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Uterine vascular suture laparoscopic hysterectomy

 
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PostPosted: Sun 14:50, 06 Mar 2011    Post subject: Uterine vascular suture laparoscopic hysterectomy

Uterine vascular suture laparoscopic hysterectomy for 32 patients


Patients, 1 patient had ureteral wrong side of the bar, postoperative symptoms of ureteral obstruction after abdominal treatment,[link widoczny dla zalogowanych], other complications are not J1j. Zhang Pingdeng reported that laparoscopic hysterectomy incidence of ureteral injury 1.67%, higher than the abdominal, vaginal hysterectomy, ureteral injury rate of 0.06%, mainly due to coagulation injury, ureteral Traveling variation. The reason for injury in this case is not fully open before the suture the posterior lobe of the broad ligament to the sacral ligament surface,[link widoczny dla zalogowanych], let out the bottom of the ureter away, suture with surrounding tissue over time, so the error bar ureter. Therefore, to fully open the broad ligament before suturing, and to distinguish blood vessels, close to the cervical suture, not to take too many uterine tissue. Exposure to the use of surgery laparoscopic ureteral peristalsis good advantage of checking the situation to avoid accidental injury ureter. Such as the pelvic ureter in endoscopic section of the free, the uterus m tube, while the security operation is guaranteed. In addition, as estimated quite difficult surgery, preoperative ureteral catheterization, surgery is easy to identify, but also to avoid injury. Operation time between the two groups was significant, which is related to proficiency in laparoscopic surgery, but there were no differences in postoperative morbidity, from which embodies the advantages of minimally invasive surgery. 3.3 governing the handling of the uterus 【bleed at the nose of the other methods of treatment of uterine blood vessels in laparoscopic surgery in the womb are more difficult problem is the number of reported methods, such as titanium clip on the after the first free post-cut off, but this method must have a harmonic scalpel cost more expensive, titanium clip off the event,[link widoczny dla zalogowanych], will increase the bleeding. LigaSure coagulation of uterine vessels cut off, without suture, saving operating time, but must purchase expensive equipment. In summary, laparoscopic to open after the palace next to the broad ligament vascular suture is safe and feasible, can reduce blood loss, does not increase postoperative complications. The required equipment is simple, simple operation,[link widoczny dla zalogowanych], the surgical field clear,[link widoczny dla zalogowanych], so easy in clinic, especially for primary hospital. But by what means management of blood vessels, due to the hands of the surgeon's proficiency in a variety of different technologies, the hospital equipment is variable and should be based on actual deeds.


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