ABSTRACT
Objective To explore the feasibility of laparoscopic resection of large uterus .Methods Patients with large uterus ( volume such as 12~20 weeks pregnant size ) by the implementation of laparoscopic hysterectomy were collected in our hospital and Dongguan Tung Wah Hospital from January 2010 to December 2012 .The uterus was carried out a complete hysterectomy through intra-operation by upward into the abdominal puncture point , ligation cutting tumor , and reduction of the uterine body method .Results A total of 38 patients was carried out hysterectomy operation .According to the size of uterus , the lens opening and operating hole was cor-responding upward to expand the horizons and operating space under microscope , and the use of stepwise ligation method to gradually cut reduced uterine body and release the operation space for overcoming the narrow operation space .Each hysterectomy operation was smoothly completed , and no case was converted to laparotomy .Conclusions Laparoscopic hysterectomy with the puncture point , and moving after ligation cutting shrink small palace body method can effectively create space for operation , and safety and feasibility of lap-aroscopic resection is helpful to improve the large uterus .
ABSTRACT
Objective To investigate the effectiveness and surgical techniques of the improved laparoscopic treatment of ovarian dermoid cyst to prevent the occurrence of intraoperative rupture of teratomat, so to preserve the ovarian function at the maximum. Methods The modified laparoscopic extra-cavity and cavity outside the teratoma removed surgical suture treatment from February 2005 to February 2009,39 cases with large dermoid cyst were trea-ted by improved surgery and 45 cases treated by normal removal of laparoscope. The rupture, surgery time, bleeding volume,frequency of use of electrocoagulation and the effect of body temperature on intestinal canal and hospitaliza-tion day after operation as well. Results 39 cases of dermoid cyst were successfully managed by improved laparo-scopie surgery, during which no cyst contents broke into the abdominal cavity, no one was placed on electrocoagula-tion to stop bleeding, bleeding volume was (35.13±5.49) ml, operative time was (36.07±12.53) min, significantly leas than that of normal laparoscopic surgery group [the cyst rupture rate was 46.7% (21/45), the frequency of elec-trocoagulation was (5.0±3.0) times, the duration of electrocoagulatian was (5.5±2.5) s, bleeding loss was (40.73±6.04) ml and the time for operation was (67.47±20.73) min], with significant difference between the two groups (P<0.05 or 0.01);howevere, there was no remarkable difference in the effect of the two types of surgery on postoperative body temperature,anal exhaust time,postoperative hospitalization day. Conclusions In addition to minimally invasive laparoscopic surgery in the treatment of gastro-intestinal effects of small, quick recovery, the im-proved laparoscopic surgery for dermoid cyst shortens the operation time. The improved abdominal cavity and suture outside the strip surgical method can effectively prevent the complication caused by intraoperative tumor capsule rup-ture,reduce electrocoagulation injury,and preserve the ovarian function at the maximum.