As human civilization moves into the 21st century, the development of medicine has also entered a brand new era. With the improvement of science and technology and medical level, medical treatment is not only limited to curing diseases, how to reduce complications during treatment, how to make gynecological surgery really only remove the lesion without damaging the normal tissues, and how to fundamentally prevent the occurrence of diseases has become a higher pursuit of the quality of medical treatment today. Minimally invasive means to minimize trauma, the best means of treatment to achieve the purpose of curing the disease. In the past 10-20 years, the broadening of the indications for vaginal surgery and the improvement of surgical skills in line with the concept of minimally invasive, and the application of techniques such as cervical LEEP knife and cervical cold knife conotomy for cervical lesions have realized the wish of the majority of patients to "cure big diseases without using a knife or a small knife", and the traditional "open and dissect" surgery has been gradually reduced. "Surgery has been gradually reduced. Some developed countries and some domestic hospitals more than 80% of open surgery has been replaced by minimally invasive surgical methods.
Types of surgery
Minimally invasive laparoscopic
Laparoscopic surgeryLaparoscopic surgery is an operation performed by a surgeon using a set of optical, computer, ultrasound, mechanical and other technologies with special laparoscopic instruments. The basic process of surgery is: after the patient is anesthetized, the doctor makes 3 to 4 small holes of 0.5 to 1 cm in diameter in the patient's abdominal wall, and one of the holes is put into a mirror. The mirror is connected to a TV screen through a miniature camera, which allows the lesions in the patient's abdominal cavity to be reflected on the TV screen at a glance. Several other small holes in the abdominal wall are used to insert
surgical instruments such as scissors and forceps, and the surgeon looks at the screen to perform the surgery. Surgical process is basically the same as open surgery, due to the role of the mirror has a magnification of 8 to 10 times, and can even do more than open surgery is more delicate, the doctor looked at the screen on the lesion of the tissue for clamping, cutting, suturing and a series of operations. At the same time, the application of electro-knife, argon knife, laser, microwave and other advanced technologies in the operation, making the operation more perfect. Finally, the excised mass is placed in a plastic bag and chopped up and
removed, or taken out directly from the vagina.
Laparoscopic surgery can treat the following gynecological diseases: uterine fibroids, uterine fibroadenomas, ovarian tumors, ovarian teratomas, endometriosis, endometrial cancer, ectopic pregnancy and infertility.
Hysteroscopic minimally invasive
In the treatment of uterine fibroids, patients with subplasma uterine fibroids or interstitial fibroids should be selected for myomectomy, and patients with multiple uterine fibroids and fibroids combined with cervical lesions should be selected for hysterectomy. In our previous laparoscopic hysterectomy, the largest uterus removed weighed 1700 grams, which is about the size of the uterus in the 6th month of pregnancy. And in laparoscopic myomectomy, up to 8 fibroids, large and small, were removed, basically achieving the purpose of open surgery.
Hysteroscopic hysteroscope works on the same principle as laparoscopy, and the surgical process is as follows: after the patient is anesthetized, the doctor puts in the hysteroscope through the patient's vagina and cervical canal, and connects it to the TV screen through a miniature video camera; the doctor looks at the screen afterward, and performs the surgical operation through the hysteroscope's cutting instruments; at last, the resected mass or lesion will be taken out of the vagina through the cervical opening by the forceps and the abdomen will be removed without leaving a surgical scar. No surgical scar is left.
Diseases suitable for hysteroscopic surgery: submucosal fibroids, interstitial fibroids protruding into the uterine cavity, functional uterine bleeding, longitudinal uterine septum, endometrial polyps, uterine adhesion disintegration, etc., fallopian tube obstruction caused by infertility, removal of broken or dislocated sterilizing rings.
Lady surgery
Lady surgery utilizes the vagina as a natural orifice to perform surgery, which has the advantages of less trauma, less intestinal interference, less postoperative pain, faster recovery, and no surgical scar on the abdomen, and can be used to perform adnexa resection at the same time, and to do anterior and posterior wall of the vagina, urethroplasty, vaginal tightening, etc. In the clinical application, most hospitals only use the vagina to perform surgery. In clinical application, most hospitals are limited to perform negative hysterectomy for uterine prolapse, the main reason for this is that the surgical field is narrow, and it is difficult to grasp the indications and contraindications; the doctor lacks deep operating skills and applicable surgical instruments; and the patient lacks awareness of the choice of surgical modality. With the development of laparoscopy, which opens up the surgeon's field of vision and provides direct insight into the abdominal cavity, the scope of laparoscopically assisted vaginal hysterectomy is expanding.
The negative procedure can treat the following gynecological conditions: uterus with no obvious adhesions to the pelvis, uterus with good mobility, diseased uterus that needs to be removed, such as uterine fibroids, uterine fibroadenomas, uterine adenomas, myomatosis, endometriosis, and tension urinary incontinence.
Treatment benefits
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There are many types of minimally invasive gynecological surgery, and the benefits are obvious, so it has become the first treatment for many women. These include advantages such as less trauma, faster recovery, and less scarring after surgery.
The benefits of minimally invasive gynecologic surgical treatment: laparoscopic minimally invasive gynecologic surgery is performed in the closed pelvic-abdominal cavity, the physician direct vision surveillance screen, outside the abdominal cavity manipulation insertion of pelvic-abdominal surgical instruments to complete the operation. simple gynecologic laparoscopic surgery was carried out at the end of the 1970's and the beginning of the 80's. In 1989, Reich reported for the first time a laparoscopic total uterine excision, to the 90's most of the classic gynecologic procedures were performed laparoscopically. Minimally invasive laparoscopic gynecologic surgery is the gold standard for the diagnosis of some gynecologic diseases. such as pelvic inflammatory disease, ectopic pregnancy, and endometriosis.
This minimally invasive gynecologic surgery is both diagnostic and therapeutic. Such as tubal pregnancy (ectopic pregnancy) in the early stages without rupture bleeding, symptoms are atypical and difficult to diagnose at an early stage, but laparoscopy can be found lesions, while the implementation of conservative surgery to preserve the diseased side of the fallopian tube and function.
Fast postoperative recovery. Minimally invasive gynecological surgery through the abdominal wall puncture holes (diameter 5mm ~ 10mm,*** 3 ~ 4), from the abdominal cavity outside the insertion of surgical instruments to complete, the pelvic and abdominal cavity of the internal environment of the interference is small, minimally invasive gynecological surgery can be restored to health in a short period of time after the operation. Postoperative discomfort is light. There is no long incision in the abdominal wall, so the pain after minimally invasive gynecologic surgery is light, and you can eat normally after the surgery and keep the catheter for a short time. On the first day after surgery, you can move around appropriately, and the time of infusion and medication are shorter than that of open surgery.
Minimally invasive gynecologic surgical methods are clinically applicable to acute abdominal pain, uterine perforation. (Non-emergency) chronic pelvic pain, infertility. Indications for therapeutic minimally invasive gynecologic surgery: tubal ligation, ectopic pregnancy, endometriosis, endometriosis cysts of the ovary, benign teratoma of the ovary, ovarian cysts, myomectomy, hysterectomy.
Decrease in hospitalization daysDecrease in medical costs. Moderate minimally invasive gynecological surgery can be discharged from the hospital in 3 to 4 days without special circumstances. Abdominal wall without obvious scars after surgery to achieve cosmetic results, less postoperative pelvic and abdominal adhesions, light impact on fertility. These are the benefits of minimally invasive gynecological surgical treatment, need to be reminded that surgery must choose a professional hospital.