治疗子宫脱垂的新型阴道瓣膜缝合术辅助腹腔镜宫颈骶骨固定术

IF 1.2 4区 医学 Q3 SURGERY
Surgical Innovation Pub Date : 2024-10-01 Epub Date: 2024-08-02 DOI:10.1177/15533506241273447
Serdar Aydın, Sebile Güler Çekiç
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引用次数: 0

摘要

目的:腹腔镜子宫切除术是一项复杂的手术,需要专业的手术技巧,包括精确的解剖和缝合。本文旨在描述一种新的、可行的微创技术,用于矫正阴道顶端和同时存在的阴道顶端和前壁缺损时的技术注意事项:方法:对 70 名连续接受子宫阴道脱垂≥3 期手术的妇女进行了回顾性分析。作为技术的一部分,在宫颈阴道前方交界处做一个 2 厘米长的前横切口,通过钝性和锐性剥离将膀胱剥离至峡部水平。进行后方结肠切除术。将聚丙烯胶带插入宫颈结缔组织,胶带的自由臂通过后结肠切口插入腹膜。胶带的两臂从隧道平行向内侧穿过右侧骶骨皱褶,然后通过腹腔镜途径固定在前纵韧带上:结果:胶带插入宫颈的时间为 15 分钟,腹腔镜手术时间为 24 分钟。未发生网片糜烂或长期并发症。在 1 年的对照中,没有出现复发病例:这种新型的宫颈骶骨外翻术是一种可行、安全的微创方法,可用于矫正顶端或多腔缺损,手术时间短,解剖效果模仿正常的骶骨韧带。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Novel Vaginal Cerclage Assisted Laparoscopic Cervico-Sacropexy Technique for Uterovaginal Prolapse.

Aim: Laparoscopic hysteropexy is a complicated procedure that requires specialized surgical skills, including precise dissection and suturing. The aim is to describe the technical considerations for performing a new, feasible, and minimally invasive technique to correct apical and concurrent apical and anterior vaginal wall defects.

Method: A retrospective analysis was conducted on 70 consecutive women who underwent surgery for stage ≥3 uterovaginal prolapse. As a part of the technique, an anterior 2-cm long transverse incision was made at the anterior cervicovaginal junction, and the bladder was dissected through blunt and sharp dissection to the level of the isthmus. A posterior colpotomy was performed. A polypropylene tape was inserted into the cervical connective tissue, and the free arms of the tape were inserted into the peritoneum via the posterior colpotomy. Two arms of the tape were passed from the tunnel parallel and medial to a right sacrouterine fold, then fixed to the anterior longitudinal ligament via the laparoscopic route.

Results: The tape can be inserted into the cervix in a median of 15 min, and the laparoscopy procedure can be completed in 24 min. No mesh erosion or long-term complications occurred. At a 1-year control, there were no cases of recurrence.

Conclusions: This novel cervico-sacrocolpopexy technique is a feasible and safe, minimally invasive way to correct apical or multicompartment defects, with a short operation time and an anatomical result that mimics the normal sacrouterine ligament.

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来源期刊
Surgical Innovation
Surgical Innovation 医学-外科
CiteScore
2.90
自引率
0.00%
发文量
72
审稿时长
6-12 weeks
期刊介绍: Surgical Innovation (SRI) is a peer-reviewed bi-monthly journal focusing on minimally invasive surgical techniques, new instruments such as laparoscopes and endoscopes, and new technologies. SRI prepares surgeons to think and work in "the operating room of the future" through learning new techniques, understanding and adapting to new technologies, maintaining surgical competencies, and applying surgical outcomes data to their practices. This journal is a member of the Committee on Publication Ethics (COPE).
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