauze or suture lines, making postoperative pelvic cavity adhesion far less than transabdominal surgery.
For some diseases such as endometriosis easy adhesion easy to relapse, can be repeated laparoscopic surgery, it is not easy to occur after multiple abdominal surgery pelvic adhesions.