What are the gynecological minimally invasive operations? 1. Laparoscopic minimally invasive surgery
Laparoscopic surgery laparoscopic surgery is a kind of surgery performed by doctors using special laparoscopic instruments that integrate optics, computer, ultrasound and machinery. The basic procedure of the operation is: after the patient is anesthetized, the doctor opens 3 ~ 4 small holes with a diameter of 0.5 ~ 1 cm on the abdominal wall of the patient, and a mirror is placed in one of the holes. The mirror is connected to the TV screen through the micro camera, so that the focus in the abdominal cavity of the patient can be clearly reflected on the TV screen. Other small holes in the abdominal wall are filled with scissors, pliers and other surgical instruments, and the doctor looks at the screen for surgery.
2. Minimally invasive hysteroscopy
In the treatment of hysteromyoma, patients with subserous myoma or intramural myoma should choose myomectomy, and patients with multiple myomas and hysteromyoma complicated with cervical lesions should choose hysterectomy. In the previous laparoscopic hysterectomy in our hospital, the maximum weight of the uterus removed was 1700g, which was equivalent to the size of the uterus after 6 months of pregnancy. Laparoscopic myomectomy can remove up to 8 large and small myomas, which basically achieves the purpose of open surgery.
3. Vaginal surgery
Vaginal surgery, using natural vaginal canal, has the advantages of less trauma, less intestinal interference, less postoperative pain, quick recovery and no surgical scar on the abdomen. At the same time, appendectomy, vaginal wall repair, urethral plastic surgery, vaginal contraction and other operations can be performed. In clinical application, most hospitals are limited to vaginal hysterectomy for patients with uterine prolapse, mainly because the surgical field of vision is narrow and the indications and contraindications are difficult to grasp; Doctors lack profound operating skills and suitable surgical instruments; Patients lack understanding of the choice of surgical methods. With the development of laparoscopic technology, doctors can broaden their horizons and directly understand the situation in abdominal cavity. With the help of laparoscopy, the scope of vaginal hysterectomy is expanding.
The indication of gynecological minimally invasive surgery is 1. Evaluate the factors such as fallopian tube, ovary and pelvic cavity of infertile patients to determine whether there is genital malformation;
2. Diagnosis and differential diagnosis of abdominal and pelvic masses;
3. Unexplained abdominal pain and pelvic pain;
4. Chronic pelvic inflammatory disease with infertility, repeated acute or subacute attacks, forming encapsulated effusion;
5. Diagnosis and differential diagnosis of abdominal and pelvic masses.
6. Monitoring intrauterine or transvaginal surgery.
7. Early diagnosis, correct staging and focus removal of endometriosis.
8. Patients with acute and chronic pelvic pain with poor anti-inflammatory treatment effect or prolonged symptoms.
9. Early diagnosis of ectopic pregnancy;
10. Early diagnosis, staging, preoperative evaluation, curative effect judgment and follow-up monitoring of genital malignant tumors;
1 1. Find or take out the IUD lost in the abdominal cavity;
12. Examination of uterine perforation and monitoring of uterine cavity operation, such as aspiration after uterine perforation, uterine cavity operation of abnormal and pathological uterus and hysteroscopic electrotomy;
13. Evaluation of curative effect of secondary exploration of pelvic malignant tumor and diaphragm exploration of ovarian malignant tumor.